Chemical dependency clinic set to close; critics say it’ll put patient health at risk
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RFK Jr. says he’ll fix the overdose crisis. Critics say his plan is risky
RFK Jr. says he’ll fix the overdose crisis. Critics say his plan is risky. If confirmed, Kennedy would hold broad sway over many of the biggest federal programs in the U.S. tackling addiction. Some addiction activists have praised Kennedy’s approach and are actively campaigning for his confirmation.”I’m going to bring a new industry to [rural] America, where addicts can help each other recover from their addictions,” Kennedy promised. “I think [Kennedy’s plan] would be an enormous step backward,” said Maia Szalavitz, an author and activist who used heroin and other drugs before entering recovery. “We have spent the last 15, 20 years trying to move away from treating addiction as a sin rather than a medical disorder,” she said. “He seems to want to go backwards on all that,” said Keith Humphreys, a leading national drug policy researcher at Stanford University. “That’s a risk to the well-being of patients, and I don’t see any merit”
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When Robert F. Kennedy Jr. talks about the journey that led to his growing focus on health and wellness — and ultimately to his confirmation hearings this week for U.S. secretary of health and human services — it begins not with medical training or a background in research, but with his own addiction to heroin and other drugs.
“I became a drug addict when I was 15 years old,” Kennedy said last year during an interview with podcaster Lex Fridman. “I was addicted for 14 years. During that time, when you’re an addict, you’re living against conscience … and you kind of push God to the peripheries of your life.”
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Kennedy now credits his faith; 12-step Alcoholics Anonymous-style programs, which also have a spiritual foundation; and the influence of a book by philosopher Carl Jung for helping him beat his own opioid addiction.
If confirmed as head of the Department of Health and Human Services after Senate hearings scheduled for Wednesday and Thursday, Kennedy would hold broad sway over many of the biggest federal programs in the U.S. tackling addiction: the Centers for Disease Control and Prevention, the National Institute on Drug Abuse and the Substance Abuse and Mental Health Services Administration.
While campaigning for the White House last year, Kennedy, now 71 years old, laid out a plan to tackle the United States’ devastating fentanyl and overdose crisis, proposing a sprawling new system of camps or farms where people experiencing addiction would be sent to recover.
“I’m going to bring a new industry to [rural] America, where addicts can help each other recover from their addictions,” Kennedy promised, during a film on addiction released by his presidential campaign. “We’re going to build hundreds of healing farms where American kids can reconnect with America’s soil.”
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Some addiction activists — especially those loyal to the 12-step faith- and values-based recovery model — have praised Kennedy’s approach and are actively campaigning for his confirmation.
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“RFK Jr is in recovery. He wants to expand the therapeutic community model for recovering addicts,” Tom Wolf, a San Francisco-based activist who is in recovery from fentanyl and opioid addiction, wrote on the social media site X. “I support him for HHS secretary.”
A focus on 12-step and spirituality, not medication and science-based treatment
But Kennedy’s approach to addiction care is controversial, described by many drug policy experts as risky, in part because it focuses on the moral dimension of recovery rather than modern, science-based medication and health care.
“He clearly cares about addicted people,” said Keith Humphreys, a leading national drug policy researcher at Stanford University. “But in terms of the plans he’s articulated, I have real doubts about them.”
According to Humphreys, Kennedy’s plan to build a network of farms or camps doesn’t appear to include facilities that offer proper medical treatments for seriously ill people facing severe addiction.
“That’s a risk to the well-being of patients, and I don’t see any merit in doing that,” Humphreys said.
“I think [Kennedy’s plan] would be an enormous step backward,” said Maia Szalavitz, an author and activist who used heroin and other drugs before entering recovery.
“We have spent the last 15, 20 years trying to move away from treating addiction as a sin rather than a medical disorder,” she said. “We’ve spent many years trying to get people to take up these medications that we know cut your death risk in half, and he seems to want to go backwards on all that.”
The vast majority of researchers, doctors and front-line addiction treatment workers agree that scientific data shows medications like buprenorphine, methadone and naloxone are game changers when it comes to treating the deadliest street drugs, including fentanyl and heroin.
The Biden administration moved aggressively to make medical treatments far more affordable and widely available. Many experts believe those programs are factors in the dramatic national drop in overdose deaths that began in 2023.
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Kennedy, who studied law and political science, not health care, before becoming an activist on subjects ranging from pharmaceuticals and vaccines to the American diet, has remained largely silent on the subject of science-based medical treatments for opioid addiction.
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His campaign film included a scene that appeared to blame methadone — a prescription medication that has been used to treat opioid addiction since the 1970s — for some of the high-risk street-drug use visible on the streets of San Francisco.
In public statements, Kennedy has also repeated the inaccurate claim that the addiction and overdose crisis isn’t improving. In fact, fatal overdoses have dropped nationally by more than 20% since June 2023, according to the Centers for Disease Control and Prevention, falling below 90,000 deaths in a 12-month period for the first time in half a decade.
“What we have mostly heard from Kennedy is a skepticism broadly of medications and a focus on the 12-step and faith-based therapy,” said Vanda Felbab-Brown, an expert on drug policy at the Brookings Institution, a Washington, D.C., think tank.
“That appeals to a lot of crucial groups that have supported President Trump in the election. But we know what is fundamental for recovery and stabilization of people’s lives and reducing overdose is access to medications,” Felbab-Brown said. “Unfortunately, many of the 12-step programs reject medications.”
She’s worried that under Kennedy’s leadership, the Department of Health and Human Services could shrink or eliminate funding for science-based medical treatment and instead focus on spirituality-based approaches that appear to help a relatively small percentage of people who experience addiction.
Kennedy’s views on other science-based treatments, including vaccines, have sparked widespread opposition among medical researchers and physicians.
Kennedy boosts an Italian model for addiction recovery that has faced controversy
Another concern about Kennedy’s addiction proposals focuses on his interest in a program for drug treatment created in Italy in the 1970s.
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“I’ve seen this beautiful model that they have in Italy called San Patrignano, where there are 2,000 kids who work on a large farm in a healing center … and that’s what we need to build here,” Kennedy said during a town hall-style appearance on the cable channel NewsNation last year.
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According to Kennedy’s plan, outlined in interviews and social media posts, Americans experiencing addiction would go to San Patrignano-style camps voluntarily, or they could be pressured or coerced into accepting care, with a threat of incarceration for those who refuse care.
But the San Patrignano program has been controversial and was featured in a 2020 Netflix documentary that included images of people with addiction allegedly being held in shackles or confined in cages. The farm’s current leaders have described the documentary as biased and unfair.
Kennedy, meanwhile, has continued to use the program as a model for the camps he would like to build in the United States.
“I’m going to build these rehab centers all over the country, these healing camps where people can go, where our children can go and find themselves again,” he said.
Szalavitz, the author and activist who is herself in recovery, noted that the Italian program doesn’t include science-based medical care, including opioid treatment medications. She said Kennedy’s fascination with the model reflects a lack of medical and scientific expertise.
“It really is great to include people who have personal experience of something like, say, addiction in policymaking. But you don’t become an addiction expert simply because you’re someone who struggled with addiction,” Szalavitz said. “You have to engage with the research literature. You have to understand more beyond your own narrow anecdote. Otherwise you’re going to wind up doing harm to people.”
Inpatient chemical dependency treatment clinic set to close; risking patient safety
Allina Health is closing the inpatient chemical dependency unit at Mercy Hospital in Fridley. The 24-bed unit focuses on addiction treatment for alcohol and drugs. Nurses say some will suffer due to the decision by Allina Health, but healthcare system leaders say this type of care has evolved. The Minnesota Nurses Association says relocating patients to open-floor hospital units will put patients at greater risk of relapse, undermine their recovery, and deny them the level of care they require. Allina says the majority of patients requiring medical detox services will continue to access services through general admission at both campuses of Mercy Hospital, as well as through medical units and outpatient services throughout the Allina health system. The latest cut continues a troubling pattern by the healthcare system: Abbott Northwestern’s Infusion Department shut down in 2023, and United Hospital’s Pain Center closed earlier this month.
“This unit was one of the pioneering units in the state and also one of the last,” said Joe Clubb, Vice President for Allina Health Mental Health and Addiction Services.
In a public hearing on Thursday, Allina Health leadership explained why they’re closing the inpatient chemical dependency unit at Mercy Hospital in Fridley.
“For the last two years, we’ve seen a significant change to receive authorization for payment for inpatient chemical dependency treatment,” said Clubb.
On the healthcare system’s website, it says the 24-bed unit focuses on addiction treatment for alcohol and drugs, offering programming up to 40 hours a week, including therapy, monitored detoxification and more.
“Our average length of stay has slowly been going down to 3 to 5 days,” said Clubb.
In an anonymous interview, current and former employees of the unit pushed back.
“You basically said what we do doesn’t matter. And they can get the same level of care at a medical unit or county detox and that’s not true,” said one employee.
They group says they’ve advocated for better marketing for years. They add that the clinic is a special place.
“A lot of people were suicidal with significant trauma abuse, difficult to engage, but because of our unit they were able to,” another employee added.
In a statement, Allina tells WCCO:
“Allina Health’s inpatient chemical dependency unit at Mercy Hospital — Unity Campus in Fridley will close effective Friday, Feb. 20, 2026. Similar to other areas of medical advancement, care options for addiction treatment have rapidly evolved to include outpatient care, community-based residential care and addiction medicine management which have led to declines in patient demand and less support from payers for specialized inpatient services. The majority of patients requiring medical detox services will continue to access services through general admission at both campuses of Mercy Hospital, as well as through medical units and outpatient services throughout Allina Health. Allina Health continues to navigate current financial pressures related to the rising cost to deliver care, falling reimbursements, and the expected impacts of funding cuts for critical health care programs like Medicaid. Allina Health’s decisions to change services are part of an effort to ensure long-term sustainability and maintain excellence in care for the patients and communities we serve. We are incredibly grateful to the care team members that have been part of the inpatient chemical dependency unit at Mercy Hospital—Unity Campus.”
2023 data from Anoka County shows 4.5% of those receiving drug and alcohol treatment are choosing hospital inpatient care, with most choosing a non-residential option.
“I just want to lead with gratitude for many of the staff,” Clubb added.
The Minnesota Nurses Association also released a statement saying in-part:
“The Unity Campus inpatient chemical dependency unit is designed to provide the structure, safety, and focus that patients with severe addiction need to recover. Nurses warn that relocating these patients to open-floor hospital units will put patients at greater risk of relapse, undermine their recovery, and deny them the level of care and appropriate setting patients require.”
This latest cut continues a troubling pattern by Allina Health:
Abbott Northwestern’s Infusion Department shut down in 2023.
United Hospital’s Pain Center closed.
United Hospital’s Infusion Department shut down earlier this month.
After cutting Unity’s pediatric beds last year, Allina now plans to close Unity’s Inpatient Chemical Dependency Unit and Abbott Northwestern’s Inpatient Kidney Transplant Program.
At the same time, Allina reported $230 million in profit from its Quest Diagnostics venture, partnered with UnitedHealth Group to expand lucrative ambulatory surgery centers, and continues investing in executive compensation.”
The full statement can be read online.
Liver Transplant: Criteria, Surgery & Recovery, Life After
Liver transplant surgery is a major operation so you’ll receive general anesthesia. Your surgeons will place a variety of tubes in your body to carry out certain functions during and right after your surgery. If there’s a match for a donor liver, your transplant coordinator will call you with instructions about what you need to do right away. If you have acute liver failure, meaning you got very sick very fast, you will be at the top of the list. The list ranks prospective recipients by need. For example, if you have cholangiocarcinoma or hepatocellular carcinoma, you may be eligible for a liver transplant if you are well enough to have surgery. You will need to be about the same height and weight as the potential donor so that the donor liver is large enough to meet your body’s needs. The ventilator will expand your lungs mechanically to make sure you keep breathing during surgery. A nasogastric catheter in your stomach will drain fluid from your stomach to your bladder.
The criteria to be on the liver transplant waiting list are:
Have acute or chronic liver failure. Acute liver failure is when you get very sick very fast from liver failure. Chronic liver failure develops over time and usually happens because you have cirrhosis.
Have cholangiocarcinoma or hepatocellular carcinoma. You may be eligible for a liver transplant if you have other kinds of cancer. But there are specific eligibility criteria for each cancer type.
Have cancer that spread to your liver like metastatic colorectal cancer or gastrointestinal neuroendocrine tumors.
Be well enough to have surgery.
Don’t have substance use disorders or be considered at risk of these disorders.
If your healthcare provider recommends an organ transplant for you, they’ll refer you to a transplant hospital. The transplant center’s multidisciplinary team will evaluate you to decide if you’re a suitable candidate.
Each transplant hospital has its own criteria for accepting candidates for organ transplantation. If they accept you as a candidate, they’ll put you on the national waiting list maintained by United Network for Organ Sharing (UNOS). They’ll let you know when you join the waiting list.
The list ranks prospective recipients by need. For example, if you have acute liver failure, meaning you got very sick very fast, you’ll be at the top of the list.
If you’re like most people, you have chronic liver failure and/or liver cancer. In that case, the UNOS will use a scoring system called MELD (Model for End-Stage Liver Disease) or PELD (Pediatric End-Stage Liver Disease). The scoring system uses information about your liver and blood test results to determine your place on the waiting list.
How are donors matched with transplant recipients?
To be a match for a donor liver, you’ll need to:
Have the same or compatible blood type as the potential donor.
Be about the same height and weight as the potential donor so that the donor liver is large enough to meet your body’s needs.
What happens when you’re matched with a donor liver?
If there’s a match, your transplant coordinator will call you with instructions about what you need to do right away. For example, they’ll tell you not to eat or drink anything so that you’ll be ready to receive anesthesia just before your surgery.
They’ll tell you to get to the transplant hospital right away. The transplant surgery team will start surgery as soon as possible after the donor liver arrives at the transplant hospital. When you arrive at the transplant hospital, you’ll:
Have standard health screening tests to confirm you’re still able to go through surgery. For example, you may have an electrocardiogram (EKG) to check your heart rhythm and a complete blood count (CBC) to confirm you don’t have an infection.
Meet with your surgeon and anesthesiologist to prepare for surgery.
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What happens during a liver transplant?
Liver transplant surgery is a major operation. You’ll receive general anesthesia so you’re asleep during the surgery. Your surgeons will place a variety of tubes in your body to carry out certain functions during and right after your surgery. You’ll have:
An IV (intravenous catheter) in a vein of your arm or hand to deliver fluids and medicine.
An IV in a vein of your neck or thigh so providers can take blood samples and continuously check your blood pressure.
A tube through your mouth and into your windpipe that connects to a mechanical ventilator. The ventilator will expand your lungs mechanically to make sure you keep breathing during surgery.
Tubes in your abdomen to drain blood and fluid from around your liver.
A nasogastric tube that your providers will insert through your nose to your stomach. The tube will drain fluid from your stomach.
A catheter in your bladder to drain urine.
To begin the operation, your surgeon will:
Make one long incision across your abdomen to reach your liver. Carefully separate your liver from the ligament that connects to your abdominal wall. Place a clamp on your bile ducts and the blood vessels that are connected to your liver. Remove your liver and gallbladder. Put the donor liver in place. Attach it to your blood vessels and bile ducts. Close your incision.
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How long is liver transplant surgery?
Your surgery may take up to 12 hours. If you have friends or family waiting at the hospital, a member of your care team will check in with them throughout your surgery.
How much of a donated liver is needed for a liver transplant?
That depends on the type of donation. If you receive a liver from a deceased donor, you receive the entire liver.
In living donor transplantation, most adults only need one liver lobe (hemisphere) from a living donor. If the donated lobe is healthy, it’ll regenerate to its former size. Surgeons often select the right lobe for transplant because it’s a bit bigger, but in a pinch, the left lobe will do fine, too.
What happens after liver transplant surgery?
You may remain in intensive care for several days following your surgery. You’ll have a nasogastric tube, and you’ll get nutrition from an IV line until your body can process liquids and solid food.
Your healthcare team will monitor your condition and watch for signs of complications. They’ll take blood samples to check how your new liver is working. They may need to manage issues like:
Blood sugar levels.
Blood volume.
Electrolyte levels.
Fluid levels.
When tests show your new liver is working and your vital signs are stable, your providers will remove the IV tubes from your neck and nasogastric tube.
You’ll move from intensive care to another area in the hospital where you’ll stay for one to three weeks as your body continues to recover.
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Next, your bowels will start working again, meaning you can pass gas or poop. You’ll begin drinking liquids. Your care team will start providing small amounts of solid food. They’ll begin reducing the amount of pain medication you receive via IV.
Before you go home, your team will show you:
How to care for your surgical wound.
How to take your medications, like the immunosuppressants you’ll take to reduce the chance your body will attack the donor liver.
How to check your own blood pressure and pulse.
How to recognize signs of infection.
When it’s important to contact them.
What kind of follow-up care will I have during recovery?
As you continue to recover at home, you’ll have frequent checkups with your healthcare team. They’ll do blood tests to check your liver’s health.
Drug Abuse & Addiction: Effects on Brain, Risk Factors, Signs
Addiction is a disease that affects your brain, body, and behavior. It can make it hard to stop using a substance, even when it starts to cause problems in your life. The sooner you get help for addiction, the better your chances of avoiding more serious health or life problems. In 2018, opioids played a role in about two-thirds of all drug overdose deaths.
Addiction is a disease that affects your brain, body, and behavior. It can make it hard to stop using a substance, even when it starts to cause problems in your life. The sooner you get help for addiction (also called substance use disorder), the better your chances of avoiding more serious health or life problems.
“We know that addiction is a chronic condition. And we know that people get better with treatment,” says Jeanette Tetrault, MD, professor of medicine and public health and associate director for training and education for the Program in Addiction Medicine at Yale School of Medicine.
Addiction doesn’t only involve illegal drugs such as heroin or cocaine. You can also develop a substance use disorder with legal substances such as alcohol, nicotine, sleep aids, or antianxiety medications.
Prescription pain medications — especially opioids — can also lead to addiction. You can get these drugs legally through prescription or illegally. Opioid misuse remains a major public health concern in the U.S. In 2018, opioids played a role in about two-thirds of all drug overdose deaths.
For many people, drug use begins as a choice. You might take something to feel better, ease pain, or manage stress. At first, you may feel in control. But over time, substances can change how your brain functions. These changes can last well beyond the drug’s effects and may make it harder to stop using — even when you want to.
Trump team revokes $11 billion in funding for addiction, mental health care
Trump team revokes $11 billion in funding for addiction, mental health care. State and county public health departments and nonprofit groups are reeling. The federal grant funding had been scheduled to run through September 2025. The move to rescind funds drew criticism from experts who warned progress reducing overdose deaths could be reversed.”This is chopping things off in the middle while people are actually doing the work,” said an addiction policy researcher at Stanford University, who also volunteers doing harm reduction work with people in addiction.”Senselessly ripping away this funding will undermine our state’s ability to protect families,” said U.S. Sen. Patty Murray, a Democrat from Washington state. The Substance Abuse and Mental Health Services Administration is also being merged into a new organization, called the Administration for a Healthy America (AHA), as part of a restructuring of HHS that’s expected to eliminate 20,000 federal employees. Democratic leaders across the United States condemned the move, saying the cuts could put patient at risk and put state and county health departments at risk.
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State and county public health departments and nonprofit groups are reeling after the Trump administration announced abrupt cancellation and revocation of roughly $11.4 billion in COVID-era funding for grants linked to addiction, mental health and other programs.
“This is chopping things off in the middle while people are actually doing the work,” said Keith Humphreys, an addiction policy researcher at Stanford University, who also volunteers doing harm reduction work with people in addiction. He warned the move could trigger layoffs and treatment disruptions.
“Services will be dropped in the middle. Bang, the clinic is closing. It’s a brutal way to make these cuts,” Humphreys said.
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The federal grant funding had been scheduled to run through September 2025. In a statement sent to NPR, a spokesperson with the U.S. Department of Health and Human Services said it made sense to freeze the program immediately.
“The COVID-19 pandemic is over, and HHS will no longer waste billions of taxpayer dollars responding to a non-existent pandemic that Americans moved on from years ago,” the statement said, adding that the Trump administration will refocus funding on America’s “chronic disease epidemic.”
Drug overdoses linked to fentanyl and other substances have declined sharply in recent years, thanks in part to a surge in funding for addiction treatment during the Biden administration. But street drugs still kill more than 84,000 people in the U.S. every year, according to the latest data from the Centers for Disease Control and Prevention.
President Donald Trump has made fentanyl smuggling a top concern during the opening weeks of his administration, extending an emergency declaration linked to the powerful street opioid.
But his team has also rapidly slashed the number of federal researchers focused on addiction and Trump pardoned a tech mogul convicted of building a “dark web” platform used to traffic illicit drugs.
The Substance Abuse and Mental Health Services Administration is also being merged into a new organization, called the Administration for a Healthy America (AHA), as part of a restructuring of HHS that’s expected to eliminate 20,000 federal employees.
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The move to rescind funds that include addiction-care grants drew criticism from experts who warned progress reducing overdose deaths could be reversed.
“DOGE is now actively cutting funding aimed at reducing overdose deaths by clawing back money from states,” wrote Regina LaBelle, an expert on drug policy at Georgetown University who served in the Biden administration in a post on social media. “With overdose deaths still exceeding 80,000 annually, is DOGE declaring victory?”
In a statement sent to NPR, a spokesman for Ohio’s Republican Governor Mike DeWine said they are “awaiting firm details before commenting” on the cuts.
Some Democratic leaders across the U.S. condemned the move.
“Senselessly ripping away this funding Congress provided will undermine our state’s ability to protect families from infectious diseases like measles and bird flu and to help people get the mental health care and substance use treatment they need,” said U.S. Sen. Patty Murray, a Democrat from Washington state, in a statement.
She said the loss of $160 million in federal funds designated for use in her state could cost “more than 200 jobs” in public and non-profit health organizations.
New York Governor Kathy Hochul said her state would lose roughly $300 million in funding, much of it earmarked for county health departments in rural areas.
“At a time when New York is facing an ongoing opioid epidemic, multiple confirmed cases of measles and an ongoing mental health crisis, these cuts will be devastating,” Hochul said. “There is no state in this country that has the financial resources to backfill the massive federal funding cuts.”
A spokesperson for Colorado’s Behavioral Health Administration said $250 million in federal cuts to her state would affect as many as 60 programs and could put patient at risk.
“In so many cases, these are life-saving programs and services, and we worry for the wellbeing of those who have come to count on this support,” spokeswoman Allie Eliot, wrote in an email to Colorado Public Radio.
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In their statement to NPR, HHS officials downplayed the impacts of the cuts and said most grants being rescinded fund outdated programs linked to the pandemic, including efforts to “address COVID-19 health disparities among populations at high-risk and underserved, including racial and ethnic minority populations.”
Tom Wolf, an addiction activist in San Francisco who has been critical of Democratic approaches to address the overdose crisis, said he remains broadly supportive of Trump’s policy ideas.
“There are certain aspects of what he’s doing that I think are good. For me it’s about getting things done,” Wolf said.
But he also voiced concern about the pace of change and the risk that effective addiction treatment programs could be defunded at a time when tens of thousands of people in the U.S. are still dying from fatal overdoses each year.
“Are they stopping to look at the efficacy of those programs?” Wolf said.
Addiction experts told NPR they are now bracing for what many believe will be deep cuts to Medicaid funding, which provides the largest single source of insurance coverage for drug and alcohol treatment nationwide.
“It’s very hard to look at the budget framework created by Republicans and imagine a scenario other than Medicaid being cut severely,” Stanford University’s Keith Humphreys said. “It’s a frightening prospect. That will be extremely painful for families facing addiction.”