For medical experts in western Western Appalachia, the dramatic decline in recent opioid overdose deaths is spectacular.

Last year, Kentucky's record dropped 30% to 1,410 people. In neighboring West Virginia, state health authorities estimate that at least 318 people are alive today, largely due to the availability and widespread use of naloxone or nalcon, a nasal spray that will be administered promptly and promptly and can reverse the effects of opioid overdose.

In recent years, a range of treatment and recovery programs have helped trigger a sharp drop in the number of deaths from illegal drug overdoses. In Tennessee alone, authorities attributed it to "at least 103,000 people" between late 2017 and mid-2024.

Chris Tucker, who works with healthcare provider Pathways in Northeast Kentucky, said: “It’s damn good.

"It's a great show compared to two years ago. You see stories of success every day. If people move forward, it's success."

But now, White House and Republican politicians are cutting plans to plans and departments that may cancel hard progress.

On May 2, the Trump administration announced $33.3 billion in cuts to the Department of Health and Human Services budget, which will eliminate $56 million to train first responders and law enforcement officers to manage Narcan.

In March, the White House cut more than $11 billion in federal grants for addiction, mental health and infectious disease programs and programs. In the same month, it announced plans to include the Drug Abuse and Mental Health Services Administration (SAMHSA) in the newly formed U.S. Government of Health (AHA). SAMHSA lost more than 100 employees in March and is preparing to cut further.

House Republicans have been seeking to cut Medicaid funds, a move that provides millions of dollars in opioid treatment and recovery to communities, a move that has recently warned of. Many of the proposed funding cuts are part of the government's fiscal 2026 budget proposal, which begins on July 1.

"Last year we still saw nearly 90,000 people die from overdose. We owe them to do better and save lives. The answer can't be to cut those plans," said Hanna Sharif-Kazemi of the Drug Policy Coalition.

Few elsewhere in the United States see the impact of cutting funding greater than that of the Appalachian community. For decades, for decades, major drug manufacturers have flooded an area along the Ohio River, a part of the Ohio River, and for decades, few of the areas along the Ohio River have been hit hard.

Cabell County, Huntington, has the highest rate of opioid overdose deaths, the country's worst state. Near Boyd County, Kentucky, 31 drug-related deaths in 2019 were more than three times that of the national level, the second highest in any county in the Commonwealth.

Kyle Gibson, 37, grew up in the late 1990s in Kentucky's neighbor Boyd County.

“What I worry about is getting treatment because there is a lot of money to put peer support where they wouldn’t have been — hospitals, ERS, syringe communication everywhere.

"They meet people in the most vulnerable places in their lives and try to give them instructions. If that's cut, it's harmful."

Now recovered, Gibson’s addiction journey is similar to many others in the field. In high school, he found the painkiller oxycontin in his grandmother's house, which took him on the road to addiction to methamphetamine, suboxone and other substances.

"That was when (the doctor) really pushed (highly addictive opioid painkillers). Shopping doctors is a thing. In 11 years, it's getting really bad."

“I went for treatment so my mom could sleep at night.”

More than a decade ago, authorities seized the pills and medicines, replaced them, followed by heroin, and then the synthetic opioid fentanyl, and most recently, carfentanyl.

Health experts say the pandemic has caused increased loneliness in many small rural communities, which in turn has exacerbated the wave of opioid overdose deaths.

From 2019 to 2020, the number of excess deaths in Kentucky increased by 49%. Two years later, it still ranks the highest among states with the highest number of per capita opioid overdose deaths.

So, the recent budget cuts are a major blow to those working to develop rehabilitation and treatment efforts in Kentucky.

“Reducing this funding not only ruins life-saving efforts, it also contradicts the goal of achieving higher government efficiency. Now, increasing support not only stalls the momentum, but also restores us to years of development in the enormous investments we have made.”

Experts say the benefits of reducing the number of overdose deaths include having more people in the local workforce, reducing the burden on the emergency rooms and staff of the hospital that are already in trouble, and parents are still alive, healthy and able to raise children.

“This advancement has created a momentum that helps reduce stigma as more and more people showcase the reality of recovery and speak out that they are thriving in the workforce, going to school or studying for trade,” Hyde said.

Since the 1950s, population decline has now slowed down while household income levels are rising.

The area still covers a corner of Ohio, Kentucky and West Virginia, locally known as "kyova" and is dissected by the slowly moving Ohio River, and its recent success does not mean that the community is completely left with addiction and its associated drawbacks - poverty, crime and mental health.

Outside the Harmony House Shelter on 4th Street in Huntington, there are about a dozen people with their own belongings – sleeping bags, clothes and a bottle of water gathered in the shopping cart – baked in the early summer.

“We are used to adapting and overcoming,” Gibson said.