Fifty eight billion dollars, and nobody was there when I got out.

Reviewed 28 August 2026. Every figure below is sourced and dated at the bottom. Where I am doing my own arithmetic I say so. Where I checked something popular and it did not hold up, I say that too.

Start with the thing that made me angry

On 1 July the DEA published its notice. On 26 August the order was signed and three substances were in Schedule I. Call it eight weeks from paperwork to law.

Now hold that next to the grant that actually pays for treatment in your state. The federal block grant that funds substance use treatment came in at roughly two billion dollars for 2026, an increase of five to twenty million depending on which chamber you read. On a two billion dollar program that is under one percent. Against any honest measure of medical inflation it is a cut with a press release attached.

Eight weeks to schedule a compound. Two years running to not fund the thing that treats the people taking it.

I want to be careful here, because the cheap version of this argument is wrong and I am not going to make it. Scheduling a substance costs almost nothing. It is paperwork. So this is not money going to enforcement instead of treatment. It is attention going one place and not the other. Speed is a choice, and we only ever seem to find it for the banning.

The number that sounds enormous

Fifty eight billion is a real number. Here is the other one.

My own arithmetic, so weigh it accordingly. In 2024, 2.7 billion dollars of settlement money was spent or committed nationally. Spread that across forty million untreated people and you get about sixty eight dollars each, for the year. One month of buprenorphine costs more than that. That is the real scale of this. Not a scandal. A rounding error wearing a very large headline.

Where I have to be fair, because the truth is more interesting

I sat down to write that they spent it all on police cars. Then I checked, and that is not what the numbers say, so I am not going to write it.

So the cop car story is real, and it is small. It gets written because rifle suppressors bought with overdose money is an unforgettable sentence, and it is unforgettable because it is rare. If you argue this at a town meeting using only that, you will get taken apart by somebody holding a spreadsheet, and you will deserve it.

There is also a fair answer from the small towns. The typical city got about six hundred and ninety thousand dollars spread across eighteen years. That is around thirty eight thousand a year. You cannot open a detox on thirty eight thousand a year. Buying naloxone for the people who will get there before the ambulance is a rational use of it. And jails are, in practice, where an enormous number of untreated people with opioid use disorder actually are. Jail based medication is evidence based, it is explicitly allowed, and one Louisiana parish put every dollar it got into exactly that. It does not belong in the same paragraph as a shooting range.

So here is what I actually think is wrong

One. A fifth of it cannot be traced at all

Untrackable is not the same as stolen and I am not going to pretend it is. A county that spends every cent correctly and publishes nothing scores exactly the same as a county that wasted it. That is the point. We built a fifty eight billion dollar programme with no receipts, so we cannot tell the honest counties from the rest, and neither can they.

Two. Nobody has the authority to enforce it

Three. It is quietly replacing money that already existed

Some of that is opportunism. A lot of it is triage. Washington has been cutting the other end at the same time, and the people running these programmes are keeping the lights on with whatever is nearest to hand. If you want to be angry about supplantation, be angry at both hands, not just the one you can see.

The part I am qualified to talk about

Look back at the categories. Treatment got 615 million. Recovery services got 450 million, and that bucket has to hold housing, transport, legal aid and peer support all at once. Nobody publishes what peer support alone got, nationally, because it is not tracked as its own line. Neonatal abstinence syndrome, which is one of the nine named core strategies, got 8.4 million. Under half of one percent.

What I would ask for, and it is not more money

• Receipts. Every jurisdiction publishes what it spent, on what, to whom, once a year, in a spreadsheet a normal person can open. California wrote actual rules for this. It is not difficult, it is just unpopular.
• Somebody with the authority to say no. Right now the enforcement mechanism is a journalist noticing. That is not a mechanism.
• A funded line for the day after discharge. Peer support, recovery coaching, somebody who calls on day thirty one. Tracked separately so we can see whether it is happening.
• Stop letting it backfill. If a settlement dollar replaces a dollar that already existed, nothing was added and somebody should have to write that down.

None of that requires a new appropriation. All of it requires somebody being willing to be told no, which is why it has not happened.

Sources