Get the latest news from our field
In his first year back in office, President Trump has reshaped U.S. drug policy.
- The main point: Trump quickly pivoted from the Biden-era public health policies to a more militarized, supply-side approach.
The details:
- Trump has launched U.S. Naval strikes against alleged drug boats, designated cartels as terrorist organizations, and classified fentanyl as a weapon of mass destruction.
- At the same time, the administration has thrown into question support for even basic federally funded addiction programs. The administration and Congress moved to cut $1 trillion from Medicaid and have made cuts to the Substance Abuse and Mental Health Services Administration and addiction-related programs. In July, Trump issued an executive order that attacked harm reduction efforts.
Reminder: Fentanyl deaths did surge in the first two years of the Biden administration, during COVID, but they sharply declined in 2023 and 2024.
- The Biden administration expanded access to naloxone and MOUD, boosted federal spending on addiction treatment, and embraced a harm reduction approach.
- There is also growing evidence that Biden-era law enforcement and diplomatic efforts disrupted the flow of fentanyl into the U.S., in part by convincing China to control the sale of precursor chemicals.
The bottom line: Public health responses are needed to address the addiction and overdose crisis. While supply-side measures may also be needed, a focus exclusively on enforcement-based responses, without ensuring adequate prevention, treatment, and other services, will not be effective.
Read more: In one year, Trump pivots fentanyl response from public health to drug war
Published
January 2026