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.