President Trump delivered the first State of the Union address of his second term to a joint session of Congress on Tuesday.

The big picture: He spent little time discussing health care, and his mentions of the opioid crisis focused on interdiction efforts.

The details: But here is what he had to say on those issues…

Fentanyl: At the top of the speech, Trump claimed that “the flow of deadly fentanyl across our border is down by a record 56 percent, in one year.” He highlighted actions from his administration such as designating drug cartels as foreign terrorist organizations, declaring illicit fentanyl a weapon of mass destruction, and the military campaign against alleged drug smuggling boats. He also highlighted the takedown of “one of the most sinister cartel kingpins,” a reference to the leader of the Jalisco New Generation Cartel who was killed over the weekend. Trump suggested that immigrants coming into the country are often “drug lords” or coming “from mental institutions.”
Health care: Trump said he is “confronting one of the biggest rip-offs of our times: the crushing costs of health care.” He touted his “Great Health Care Plan” and said he wants to “stop all payments to big insurance companies and instead, give that money directly to the people so they can buy their own health care, which will be better health care at a much lower cost.” He also claimed, “We will always protect Social Security, Medicare, Medicaid,” and touted the administration’s efforts to target alleged Medicaid fraud.

But:

Most drugs are brought into the country by U.S. citizens at ports of entry, not through illegal border crossings.
Trump has proposed redirecting insurance subsidies to individual health savings accounts that people could use to purchase health care services as a way to compensate for rising premiums following the expiration of the enhanced Affordable Care Act (ACA) subsidies. But his proposal does not offer specifics, and there is no evidence that people paying directly for care would directly lower prices.
Trump’s claim that he will “always protect” Medicaid is false. The One Big Beautiful Bill Act, his signature legislation passed last summer, made more than $1 trillion in cuts to Medicaid over the next decade, the largest reduction in the program’s history. Much of these cuts is expected to come by pushing more than 10 million people out of the program through more stringent eligibility checks and work requirements.
Trump did not discuss any public health efforts to address the demand side of the addiction crisis through prevention or treatment initiatives. He did not mention the administration’s cuts to the health workforce and funding through cuts to the Department of Health and Human Services (HHS) and sub-agencies including the Substance Abuse and Mental Health Services Administration (SAMHSA).