Trump pivots U.S. fentanyl struggle from public well being to drug conflict : NPR

In his first 12 months again in workplace, President Trump reshaped U.S. drug coverage and the response to fentanyl deaths in sweeping, usually chaotic style, quickly dismantling efforts launched by the Biden administration geared toward increasing drug remedy.

Many specialists credit score Biden-era public well being insurance policies with saving tens of 1000’s of lives. However with new legal guidelines, government orders, finances cuts, and army redeployments, Trump pivoted the nation from these methods to a militarized drug conflict.

“From day one of many Trump administration we declared an all-out conflict on the sellers, smugglers, traffickers and cartels,” Trump stated in July, throughout a signing ceremony for the Halt Fentanyl Act.

Trump has launched U.S. Naval strikes in opposition to alleged drug boats; designated drug cartels as terrorist organizations; labeled fentanyl as a weapon of mass destruction; and deployed Nationwide Guard troops in American cities and alongside the U.S.-Mexico border.

In the meantime, his administration threw into query assist for even fundamental federally funded habit remedy applications, at one level quickly freezing $140 million in federal grants as front-line care suppliers scrambled to keep up companies.

Scrapping the general public well being method

Trump’s fast realignment of U.S. drug coverage stems partially from his assertion that Biden’s effort to cut back fentanyl deaths was a wholesale failure. Talking this month, Trump made the false declare that “300 million folks died final 12 months from medication.”

Fentanyl deaths did surge within the first two years of the Biden administration, through the COVID pandemic. However deadly overdoses declined sharply in 2023 and 2024, because the Biden crew raced to increase entry to opioid-treatment drugs, together with buprenorphine and naloxone.

The Biden administration additionally boosted federal spending by tens of billions of {dollars} on habit remedy, whereas embracing a “hurt discount” method, offering Medicaid medical health insurance, housing and different companies to folks even when they weren’t but in a position or prepared to cease utilizing road medication.

In 2023, then-Secretary of State Antony Blinken and President Joe Biden spoke throughout a gathering about countering the move of fentanyl into the US. The session adopted conferences with Chinese language chief Xi Jinping, the place Biden introduced that he and Xi reached an understanding about lowering the move of fentanyl precursor chemical compounds from China to the U.S.

Drew Angerer/Getty Photographs

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Drew Angerer/Getty Photographs

In response to provisional information compiled by the Facilities for Illness Management and Prevention, deadly overdoses within the U.S. plunged practically 27 p.c throughout Biden’s final 12 months in workplace.

“We have made beneficial properties. There are extra folks now being handled for substance use problems and opioid use problems,” stated Richard Frank, a drug coverage researcher on the Brookings Establishment. “That’s largely because of the Medicaid (insurance coverage) growth.”

However after returning to the White Home, the Trump administration, working with GOP leaders in Congress, moved swiftly to strip roughly $1 trillion from Medicaid funding, together with cuts to applications that assist habit care. In a July government order, Trump additionally attacked hurt discount efforts, claiming with out proof that they “solely facilitate unlawful drug use.”

The shift alarms many researchers, physicians, and drug coverage analysts, who worry a resurgence of drug deaths.

“The most important threat actually of accelerating overdose deaths is the Medicaid cutbacks,” stated Regina LaBelle, who briefly served as appearing director of the White Home Workplace of Nationwide Drug Management Coverage underneath Biden and now teaches drug coverage at Georgetown College. “It isn’t nearly defunding hurt discount. They’re additionally defunding prevention, remedy and restoration applications.”

Fentanyl, a “weapon of mass destruction”

There’s additionally rising proof that Biden-era regulation enforcement and diplomatic efforts managed to disrupt the move of fentanyl into the U.S., partially by convincing China to assist cut back the sale of commercial “precursor” chemical compounds used to make road fentanyl.

“The essential (Biden crew) success was the cooperation with China that constructed up throughout 2024,” stated Vanda Felbab-Brown, who research drug cartels and road drug trafficking on the Brookings Establishment. “This included regulation enforcement cooperation and intelligence trade and cooperation on anti-money laundering efforts.”

Over the past 12 months, nevertheless, Trump and his crew discounted the Biden crew’s efforts. Talking in July, Trump steered the lethal fentanyl disaster was “allowed to occur by folks both that did not care or have been silly folks.” He has additionally steered that carnage from overdoses was so nice it justified a militarized response.

“Two to a few hundred thousand folks die yearly, that we all know of, so we’re formally classifying fentanyl as a weapon of mass destruction,” Trump stated in December, citing a statistic contradicted by federal information.

Analysis by the CDC, the U.S Drug Enforcement Administration, and different high U.S. drug researchers exhibits that drug deaths peaked in 2023 at roughly 115,000 deaths in a single 12-month interval. The most recent provisional CDC information exhibits roughly 76,500 deadly overdoses within the 12-month interval ending in April 2025.

Certainly, a lot of Trump’s new drug coverage initiatives are primarily based on claims that drug coverage researchers describe as wildly inflated or wholly inaccurate. Certainly one of his first main fentanyl-related actions was an government order signed in February imposing steep tariffs on Canadian merchandise, due to what Trump described as Canada’s “central position” in fentanyl smuggling.

However information from the U.S. Drug Enforcement Administration exhibits Canada performs virtually no position within the U.S. fentanyl disaster. In 2024, roughly 43 kilos of fentanyl was seized at America’s northern border. That compares with roughly 21,100 kilos seized on the southern border.

High administration officers have additionally made exaggerated claims about progress made to cut back drug deaths throughout Trump’s first 12 months again in workplace.

Throughout a cupboard assembly, Legal professional Basic Pam Bondi stated aggressive anti-drug insurance policies had already saved 258 million American lives. In a separate put up on social media, Bondi estimated the lives saved at a a lot decrease determine, claiming roughly 119 million lives saved. Researchers who examine the potential hurt of fentanyl and different road medication informed NPR each claims are vastly inflated.

Will blowing up boats cease fentanyl deaths within the U.S.?

Protection Secretary Pete Hegseth, in the meantime, has stated Trump’s army strikes close to Venezuela are already having a deterrent impact on drug cartels.

“There aren’t many individuals getting in boats proper now operating medication, which is the entire level. We wish to cease the poisoning of the American folks,” Hegseth stated, throughout an look hosted by the Ronald Reagan Presidential Basis.

The Trump administration has declined to supply proof that boats focused by the Navy are operated by cartel-linked smugglers. Researchers who examine drug traffickers, together with Felbab-Brown at Brookings, say even when some boats are carrying road medication, they virtually actually aren’t carrying fentanyl, the drug that accounts for many U.S. overdose deaths.

The most recent U.S. Nationwide Drug Risk Evaluation, revealed by the DEA in July 2025, says drug gangs in Mexico, not Venezuela, “stay the dominant threats” trafficking fentanyl into American communities.

Drug gangs, motivated by the lure of big income, have additionally developed versatile underground provide routes, which can be largely unaffected by army strikes that kill low-level gang members.

Critics of the Trump administration’s method informed NPR the deterrent impact of a militarized U.S. drug conflict will even be hampered by Trump’s determination over the past 12 months to pardon or free a rising variety of drug “kingpin” figures.

Since returning to workplace, Trump pardoned Ross Ulbricht, who was serving a life sentence after creating Silk Street, an web web site used to visitors fentanyl and different road medication; pardoned Larry Hoover, former chief of the Chicago-based Gangster Disciples; and pardoned the previous president of Honduras, Juan Orlando Hernandez, convicted on drug and weapons costs after governing his nation as “a narco-state,” in keeping with a press release from the U.S. Justice Division.

“There’s a variety of blended messages and blended indicators [from the White House] which creates kind of chaos and uncertainty,” stated Jeffrey Singer, a drug coverage analyst on the Cato Institute, in an interview with NPR in Could. “On the one hand you are threatening even more durable penalties on individuals who deal in medication, whereas then again you are releasing drug sellers from prisons.”