Trump pivots U.S. fentanyl struggle from public well being to drug struggle : 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 trend, quickly dismantling efforts launched by the Biden administration aimed toward increasing drug therapy.

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

“From day one of many Trump administration we declared an all-out struggle 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; categorized 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 help for even primary federally funded habit therapy packages, at one level briefly 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 partly from his assertion that Biden’s effort to scale back fentanyl deaths was a wholesale failure. Talking this month, Trump made the false declare that “300 million individuals died final 12 months from medication.”

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

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

In accordance with provisional knowledge 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 positive factors. There are extra individuals 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 {dollars} from Medicaid funding, together with cuts to packages that help habit care. In a July govt 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 concern 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, therapy and restoration packages.”

Fentanyl, a ‘weapon of mass destruction’

There’s additionally rising proof that Biden-era legislation enforcement and diplomatic efforts managed to disrupt the move of fentanyl into the U.S., partly by convincing China to assist scale back the sale of commercial “precursor” chemical substances used to make avenue fentanyl.

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

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

“Two to a few hundred thousand individuals 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 knowledge.

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

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

However knowledge from the U.S. Drug Enforcement Administration reveals 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.

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

Throughout a cupboard assembly, Lawyer Common Pam Bondi stated aggressive anti-drug insurance policies had already saved 258 million American lives. In a separate publish on social media, Bondi estimated the lives saved at a a lot decrease determine, claiming roughly 119 million lives saved. Researchers who research the potential hurt of fentanyl and different avenue medication instructed NPR each claims are significantly inflated.

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

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

“There aren’t many individuals getting in boats proper now working medication, which is the entire level. We need to cease the poisoning of the American individuals,” 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 research drug traffickers, together with Felbab-Brown at Brookings, say even when some boats are carrying avenue 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, printed 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 giant earnings, even have developed versatile underground provide routes, which can be largely unaffected by navy strikes that kill low-level gang members.

Critics of the Trump administration’s method instructed NPR the deterrent impact of a militarized U.S. drug struggle can even be hampered by Trump’s choice during the last 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 website used to visitors fentanyl and different avenue 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 combined messages and combined alerts [from the White House] which creates type of chaos and uncertainty,” stated Jeffrey Singer, a drug coverage analyst on the Cato Institute, in an interview with NPR in Might. “On the one hand you are threatening even harder penalties on individuals who deal in medication, whereas then again you are releasing drug sellers from prisons.”