Former President Trump has been vocal in his battle against drug traffickers for quite some time. He proposed the death penalty for their “heinous acts,” asserting this measure on the first day of his second term. A Presidential Order categorizes cartels as “terrorist organizations.”

Nonetheless, public health and addiction specialists express concern that his budget and policy proposals may inadvertently penalize individuals grappling with drug abuse and addiction.

The Trump administration pledged to combat overdose deaths, a pressing public health crisis, by enhancing law enforcement efforts, bolstering border security, and imposing tariffs on China and Mexico to curb the influx of fentanyl and other hazardous substances. However, the administration also proposed substantial cuts in programs aimed at reducing the demand for drugs.

The budget introduced to Congress this month seeks to eliminate over $1 billion allocated for local and domestic treatment and preventive services. Major federal agencies involved in addressing substance use, such as Substance Abuse and Mental Health Services, have already experienced substantial staff reductions due to layoffs during the Trump administration. Critics warn that this will lead to a collapse of the necessary frameworks for a healthy America, extending far beyond just mental health and substance use issues.

If Republican talks about Medicaid cuts are implemented, millions of Americans may be unable to maintain or initiate treatment.

The White House did not provide any comments regarding the situation. The proposed budget highlights a stance on drug trafficking, stressing a commitment to secure boundaries and law and order while advocating for the reduction of redundant or insufficiently impactful addiction services.

Public health experts argue that these reductions are detrimental, particularly at a time when the nation is making meaningful advancements in combating fentanyl fatalities. Various interventions, including increased access to overdose-reversing naloxone, more treatment facilities, stable housing, and peer counseling, have been credited with this progress. Nonetheless, a clear consensus on which interventions merit further focus and funding remains elusive.

“It will be a tragedy if we dismantle these programs without a full understanding of their effectiveness, leading to a potential resurgence of overdose rates,” warns Dr. Matthew Christiansen, an addiction specialist from Huntington, West Virginia, a city once labeled as facing a severe opioid crisis.

A letter signed by over 320 behavioral medicine experts was sent to Congressional leaders, criticizing the proposed cuts, which affect crucial programs such as “community-based naloxone distribution, peer outreach initiatives, prevention programs for drug-related infectious diseases, and drug testing strip programs.”

The president’s budget proposes the termination of grants aimed at “harm reduction,” a strategy that helps curb the spread of disease and maintains the health of drug users, which has gained widespread acceptance among mainstream addiction treatment providers.

The budget questions federal financial backing for “dangerous activities” termed “harm reduction,” which includes providing “safe smoking kits and consumables” and “syringes” for users.

Such rhetoric harkens back to distorted reports from 2022, which suggested that $30 million in federal harm reduction grants would fund crack smoking and meth pipes. In reality, a small portion of the grants, designated as a “Safer Smoking Kit,” comprised alcohol swabs and lip balm while also supporting state programs for sterile syringe exchanges that have been shown to effectively reduce hepatitis C and HIV infection rates.

“Many individuals have faced significant health challenges,” remarked Dr. Christiansen, who previously directed drug management policies in West Virginia. “These tools are essential for minimizing opioid-related harm while fostering long-term recovery.”

According to the latest annual substance use survey by federal entities, 2023, approximately 27.2 million Americans over 12 years old faced substance use disorders, 28.9 million struggled with alcohol use disorders, and 7.5 million experienced both.

The budget maintains block grants for states to combat addiction and mental health issues; however, without additional grants and resources, the capacity for states to deliver necessary medical and social services for addiction prevention and treatment may fall short, as stated by Dr. Christiansen.

David Hertzberg, a Professor of Drug Policy and History at the University of Buffalo, noted that this governmental approach echoes 19th-century America, when the government was heavily intertwined with border issues tied to drug use, particularly regarding opiates and Chinese immigrants. Fearing foreign influence, Congress enacted severe restrictions on immigration from China amid hysteria over opium use among Chinese men.

Currently, as Hertzberg observed, political conservatives have recognized the targeting of foreign drug suppliers as a strategic avenue to bolster their broader agendas.

This stands in stark contrast to the frequently boasted about drug seizures, while chronic substance abuse often goes overlooked and is typically perceived as a personal failing rather than a broader social issue. Elected officials advocating for welfare are often branded as excessively lenient on crime.

“If politicians are truly willing to advocate for these individuals, I would be genuinely surprised,” Hertzberg concluded.