Trump's Terms In one year, Trump pivots fentanyl response from public health to drug war
Dec 31, 2025
Brian Mann, NPR's addiction correspondent, dives deep into how President Trump reshaped U.S. drug policy, shifting the focus from public health initiatives to a strict law enforcement approach regarding fentanyl. He highlights the dismantling of Biden's strategies aimed at expanding drug treatment, and reveals the rationale behind Trump’s strict pivot, including claims of Biden’s failures. Mann warns of the consequences of Medicaid cutbacks and discusses skepticism among experts about the efficacy of military tactics in combating drug trafficking.
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Public Health Approach Reduced Overdose Deaths
- Under Biden, the U.S. treated fentanyl as a public health crisis and expanded treatment and harm reduction programs.
- Brian Mann says those programs are credited with saving tens of thousands of lives and improving street drug deaths since summer 2023.
Shift From Health To Enforcement
- The Trump administration has shifted policy from health-focused responses to enforcement, cutting Medicaid and harm reduction funding.
- Mann warns the pivot uses military and law enforcement tools rather than continuing treatment expansions.
Rhetoric Justifies Hardline Action
- Trump frames the change as necessary because he alleges Biden mishandled rising drug deaths, a claim Mann says is often false.
- The administration uses rhetoric like calling cartels terrorists and labeling fentanyl a weapon to justify tougher measures.