The drug crisis in America continues to take a tragic toll, claiming the lives of nearly 100,000 people annually while devastating families and communities nationwide. With a new administration set to take over the White House, now is a necessary time to rethink the nation’s drug policies and align them with advances in the understanding of what works and what doesn’t.
Harm reduction, an approach focused on minimizing the adverse health and social consequences of drug use, is not only a pragmatic strategy but a moral imperative. It challenges the idea that drug use defines a person’s worth, rejecting the current notion that those who use drugs are beyond help or undeserving of compassion, recognizing that every individual deserves care and protection. Backed by decades of research, harm reduction offers an alternative framework that is more likely to yield the results everyone seeks: proven, compassionate solutions that save lives and foster healthier, more resilient communities.
In 2016, the first Trump administration focused on border security and law enforcement to combat the opioid crisis, hoping that limiting the influx of illegal drugs would decrease drug availability and opioid-related deaths. However, as reported by The Washington Post, the results from this punitive approach did not yield the desired results. Despite aggressive enforcement, overdose rates continued to rise. This outcome illustrates the limits of focusing solely on supply reduction and punitive measures; they fall short and may exacerbate the issues they aim to resolve.
The first Trump administration also attempted to address the opioid crisis by spending $6 billion to support treatment and prevention programs. Although this spending may have been more cost-effective than alternative outlays, it was still overshadowed by the immense focus on enforcement. While well-intentioned, this approach was both contradictory and overlooked key evidence. Heavy-handed enforcement can be counterproductive because it creates fear of legal repercussions among drug users, discouraging them from seeking treatment and accessing support services.
The new Trump administration should redirect its approach to combatting the dangers of drug use by keeping the focus where it should be: supporting people in need. The Office of National Drug Control Policy (ONDCP) under the first Trump administration emphasized the importance of balancing anti-drug efforts with resources for treatment and recovery for those battling addiction. Continuing to expand on that idea in the upcoming term has the potential to initiate a shift toward a harm reduction approach to the drug issue, one that cultivates the respect and care needed to foster healthier communities in the long term.
To address the opioid crisis effectively, the next administration should consider the following recommendations:
- Expand Access to Evidence-Based Treatment: Resources should be reallocated away from ineffective mechanisms and used instead to support a wide range of addiction treatment options, particularly medication-assisted treatment (MAT), which has been shown to reduce opioid-related harm significantly. In 2024, only about 10% of those battling substance abuse had access to personalized treatment options. Expanding access to these services is critical to prevent deaths.
- Empower Communities To Address Their Local Drug Problems: Education, outreach, and support services–like safe consumption sites and peer support networks–can prevent drug-related harm and promote supportive environments that foster recovery. Unfortunately, the federal “crackhouse” statute (21 U.S.C. § 856) limits what states can accomplish and limits innovation in addressing drug use. The administration should encourage Congress to amend this law to allow states the flexibility to pursue evidence-based harm reduction strategies.
- Remove Regulatory Barriers to Lifesaving Resources: Federal restrictions and grant limitations prevent naloxone distribution in critical settings like correctional facilities. It is imperative to eliminate unnecessary federal regulatory hurdles that limit access to harm-reduction tools. For example, some correctional facilities are mandated to offer naloxone upon release ”as funding allows,” but federal rules limit states’ ability to use grant funds. The administration should eliminate these funding restrictions and allow states, nonprofits, and private actors to use resources as they see fit–leaving room for innovative harm-reduction solutions to flourish.
- Eliminate Federal Barriers To Fentanyl Test Strips And Other Harm Reduction Supplies: Under 21 USC 863, test strips–simple tools used to detect the presence of fentanyl in drugs–and other harm reduction supplies are considered illegal “drug paraphernalia,” making it difficult to distribute them. While Congress would need to amend the statute to fully resolve this issue, the administration can clarify enforcement priorities through enforcement discretion to ensure that individuals and organizations distributing fentanyl test strips are not targeted, allowing broader access to these lifesaving tools.
- Use Cost-Benefit Analysis: Investing in harm reduction measures can yield substantial cost savings by decreasing healthcare and law enforcement costs related to untreated addiction. For instance, a 2013 study in the United States found that providing naloxone to individuals at risk of overdose was highly cost-effective, with costs on average landing at around $53 per individual. With this investment, the initiative marginally enhances both the quality and duration of life by approximately 0.12 extra years of quality life. When the expenses are assessed against the advantages, it amounts to $438 for each quality-adjusted life year gained. This public health strategy not only aids in individual recovery but is also more economically sustainable in the long term.
As governments at the state and federal levels address drug-related issues, the next administration should embrace a harm reduction approach that prioritizes personal rights and societal well-being. By relying on proven solutions and empowering communities, leaders have the opportunity to build a comprehensive drug policy that makes meaningful strides toward reducing overdose deaths, supporting recovery, and fostering healthier, more resilient communities. It’s time for a change—one that prioritizes healing and rehabilitation over punishment and prejudice.