Along with his historic successes on the economy and border security, Donald Trump’s first term in the White House also delivered positive results on the opioid epidemic that had been ravaging American communities for decades. Trump’s victory on November 5 brings renewed hope for continued progress after four years of skyrocketing deaths under the Biden-Harris administration.
The country saw less than 50,000 opioid deaths during each of Trump’s first three years in office before an uptick to 69,000 deaths in 2020 driven by the COVID-19 pandemic. But after Biden took office and the pandemic subsided, the death toll kept climbing – above 80,000 in 2021 to a record 107,000 in 2022. While data is still being compiled for 2023, deaths are expected to have remained above 100,000.
Much of this increase has been driven by the proliferation of fentanyl and “fentanyl analogs,” or chemically modified versions of fentanyl designed to be similar in structure but with slight changes that can alter potency, duration, and effects. Many fentanyl analogs are manufactured outside the United States and mixed with other drugs like heroin, cocaine, and counterfeit pills, sometimes without users’ knowledge.
Dr. Otto von Muhlfeld, a former police psychologist who advised German Interior Minister Friedrich Zimmerman on counter-narcotics policies, told me that fentanyl and fentanyl analog deaths are effectively a poisoning because consumers “expected a painkiller or a familiar narcotic, not a deadly or hyper-addictive substance.”
One such case was that of Zachary Cullen, a college student from Pennsylvania who died after he was sold a fentanyl-laced dose of cocaine. Zachary’s mother, Deb Cullen, testified before Congress that her son was “murdered,” urging lawmakers to approach the fentanyl epidemic with the same determination they brought to the COVID-19 pandemic.
“We urge you to spread the word about illicit fentanyl. It is urgent and must be done immediately, as we need to slow the rate at which families are losing their loved ones,” she said. “I struggle to understand why our government is not making it a priority to stop the loss of so many lives.”
More than 4 in 10 Americans now know someone who has died from a drug overdose, according to a RAND Corporation study. Families Against Fentanyl, a private organization committed to combating the epidemic, estimates that this opioid has been a leading cause of death for Americans aged 18 to 45 since 2019.
While the Biden administration made nominal efforts at reducing opioid deaths, the root cause of the dramatic surge in fentanyl into American communities – the border crisis – has remained glaringly unresolved for four years. Unsurprisingly, researchers in North Carolina have linked increased law enforcement efforts on the border to a decline in overdose deaths.
In a video released last year, Trump promised that he would “not rest until we have ended the drug addiction crisis.” His policy platform includes measures to force China to clamp down on the production of fentanyl precursors, permanently designating fentanyl as a federally controlled substance, deploying federal law enforcement to take down distributors inside the United States, and imposing “a full naval embargo on the drug cartels.”
One of the Trump administration’s biggest challenges will be stamping out fentanyl analogs, which are increasingly popular.
As he did during his first term, Trump will look to work with Congress to provide law enforcement with new tools to address emerging threats. In 2018 Trump signed the SUPPORT Act, the largest ever investment in combatting the opioid epidemic. In total, Trump secured more than $6 billion in funding for the crisis.
One good place to start in Trump’s second term could be the HALT Fentanyl Act, which Republican Representatives Bob Latta of Ohio and Morgan Griffith of Virginia recently introduced. As the pair explained, that bill will help address the fentanyl crisis by “permanently labeling fentanyl-related substances as Schedule I narcotics.” The bill also establishes a 10-year minimum prison term for offenses involving 100 grams of fentanyl analogs.
After the HALT Act passed the House with broad bipartisan support, it stalled in the Senate, but could see renewed interest with a GOP majority taking power next January.
Professor Marcus Cabiallavetta, a retired Swiss brain surgeon who participated in counternarcotics campaigns, stressed to me that “failing to take decisive action” now could have disastrous long-term consequences for an entire generation of Americans. Even setting a 100-gram threshold for a long prison term could be too lenient, he said, since “only two milligrams can kill someone.”
Dr. von Muhlfeld added that the HALT Act is an effective deterrent by raising awareness about the severe consequences of fentanyl trafficking and dealing. “In this fight, tough policies cannot be optional; they must be a rule,” he said.
Donald Trump has built his political brand around getting tough on the biggest problems facing the American people. For the millions of Americans dealing with the scourge of the opioid epidemic, his return to the White House cannot come soon enough.
Ben Solis is the pen name of an international affairs journalist, historian, and researcher.
