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      Trump policies could fuel illicit drug trade despite vow to curb fentanyl

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      Donald Trump’s policies could leave the US more vulnerable to dangerous synthetic drug trafficking from abroad, even as the administration has vowed to stop fentanyl from entering the country, former government officials say.This week, Trump imposed tariffs on Mexico, Canada and China, ostensibly as a tactic to stem the flow of illicit drugs into the US.Jim Crotty, the former Drug Enforcement Administration deputy chief of staff, called the approach “coercive” and said it has the potential to backfire. Federal funding cuts could also leave US borders more insecure, according to Enrique Roig, a former Department of State official who oversaw Bureau of International Narcotics and Law Enforcement Affairs (INL) portfolios and who has also worked with USAid.US overdose deaths began to decrease significantly for the first time in 2023, after rising for decades. But Crotty notes this progress is fragile.“We’re seeing this decrease in overdose deaths and everyone’s still trying to suss out exactly why. I don’t think now is the time that we want to stop any of those existing efforts because we know that at least some, or a combination of them, have been working,” Crotty said.Roig agreed: “All this has to be working together in concert.”Federal funding cuts could put the US behind when it comes to drug detection technology. The global drug supply has increasingly shifted towards highly potent synthetic substances such as fentanyl and newly emerging nitazenes. Often, these drugs arrive in the US in the form of powders or precursor chemicals that take up minimal space, and are difficult to detect by odor.Roig says advanced drug detection technology is therefore vital, but Trump’s federal funding and staff cuts mean less money for the latest technology and equipment, and fewer people to install it.Ram Ben Tzion, the CEO of Publican, which provides drug detection technology to government agencies outside the US, says cutting-edge methods detect suspicious shipments even before they get to the border. Publican uses large language models to flag shipments that “don’t make sense” and are likely to contain illicit substances. For example, his company once found fentanyl precursors in a shipment to a residential address in California. The shipment claimed to contain fashion items, but came from a Chinese construction company.Similarly, the UN Container Control Programme, which has historically received state department funding, helps authorities flag suspicious shipments before they reach their destination. This program has helped authorities around the world seize hundreds of tonnes of illicit drugs each year. Roig says federal funding cuts have stalled CCP’s implementation in Mexico, even though it’s a primary security target for Trump.Some of Trump’s measures are more showy than they are constructive, Crotty and Roig said. The designation of certain cartels as terrorist organizations “doesn’t do much of anything”.It’s symbolic, says Crotty, given that they were already designated transnational criminal organizations. Other measures are a harmful waste of money, according to Roig. Just this week, for instance, the administration suspended the use of military planes to deport immigrants, including those accused of drug related crimes, due to the extravagant cost.Roig says this measure was completely unnecessary, as “Ice already has its own fleet of airplanes” that are much cheaper.Crotty is concerned the aggression could backfire.“The Mexican people are protective of their culture and their sovereignty. If you push them too hard, could it do more harm than good?” he said.Mexico sent 10,000 troops to its US border to cooperate with Trump’s demands, but Crotty says “while in a vacuum that sounds like a whole lot”, Mexico’s border is vast, and drugs are often transported in “minute quantities”. So, the US needs Mexico’s cooperation when it comes to intelligence – otherwise “you’re not going to find the proverbial needle in the haystack”, Crotty said.Roig said that “it’s important that we do this in cooperation with Mexico and not alienate them,” adding that Trump’s aggressive stance toward China could harm the Biden administration’s progress negotiating with the Chinese government to cooperate on counternarcotics initiatives.Massive USAid cuts also threaten programs intended to curb the “root causes” of the drug trade, says Roig. Some USAid-funded programs simultaneously tackled drug smuggling and another one of Trump’s key issues, migration – as cartels that traffic drugs also traffic people.When Roig worked with USAid, he says he spent a lot of time on “community violence prevention efforts”, including programs to keep young people from joining international crime organizations and cartels. (Notably, the Trump administration has purged many websites describing USAid programs.)If the drug supply does increase, it could mean US overdoses begin to rise again as well. But Crotty is worried we won’t even know if that happens. Layoffs at the Centers for Disease Control and Prevention could leave fewer people to track overdose deaths, and Trump’s attack on government data sharing could keep everyone in the dark.“​​ CDC maintains the overdose death dashboard. A lot of that stuff is data driven. Are they still going to have access to the data?” he said.The Guardian contacted INL and UNODC for comment. More

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      Mexican drug lord pleads not guilty to killing of DEA agent after US extradition

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      After years as one of US authorities’ most wanted men, the Mexican drug cartel boss Rafael Caro Quintero was brought into a New York courtroom on Friday to answer charges that include orchestrating the 1985 killing of a US federal agent.Caro Quintero pleaded not guilty to running a continuing criminal enterprise. Separately, so did Vicente Carrillo Fuentes, the leader of another cartel. Carrillo is accused of arranging kidnappings and killings in Mexico but not accused of involvement in the death of the DEA agent Enrique “Kiki” Camarena.Caro Quintero, Carrillo Fuentes and 27 other Mexican prisoners were sent on Thursday to eight US cities, a move that came as Mexico sought to stave off the Donald Trump administration’s threat of imposing 25% tariffs on all Mexican imports next week.For Camarena’s family, the arraignments marked a long-awaited moment.“For 14,631 days, we held on to hope – hope that this moment would come. Hope that we would live to see accountability. And now, that hope has finally turned into reality,” the family said in a statement thanking Trump and everyone who has worked on the case over the years.The White House, in a statement Friday ahead of the arraignments, called Caro Quintero “one of the most evil cartel bosses in the world”.In exchange for delaying tariffs, Trump had insisted that Mexico crack down on cartels, illegal immigration and fentanyl production.But members of Mexico’s security cabinet on Friday framed the transfer of the 29 prisoners as a national security decision.“It is not a commitment to the United States. It is a commitment to ourselves,” said Mexican attorney general Alejandro Gertz Manero. “The problem of drug trafficking and organized crime has been a true tragedy for our country.”Mexican security secretary Omar García Harfuch said the people sent into US custody were “generators of violence” in Mexico and represented a security threat to both countries.Caro Quintero had long been one of America’s top Mexican targets for extradition.He was one of the founders of a Guadalajara-based cartel and one of the primary suppliers of heroin, cocaine and marijuana to the US in the late 1970s and 1980s.Caro Quintero had Camarena kidnapped, tortured and killed in 1985 because he blamed the agent for a raid on a huge marijuana plantation the year prior, authorities said. Camarena’s killing marked a low point in US-Mexico relations and was dramatized in the popular Netflix series Narcos: Mexico.Caro Quintero had been 28 years into a 40-year sentence in Mexico when an appeals court overturned his verdict in 2013.After his release, he returned to drug trafficking and unleashed bloody turf battles in the northern Mexico border state of Sonora until he was arrested by Mexican forces in 2022, authorities said.skip past newsletter promotionafter newsletter promotionCaro Quintero told the Spanish newspaper El País in 2018 that he “never went back to drugs”.“Whoever’s saying it is a liar!” he said, according to the newspaper. “I’m not working any more, let’s be clear about that! I was a drug trafficker 23 years ago, and now I’m not, and I won’t ever be again.”The US, which had added Caro Quintero to the FBI’s 10 most wanted list in 2018 with a $20m reward, sought his extradition immediately after his 2022 arrest. It happened days after the Mexican and US presidents at the time, Andrés Manuel López Obrador and Joe Biden respectively, met at the White House.But the request remained in limbo as López Obrador severely curtailed his country’s cooperation with the US to protest undercover American law enforcement operations targeting Mexican political and military officials.Then, in January, a non-profit group representing the Camarena family sent a letter to the new Trump administration urging it to renew the extradition request.Carrillo Fuentes is the brother of the drug lord Amado Carrillo Fuentes, known as “The Lord of The Skies”, who died in a botched plastic surgery in 1997. Carrillo Fuentes, who was known as “The Viceroy”, continued his brother’s business of smuggling drugs over the border until his arrest in 2014.He was sentenced in 2021 to 28 years in prison for organized crime, money laundering and weapons violations.Among the others extradited are leading members of Mexican organized crime groups recently designated by the Republican administration as “foreign terrorist organizations”.They include cartel leaders, security chiefs from both factions of the Sinaloa cartel, cartel finance operatives and a man wanted in connection with the killing of a North Carolina sheriff’s deputy in 2022. More

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      If Trump’s tariffs start a trade war, it would be an economic disaster | Mark Weisbrot

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      “To me, the most beautiful word in the dictionary is tariff, and it’s my favorite word,” said Donald Trump last month. Pundits, politicians and financial markets are trying to figure out why, since he announced a week ago that he would impose tariffs on the United States’s three biggest trading partners: 25% for Mexico and Canada, and 10% for China.One theory is that tariffs can be a beautiful distraction. Trump, more than any previous US president, has fed on distractions for years, both to campaign and to govern. He can move seamlessly from one distraction to the next, like a magician preparing for the opportune moment to pull a coin from where it appears to have been hidden behind your ear.Although he still has seven weeks before he takes office, he could use a distraction that can start sooner. He has run into problems with cabinet and other appointments that require Senate confirmation. Of course he could easily find people who would do his bidding and be acceptable to a Senate with a Republican majority. But that would defeat the main purpose of nominating people who seem indefensible: to force Republican senators to display the abject subservience that Trump needs to be public, in order to ensure his unwavering dominance within his party.This is no small part of his governing strategy; it involves a big takeaway from the failures of his first term, from his point of view. The lesson is: loyalty to Trump first. Violators will be banished. And with small margins in the Senate and the House, things could begin to unravel if this core imperative goes unenforced.But the days before Trump actually takes office could also be the best time for him to use the threat of tariffs to begin bullying foreign governments for things that might benefit his allies, donors or himself. Other governments besides the three that he named are trying to figure out what they can offer Trump to avoid the economic disruption of tariffs. Christine Lagarde, the head of the European Central Bank, who does not see Trump as a friend, has urged the EU to negotiate with him, rather than adopt a retaliatory, eg tariff, response.Trump’s two offered pretexts for the tariff threat – migration and drugs, in this case fentanyl – are not credible. About 18% of the undocumented people encountered by border patrol over the past year have been from Venezuela and Cuba, two countries that have been devastated economically by sanctions imposed by the US government. If reducing immigration were really Trump’s concern, he would not have deployed sanctions that have driven millions of people from their homes to the US border; and he could end these sanctions in January by himself.Broad economic sanctions are a form of economic violence which targets civilians in order to achieve political ends, including regime change. US congressman Jim McGovern, a Massachusetts Democrat, made this clear in a letter that he wrote to Joe Biden asking for the sanctions on Venezuela to be dropped. The Trump sanctions in Venezuela in 2017 killed tens of thousands of civilians during the first year, and many more in the years that followed, including under Biden.As for fentanyl, about 75,000 people died from overdoses of this drug in 2023. But it’s difficult to see how Trump’s tariffs could help solve this problem. It’s a glaring example of how more than four decades of a failed “war on drugs”, based on criminalization of use and supply-side intervention, have made things worse. In this case the drug war has led to an innovation – fentanyl – that is vastly more powerful than heroin, much cheaper to produce, more addictive and easier to transport, distribute and produce.There is general agreement in the economic research on the effects of Trump’s trade and tariff wars in his first term as president, in which he placed tariffs on about $380bn of US imports. The overall impact on living standards for US workers and most Americans is found to be negative, with the cost of the tariffs being absorbed by US consumers. Employment overall did not increase, and may have fallen due to the negative impact of retaliatory tariffs.The economic research looking at the expected impacts of tariffs that Trump has talked about going forward also finds the impact on the US economy to be negative. And there is potential for much more damage if other countries respond with more retaliatory tariffs than they did in 2018-2020.Meanwhile, the productivity of Trump’s tariff offensive in generating distractions remains high. On Sunday he took a shot at the so-called Brics countries – Brazil, Russia, India, China and other economic powers: “We require a commitment from these countries,” Trump wrote on Truth Social, “that they will neither create a new Brics currency nor back any other currency to replace the mighty US dollar or they will face 100% tariffs and should expect to say goodbye to selling into the wonderful US economy.”None of these things will happen while Trump is in office. Nor will threats like this deter the majority of the world, when it is ready, from replacing a system of global governance that is overwhelmingly run by one country with help from the richest people in other rich countries. Our current system is one in which the “exorbitant privilege” that the dollar-based financial system bestows upon the US government gives the president the power to destroy whole economies with the stroke of a pen.But this is a longer story; for Trump it’s just another threat and another distraction in the post-truth world that he, as much as anyone, helped create. But he will need more than distractions to take this country further down the road toward de-democratization, which is what brought to him and his party the power that they now have.

      Mark Weisbrot is co-director of the Center for Economic and Policy Research. He is the author of Failed: What the “Experts” Got Wrong About the Global Economy More

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      Trump’s DEA pick Chad Chronister withdraws from consideration

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      Donald Trump’s pick to lead the Drug Enforcement Administration (DEA), Chad Chronister, said on Tuesday that he was withdrawing from consideration.“Over the past several days, as the gravity of this very important responsibility set in, I’ve concluded that I must respectfully withdraw from consideration,” Chronister, a Florida sheriff, said in a social media post.Trump announced his intention to pick Chronister, the current sheriff of Hillsborough county, Florida, to lead the DEA on Sunday, saying he would focus on stemming the flow of fentanyl across the US border with Mexico. The agency is part of the justice department and responsible for enforcing US drug laws.Chronister did not offer further details on his decision on social media and the Trump transition team did not immediately respond to a request for comment.Chronister follows former Republican representative Matt Gaetz, Trump’s first pick to serve as attorney general, in withdrawing his name for a post in the administration. Gaetz withdrew following scrutiny over a federal sex-trafficking investigation that cast doubt on his ability to be confirmed as the country’s chief federal law enforcement officer.Trump’s pick of Chronister for the DEA job drew backlash from conservatives, who raised concerns over his actions during the Covid-19 pandemic and him saying that his office “does not engage in federal immigration enforcement activities”.In March 2020, Chronister arrested the pastor of a megachurch who held services with hundreds of people and violated a safer-at-home order in place aimed at limiting the spread of the coronavirus.“Shame on this pastor, their legal staff and the leaders of this staff for forcing us to do our job. That’s not what we wanted to do during a declared state of emergency,” Chronister said at the time. “We are hopeful that this will be a wake-up call.”US representative Thomas Massie of Kentucky was among those airing public complaints, saying Chronister should be “disqualified” for the arrest.skip past newsletter promotionafter newsletter promotionTrump’s transition team said it had reached an agreement on Tuesday with the justice department that would allow it to submit names for background checks and security clearances, needed for access to classified information. More

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      Anti-opioid groups are ‘optimistic’ about Trump’s tariffs. Will the move help tackle the fentanyl crisis?

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      Anti-opioid campaigners in the US have welcomed Donald Trump’s threat to hit Mexico, China and Canada with increased trade tariffs if they do not curb the smuggling of the powerful drug driving the US opioid epidemic.Families and doctors grappling with a crisis that has claimed about 900,000 lives say the move may signal that a second Trump administration will finally get serious about tackling the flow of fentanyl into the US. But they also warn that much more needs to be done to reduce demand for opioids and to rein in the power of the pharmaceutical industry which created the epidemic.Trump said last week that he will issue an executive order on his return to the US presidency next month imposing a 25% tariff on goods from Mexico and Canada until their governments clamp down on the smuggling of fentanyl and other drugs into the US, and on people crossing the northern and southern borders illegally.The president-elect also said he will impose a 10% additional tariff on imports from China as the leading manufacturer of the precursor chemicals used by drug cartels to manufacture fentanyl, a highly potent synthetic opioid that is now the single largest cause of drug overdose deaths in the US.Ed Bisch, who lost his 18-year-old son Eddie to a prescription opioid overdose in 2001, said that tariffs are a sign that Trump “means business”.“I’m optimistic that the threat of substantial tariffs will lead to major cooperation in reducing the fentanyl poisoning of America,” he said.Bisch and other campaigners also say that some of Trump’s cabinet choices may signal a greater engagement with the crisis by the next administration, particularly as Robert F Kennedy Jr, who is nominated as health secretary, was a heroin user and the vice-president-elect, JD Vance, wrote a bestselling book, Hillbilly Elegy, about growing up in a household and region hit by drug addiction.Trump campaigned in 2016 and again this year on commitments to tackle the opioid epidemic which has devastated regions of America in ways that are often unseen in other parts. The crisis dragged entire communities deeper into poverty, drove up crime and greater dependency on welfare, and tore families apart.Millions of children have been raised by their grandparents because the intervening generation was imprisoned, dead or in no condition to parent. In West Virginia, the state worst hit by the epidemic, nearly half of all grandparents are raising their grandchildren.The opioid crisis has also played an important part in undermining public confidence in government institutions and medical practice in parts of the US because the epidemic grew out of the pharmaceutical industry pushing the wide prescribing of narcotic pain killers from which drug makers made billions of dollars with the complicity of the Food and Drug Administration (FDA). The epidemic then evolved as illegal supplies of heroin and then fentanyl drove up the death toll.But critics say Trump failed to follow through on his campaign promises in 2016 and his next administration will be a test of how really committed is he is on the issue in the face of what is likely to be major pushback from the drug industry.As president in 2017, Trump declared the opioid crisis a public health emergency.“No part of our society, not young or old, rich or poor, urban or rural has been spared this plague,” he said at the time.But two years later, the Government Accountability Office (GAO) criticised the Trump administration for a lack of coordination of efforts and failing to fulfill a legal requirement to issue a national drug control strategy.Robert Kent, who served as general counsel for the White House office of national drug control policy under Joe Biden, credits Trump with declaring the epidemic an emergency and establishing an opioid commission that issued guidelines on how to combat the crisis.“In Trump’s first term, he was the one who declared an opioid public health emergency, which is still in effect. The problem was there were no concrete actions taken specifically as a result. He didn’t put significant new resources into it,” he said.Kent said that the Biden administration put a greater emphasis on “harm reduction” such as the provision of overdose antidotes and test strips allowing drug users to detect fentanyl. But he fears those may be in danger from Republicans who see such measures as enabling drug use.Andrew Kolodny, director of Physicians for Responsible Opioid Prescribing and one of the first doctors to raise the alarm about the dangers of mass prescribing prescription painkillers, said harm reduction was necessary but did not get to the root causes of the epidemic.“It’s not hard for Trump to do better than Biden did on opioids. There were some good things that came out of the Biden administration. It was nice to see the federal government move more in a direction of harm reduction. But beyond that there wasn’t really that much done so by Biden,” he said.“When Biden ran for office, he put out a platform on how he would address the opioid crisis if he was president, and it was an excellent platform. But he never really implemented the plan.”Kolodny said that if Trump wants to have a significant impact in reducing opioid addiction he needs to create cheaper and easier access to treatment.“The vast majority of people with opioid use disorder actually want help for it. The reason they keep using fentanyl is that it’s much easier to get fentanyl and cheaper to get fentanyl than it is to get yourself onto buprenorphine or methadone treatment or find a doctor or programme that will very quickly enroll you in treatment when you ask for it,” he said.Researchers are still trying to decipher a drop in overdose deaths in the US last year. They believe better treatment and prevention are playing a part. The Drug Enforcement Administration said earlier this month that the amount of fentanyl found laced into other drugs had dropped and that they were therefore less potent and dangerous. The DEA head, Anne Milgram, attributed that to the Biden administration’s targeting of Mexican cartels and their supply chains.But Kent is cautious.“There’s a lot of people running around because we’ve seen a slight reduction in overdose deaths feeling like that’s mission accomplished when we’re only losing 93,000 people versus 111,000 a year. I would never define that as success in my world. Even within those numbers, underserved communities are being higher impacted at this point. In Black and brown communities the numbers are going up while the other numbers are going down. So there’s work to be done,” he said.Kent said he agrees with the need for an increased focus on the border.“We need to increase the number of staff at the border, just for a whole bunch of reasons, including illicit drugs coming across. There needs to be an investment in screening technology. And there needs to be a continued effort with China, trying to convince China to work with its chemical companies to stop selling the chemical precursors to the Mexican cartels so they can create the fentanyl,” he said.Bisch and others whose lives have been hit by the opioid epidemic are also keen to see broader reform of a system that enabled the drug companies to push mass prescription of opioids on the public in ways not permitted in other countries.Bisch supports Trump’s nomination for attorney general, Pam Bondi, who as Florida’s attorney general cracked down on doctors and “pill mills” churning out opioid prescriptions to anyone who would pay. In 2010, Florida dispensed more opioid prescriptions than every other US state combined as people travelled from across the country to buy the painkillers in bulk. Bisch wants to see Bondi use federal laws to prosecute the drug company executives who made false claims about the safety of prescription opioids in order to get them approved.He also backs Trump’s nomination of Kennedy, who has accused the FDA of putting the financial interests of the pharmaceutical industry ahead of people’s health by effectively encouraging the prescribing of too many drugs and the selection of Marty Makary to head the FDA. Makary has said doctors in the US prescribe too many medications compared with the rest of the world.“The best way to lower drug costs in the US is to stop taking drugs we don’t need,” he told the US Senate in September.In nominating Makary, Trump said the “FDA has lost the trust of Americans and lost sight of its primary goal as a regulator”. He said Makary and Kennedy would work together to “properly evaluate harmful chemicals poisoning our nation’s food supply and drugs”.Bondi is expected to have a relatively easy path to approval by the US Senate. But Kennedy and Makary may face a more difficult time. Kennedy, in particular, will face scrutiny over his rejection of vaccines. But Kolodny said they will also be up against the pharmaceutical industry.“I’ll actually be shocked if Kennedy gets confirmed and if Makary gets confirmed for FDA commissioner because big pharma doesn’t want them, and big pharma has a lot of muscle on Capitol Hill,” he said. More

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      Mexican president claims ‘no potential tariff war’ with US after call with Trump

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      Claudia Sheinbaum has said her “very kind” phone conversation with Donald Trump, in which they discussed immigration and fentanyl, means “there will not be a potential tariff war” between the US and Mexico.The president of Mexico spoke to reporters on Thursday following Trump’s threat earlier in the week to apply a 25% tariff against Mexico and Canada, and an additional 10% tariff against China, when he takes office in January if the countries did not stop all illegal immigration and fentanyl smuggling into the US.Trump, in a post on Truth Social on Wednesday, claimed that during the phone call with Sheinbaum she had “agreed to stop Migration through Mexico, and into the United States, effectively closing our Southern Border”.During her Thursday address Sheinbaum clarified she did not agree to shut down the border.“Each person has their own way of communicating,” Sheinbaum said. “But I can assure you, I guarantee you, that we never – additionally, we would be incapable of doing so – proposed that we would close the border in the north [of Mexico], or in the south of the United States. It has never been our idea and, of course, we are not in agreement with that.”She added that the two did not discuss tariffs, but that the conversation with Trump had reassured her that no tit-for-tat tariff battle would be needed in future.On Monday this week, Trump threatened to impose a 25% percent tariff on Mexico until drugs, including fentanyl, and undocumented immigrants “stop this Invasion of our Country”. He declared that Mexico and Canada should use their power to address drug trafficking and migration and, until they do, “it is time for them to pay a very big price!”The following day, Sheinbaum suggested Mexico could retaliate with tariffs of its own.On Wednesday, however, the conversation between Sheinbaum and Trump was “very kind”, the Mexican president said. She said she told Trump of the various migration initiatives her government has undertaken, including providing resources and support to central American countries and to migrants arriving in Mexico. Potential immigrants “will not reach the northern border, because Mexico has a strategy”, Sheinbaum said.Trump “recognized this effort” by the Mexican government, Sheinbaum added.She also said Trump expressed interest in the government-driven programs to address fentanyl addiction and overdoses in Mexico. And she raised the problem of American-made weapons entering Mexico from the US to be used by drug cartels.Sheinbaum further added that she encouraged Trump to stop the blockades against Cuba and Venezuela, since “people suffer and it leads to the phenomenon of migration”.Asked by a reporter from Rolling Stone magazine that quoted anonymous Trump-aligned sources discussing a “soft invasion” of Mexico by deploying the US military inside the country against drug trafficking groups, Sheinbaum dismissed the idea, calling it “entirely a movie”.“What I base myself on is the conversation – the two conversations – that I had with President Trump, and then, at the moment, the communication we will have with his work team and when he takes office,” Sheinbaum said. “We will always defend our sovereignty. Mexico is a free, independent, sovereign country – and that is above everything else.” More

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      US overdose deaths decreased in 2023 – will Trump continue this trend?

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      The Biden administration saw unprecedented levels of US opioid overdose fatalities, but those deaths are now declining faster than they have in decades – progress a second Trump administration could continue or threaten, experts say.The number of overdose deaths in the US declined for the first time in five years in 2023, and have continued to decline more rapidly this year, according to provisional data.Some of the decline may have resulted from Biden administration efforts to expand access to harm-reduction services, especially the overdose-reversal drug naloxone, which received over-the-counter approval for the first time last year. Public health experts worry that the second Trump administration will gut access to healthcare, including addiction treatment.The president-elect’s legacy on opioids is complicated. When Trump first took office, he inherited a rapidly escalating overdose crisis. Opioid overdose deaths more than doubled during the Obama administration,according to data from the Centers for Disease Control and Prevention. The three most recent presidential administrations have all failed to quell escalating opioid overdose deaths, which nearly doubled again during the Trump and Biden administrations, dipping slightly in 2018 but overall jumping by 62% during Trump’s first term in 2020. Under Biden, deaths increased by 19% from 2020 to 2022, to 81,806, before declining by 2% last year.At times, the Trump administration seemed to work against itself when it came to the crisis. For example, Trump repeatedly attempted to gut funding for the Office of National Drug Control Policy, although Congress blocked his efforts. Similarly, Trump was frequently in disputes with Congress over attempts to repeal elements of the Affordable Care Act and its expansions to Medicaid, which funds treatment for 40% of adults with opioid use disorder.Still, experts contacted by the Guardian within and outside the first Trump administration credit the president-elect for putting unprecedented focus on the crisis.Trump signed an executive order in 2017 forming the Presidential Commission on Combating Drug Addiction and the Opioid Crisis. Bertha Madras, a professor in Harvard’s psychiatry department who served on the commission, said it wasn’t until Trump “established the commission that a significant integrated national response materialized”.Adm Brett Giroir, who served as an assistant secretary in Trump’s Department of Health and Human Services, says that he was given the authority to head up an unofficial “opioids cabinet … which met every week at the White House under Kellyanne Conway to make sure every department was working on this crisis”.Others praise Trump for supporting harm-reduction efforts, despite past opposition from his party.“President Trump publicly supported syringe services programs, a first for a Republican president,” said Jerome Adams, who served as surgeon general under Trump. Indeed, the Trump administration in some ways paved the way for the Biden administration’s response to the crisis. Access to naloxone expanded significantly under Trump, and even more under Biden.But despite these efforts, the number of US overdose deaths climbed for the majority of Trump’s first term. Giroir and Madras both attribute the huge overdose spike in 2020 to the Covid-19 pandemic, which overwhelmed the healthcare system and increased depression and suicide.Andrew Kolodny, medical director for the Opioid Policy Research Collaborative at Brandeis University, says the administration should have done more.“The first time around, President Trump did an excellent job of calling attention to the opioid crisis and designating it as a public health emergency,” he conceded, but he also said the then president failed to take sufficient action or establish a long-term plan.While the Trump administration allocated unprecedented amounts of funding to combat the crisis, Kolodny said the impact was limited, because states were usually given funds in the form of one- or two-year grants.“That’s not really adequate for building out a treatment system that doesn’t exist yet,” Kolodny said. “If you were to hire a whole bunch of staff, what would you do if you don’t get that appropriation the next year? Do you lay everybody off?”skip past newsletter promotionafter newsletter promotionExperts disagree on whether the administration spent too much of that funding on law and border enforcement, rather than treatment. Giroir supported harm-reduction and treatment expansion during his time under Trump, and is proud of his efforts to remove red tape and increase access to the opioid-cessation drug buprenorphine. Still, he says, “enforcement has to dominate the discussion”, because treatment is less effective than preventing addiction in the first place.Other experts say that criminalization only exacerbates the crisis.“Under Trump’s previous administration, they federally criminalized all fentanyl-related substances in 2018 – and overdose deaths increased from 67,367 that year to 70,630 and 93,331 in 2019 and 2020 respectively,” said Kassandra Frederique, executive director of the Drug Policy Alliance.Kolodny didn’t necessarily agree that criminalization drove the overdose increases, but he did say “the balance should be different” when it comes to prioritizing treatment over law enforcement. He said the best way to immediately reduce the overdose death count would be to make treatment “basically free” and overall easier to access than fentanyl.“[People with opioid use disorder] are not out there using fentanyl because it’s so much fun. If they don’t use, they’re gonna be very, very sick … People can really feel like they’re gonna die,” he said.It’s hard to predict how Trump will tackle the overdose crisis the second time around. He avoided the topic during his recent presidential campaign, and instead focused on inaccurate talking points about immigrants trafficking drugs across the border. He also falsely claimed he had never wanted to repeal the Affordable Care Act. But a Republican-controlled Congress could cut ACA subsidies and Medicaid.Frederique worries that Trump will continue prioritizing drug arrests during his second term, but said during his first term “he also dedicated billions of dollars toward research, education, prevention and treatment. We are committed to supporting the Trump administration’s previous efforts to advocate for health approaches such as increasing access to treatment and naloxone.” More

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      Portland’s first ranked-choice vote elects progressive outsider as mayor

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      In 2022 it appeared the political winds in Portland, Oregon, one of the US’s most progressive cities, were beginning to shift. Residents who had grown frustrated over the city’s approach to homelessness rejected the incumbent, Jo Ann Hardesty – the first Black woman to serve on the city council – in favor of the “law-and-order” Democrat Rene Gonzalez, who pledged to back an expanded police force and “clean up” Portland.But this month, as swaths of the US electorate moved to the right, the Pacific north-west city took a markedly different approach. Residents elected the most diverse city council in Portland history, opting for more progressives, and rejected Gonzalez as mayoral candidate. Instead, they chose Keith Wilson, a businessperson who has never before held office and has promised to end unsheltered homelessness in a year.Wilson had large leads over his competitors in the election, the first in which the city used ranked-choice voting and in the latest results was leading the second place candidate 60% to 40%.The most conservative candidates for mayor and the county board, who took hardline stances, lost, Richard Clucas, a political science professor at Portland State University, pointed out.“Both were defeated significantly because Portland remains a very progressive city despite what people may have heard elsewhere,” Clucas said.The results came as the city was in the midst of what officials have described as a “once-in-a-generation” change to its government system and major voting reforms. This month, for the first time ever, Portland used ranked-choice voting to elect a mayor and a larger, more representative city council. The new officials will have different roles as Portland moves from a commission form of government to one overseen by a city administrator.Voters approved the overhaul two years ago – the same year Gonzalez won – as the city of 630,000 people grappled with a declining downtown, rising homelessness, a fentanyl crisis, growing public drug use and a sluggish recovery from the pandemic. Voters appeared to take out their dissatisfaction with crime, homelessness and drug use on Hardesty, the most progressive member of city council, said Ben Gaskins, a political science professor Lewis & Clark College in Portland.Some have speculated the city was beginning to recoil from its progressive values, particularly after voters in the county ousted the progressive district attorney for a challenger endorsed by police groups. That came shortly after Oregon moved to reintroduce criminal penalties for the possession of hard drugs, in effect scrapping the state’s groundbreaking drug decriminalization law.Claims the city is turning away from progressivism are significantly overstated, Gaskins said – instead, the shifts indicate an electorate that is more focused on tactical concerns rather than ideological ones.Gonzalez was widely considered a frontrunner in this year’s mayoral race. Calling it a “make-or-break election”, the commissioner said that as mayor he would add hundreds of officers to city streets and stop “enabling the humanitarian crisis on our streets by ending the distribution of tents and drug kits”.Wilson, who serves as the chief executive of a trucking company and founded a non-profit to expand shelter capacity and ultimately end homelessness, made the issue the center of his campaign, pledging to reform the city’s approach to alleviating the crisis. He insisted the issue could be addressed with “care and compassion”, the Oregonian reported, and said he would increase the number of night-time walk-in emergency shelters available in churches and community centers.That approach appealed to city voters, Clucas said, over harsher remedies. “They don’t simply want a crackdown, arrests and other things; they want to find some way to compassionately address it.”At a debate in October, Wilson said he would give city leaders an F for their efforts to address homelessness, according to the Oregonian. “Letting people suffer and die on our streets is unacceptable … I believe that every person in Portland deserves a bed every night,” he said.The progressive Carmen Rubio, a city council member, was also a frontrunner in the race. But she lost endorsements after reporting from the Oregonian revealed that she had received about 150 parking and traffic violations since 2004, many of which she failed to pay for months and years, and that she had her license suspended multiple times.skip past newsletter promotionafter newsletter promotionGonzalez’s campaign was hurt by reporting from the Willamette Week that showed the “public safety champion” had also received seven speeding tickets between 1998 and 2013, and had his license suspended twice.Wilson was once considered a long-shot candidate, but he was probably bolstered by the city’s new ranked-choice voting system, experts said.His position as a businessperson coming from outside the political system allowed him to be a “compromise candidate”, Gaskins said. Wilson fit the gap of someone who is progressive but still represents a change to the status quo, he said.“I think the fact Keith Wilson was able to win shows Portland wants someone who is clearly on the left but who is focused on policy solutions and getting things done versus just being the most ideologically pure candidate in the race,” he said.“He is a candidate of this particular moment.”In an acceptance speech last week, Wilson pledged to build trust and take advantage of a “transformative opportunity”.“It’s time to end unsheltered homelessness and open drug use, and it’s time to restore public safety in Portland,” he said. “Voters aren’t interested in pointing fingers. They just want us to get things done.”Along with Wilson, residents also elected 12 city councillors, nearly half of whom are people of color, Oregon Public Broadcasting reported – a remarkable shift given that just seven years ago, only two people of color had ever been elected to city government. At least four of the new councillors identify as LGBTQ+, the outlet reported, and five received endorsements from the Democratic Socialists of America chapter in Portland. More