In his first year back in office, President Donald Trump significantly changed U.S. drug policy regarding fentanyl, dismantling initiatives established by the Biden administration that aimed to expand drug treatment services. Experts have noted that the public health strategies implemented during Biden's tenure were credited with saving tens of thousands of lives. However, Trump has shifted the focus to a militarized approach, declaring an 'all-out war' on drug dealers and traffickers.

Trump's administration has undertaken military actions, including U.S. Naval strikes against alleged drug boats and designating drug cartels as terrorist organizations. Additionally, fentanyl has been classified as a 'weapon of mass destruction.' The administration has also deployed National Guard troops in urban areas and along the U.S.-Mexico border. In contrast, support for federally funded addiction treatment programs has been called into question, with a temporary freeze on $140 million in federal grants impacting front-line care providers.

Trump has criticized the Biden administration's efforts to reduce fentanyl deaths, claiming they were ineffective. While fentanyl-related deaths did rise during the early years of the Biden administration, there was a notable decline in fatal overdoses in 2023 and 2024, attributed to expanded access to opioid treatment medications and increased federal funding for addiction services. The Biden administration's 'harm reduction' approach has included providing Medicaid health insurance and housing support to individuals with substance use disorders.

Data from the Centers for Disease Control and Prevention indicates a nearly 27 percent decrease in fatal overdoses during Biden's last year in office. Experts have pointed out that the Medicaid expansion has played a crucial role in increasing treatment access. However, Trump's administration has proposed significant cuts to Medicaid funding, including programs that support addiction care, raising concerns about a potential resurgence in overdose deaths.

The Biden administration's diplomatic efforts, particularly with China, have also been noted for their role in disrupting the flow of fentanyl precursor chemicals into the U.S. Despite this, Trump has dismissed these achievements, suggesting that the fentanyl crisis was exacerbated by negligence or incompetence.

Trump's administration has made claims regarding the scale of the fentanyl crisis that have been challenged by researchers. For instance, the assertion that fentanyl-related deaths justify a militarized response has been met with skepticism, as federal data indicates that drug deaths peaked at approximately 115,000 in a 12-month period, not the inflated figures suggested by Trump.

Moreover, the U.S. Drug Enforcement Administration has reported that the majority of fentanyl trafficking into the U.S. is conducted by drug gangs in Mexico, not from Venezuela, which raises questions about the effectiveness of military strikes in addressing the root causes of the crisis. Critics have expressed concern that the mixed signals from the Trump administration, including pardons for individuals involved in drug trafficking, undermine the stated goals of a tougher stance on drug-related crime.