“America’s public enemy number one in the United States is drug abuse. To fight and defeat this enemy, it is necessary to wage a new, all-out offensive.” -Richard Nixon, July 17, 1971
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Fifty-five years ago—on June 17, 1971—President Richard Nixon launched his drug war. While heroin and other drug use raised real public health concerns, Nixon’s response was also shaped by politics and social control. The drug war gave his administration a way to target communities it saw as political threats, including anti-war activists, Black communities, and people fighting for civil rights. In 1973, Nixon created the Drug Enforcement Administration (DEA) to centralize federal drug enforcement.
Today, President Trump says his tough-on-drugs agenda is a response to the fentanyl crisis and overdose deaths. But if the goal is to save lives, the focus should be on expanding access to treatment, overdose prevention, research, and other proven supports. Instead, the administration is cutting hundreds of millions in federal funding for programs that help prevent overdose, reduce drug-related harms, and support recovery. If fentanyl, overdose, and addiction are the concern, why cut funding for the solutions designed to address them?
The lessons of the past 55 years are clear. The drug war has expanded surveillance, arrests, and incarceration, all while drug use continues, treatment remains hard to access, the drug supply has become more dangerous, and millions have died from overdoses.
We spoke with Kassandra Frederique, Executive Director of the Drug Policy Alliance, about how Nixon’s drug war shaped the policies we see today, including the Trump administration’s emphasis on enforcement over care, the expansion of government power, and what it will take to protect the health and safety of communities across the U.S.
When it comes to Nixon’s legacy, the reality is impossible to ignore. His drug war promise was to curb addiction and stop the flow of drugs. Instead, generations of families have lost loved ones to overdose: parents, siblings, spouses, children, and friends. During the height of the overdose crisis from 2021-2023, we lost over 100,000 people a year in the United States. Last year, in 2025, we lost 70,000 people.
Fentanyl drove the overdose crisis. And one of the most difficult truths is that fentanyl became dominant after years of intensified crackdowns on prescription opioids and heroin, a reminder that supply-side enforcement can push the drug market toward more potent and dangerous substances. Meanwhile, lines for treatment can often be weeks- or months-long, especially in more rural areas of the U.S. Despite drug arrests being one of the leading causes of arrests today, the promise of the drug war remains unfulfilled: drugs are still available, people are still dying, and too many families still cannot get care when they need it.
But what drug enforcement has successfully done is expand the government’s power to police, search, surveil, punish, and exclude people, often with devastating consequences for human and civil rights. For example, using drugs as a pretext allows police to enter homes without warning (no-knock warrants), which has cost lives, as in the well-known case of Breonna Taylor in 2020. Today, this practice is used in new, horrifying ways. We are now seeing ICE bashing down car windows and doors, harassing, searching, and detaining people they claim are immigrants, often without warrants.
The consequences are not limited to an arrest. A drug conviction can follow someone for years, blocking access to basic needs every person needs to survive, like a job, safe housing, and public benefits like food assistance. In other words, the drug war has not only punished people for drug use. It has made it harder for people to rebuild their lives for themselves and their families.
Nixon’s drug war was deeply punitive and helped lay the foundation for decades of criminalization, although his administration also invested federal money in treatment and research. Trump’s version doubles down on that punitive legacy while making massive cuts to federal funding for treatment, overdose prevention, and basic health care.
Under Nixon’s presidency, federal funding for addiction science infrastructure was developed with the creation of the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and eventually, the National Institute on Drug Abuse (NIDA). The predecessor to the Substance Abuse and Mental Health Services Administration (SAMHSA) was created under the Nixon administration too.
Today, SAMHSA helps communities address drug-related concerns by funding treatment and prevention programs, supporting naloxone distribution to reverse overdoses, and expanding access to medications like methadone and buprenorphine that reduce cravings, withdrawal, and overdose risk. It also helps people, especially in rural and underserved communities, connect to care.
But the current administration is taking a different path: prioritizing enforcement and punishment while gutting the very health infrastructure that keeps people alive.
They have already cut hundreds of millions of federal dollars (and are proposing more) from treatment, prevention, and recovery programs (including SAMHSA), while also cutting one trillion dollars over ten years from Medicaid funding—the nation’s largest payer of addiction treatment. A recent analysis found that roughly 400 hospitals across the country could be at risk of closing or significantly reducing services because of these federal funding cuts, potentially limiting access to care in communities already struggling with addiction and overdose. They have also cut millions from NIAAA and NIDA that would have been used to conduct research on prevention, treatment, and harm reduction approaches.
There are real solutions to drugs, overdose, and addiction that our government should support: overdose prevention services, addiction treatment, affordable healthcare, drug-related research, and international diplomacy. But instead, the focus is often on enforcement practices that come with real implications for our collective rights and freedoms and can even be fatal.
The drug war has normalized tactics such as no-knock raids, allowing police to force entry into a person’s home without warning. While the Fourth Amendment generally protects people from unreasonable searches, no-knock and quick-knock warrants were deemed constitutional after several notable drug-related court cases. These raids can come in the middle of the night, may involve military-grade equipment, and often end in immense emotional distress and trauma, destruction of property, physical injury, and sometimes, death.
The human cost of these policies became painfully clear in 2020 when Breonna Taylor, a 26-year-old emergency room technician, was asleep in her apartment when police executed a late-night drug raid. Her boyfriend, believing intruders were breaking in, fired a shot, and officers responded with a barrage of gunfire that killed Taylor. No drugs were found in the apartment. Her death became a devastating example of how aggressive drug war tactics can turn an ordinary home into a deadly battlefield.
Today, the administration is using the drug war to expand U.S. military power across the Americas. By labeling fentanyl a “weapon of mass destruction” and declaring a “war on cartels,” the administration is giving itself permission to kill at will without evidence or authorization. Since 2025, Trump has ordered illegal strikes on boats in the Caribbean and eastern Pacific, killing more than 200 people. The administration calls them “narcoterrorists,” but families, local officials, and journalists have challenged those claims, pointing out some of the men killed were fishermen, trafficking victims, or workers trying to make a living.
Even if drugs were on those boats, people are entitled to arrest, investigation, and trial, not execution at sea. Coastal communities are struggling to identify remains that wash ashore, while many others remain missing at sea. Local economies that rely on boating have been shut down out of fear that the U.S. government may decide their boat looks suspicious enough to destroy. And this isn’t solving the overdose crisis. Fentanyl largely enters through the U.S.-Mexico border, not these waters.
That is what the drug war has always done at its worst: turn suspicion into a death sentence and then ask the public to accept it because drugs are involved.
The drug war has normalized cruel and inhumane healthcare practices because people who use drugs and those with addictions are seen as a threat, not as human beings with rights.
One example that really angers me is when incarcerated pregnant women, including those with drug convictions, are routinely shackled to their bed while they give birth. This cruelty is now being used in ICE detention centers today, even though it can negatively impact the health of both mothers and their babies.
The drug war has also embedded itself into medical care. For example, someone with opioid use disorder may have a doctor’s prescription for buprenorphine. But if they are in a court-mandated drug program, a judge may have the final say over whether they can take that medication—regardless of their doctor’s professional opinion. That means a medical decision about addiction treatment can be overruled by a courtroom. Medications for opioid use disorder, including methadone and buprenorphine, reduce cravings, ease withdrawal symptoms, and significantly lower the risk of overdose death. Without them, a person can be forced into painful and intense withdrawal: sweating, shaking, vomiting, diarrhea, body aches, insomnia, and panic. If the person is pregnant, this withdrawal can lead to pregnancy complications. Forcing someone through that pain when safe, effective medication exists is not accountability; it’s inhumane.
The drug war has been used to strip people of the basic necessities they need for a healthy and full life. A drug conviction can be used to deny housing, deny employment, or even food stamps. If someone can’t eat, doesn’t have a stable place to live, can’t get a job, and has no autonomy over their healthcare, how do we expect them to be stable, to thrive, to recover?
One of the promises of the drug war was to stop the flow of drugs. Instead, it’s led to stronger, more potent drugs, including fentanyl. If the drug war achieved its goal, fentanyl would never have emerged in the street drug supply.
After prescription opioid crackdowns, people dependent on opioids turned to the streets to ease painful withdrawals. The illegal drug market responded by mixing fentanyl with heroin and counterfeit pills. People with minor roles in the drug trade are most often criminalized, but the supply chain continues as they’re easily replaced.
Now, as overdose deaths are starting to decline due to health, harm reduction, and overdose prevention efforts, crackdowns on fentanyl continue with harsher sentencing and increased international attacks in the name of enforcement, like the illegal boat strikes in the Caribbean that have killed 200 people. But as we saw before, these crackdowns are leading to the emergence of new drugs, like nitazenes, which can be up to five times more potent than fentanyl, and xylazine, which can cause hard-to-treat open wounds. These emerging drugs can increase the risk of overdose, infections, painful abscesses, heart disease, and other serious health issues. And recent federal funding cuts to drug research are making it harder for scientists’ ability to track these risks and develop lifesaving treatments.
For decades, drug war policies have prioritized enforcement over care, and government power over people’s rights. The harms of the drug war have only added to the harms that can come from drugs themselves. After 55 years, the lesson is clear: we need a different approach, one rooted in health, dignity, safety, and rights.
We need policies that support what actually works to address drug harms and keep people safe and alive. Fewer people are dying of overdose in the last few years, and health-based solutions are a huge reason why. That means expanding access to proven medications like methadone and buprenorphine, which reduce cravings, withdrawal, and overdose risk; naloxone, which can reverse otherwise fatal overdoses; and fentanyl test strips, which help people make safer choices. It also means investing in drug education without stigma, overdose prevention centers that respond to active overdose and connect people to care, and crisis response teams led by trained social workers and outreach workers who can quickly respond to public drug use and other community concerns without criminalizing people.
We need policies that ensure everyone’s fundamental rights are respected and restored. We need to end policies that allow suspicion of drug involvement to become a possible death sentence, such as no-knock and quick-knock raids that allow police to barge into homes without warning. We need to ensure people’s healthcare decisions rest with themselves and their doctors, not a judge in a courtroom. And we need to make sure that people’s ability to live full and stable lives – to get a job, have a place to live, and even have food to eat – can never be stripped away by a drug conviction.
Finally, when it comes to international drug enforcement, we need policies that prioritize diplomacy and cooperation, not more conflict. Heavy-handed enforcement approaches, which often involve violent conflict at home and abroad, have not stopped the flow of drugs into our communities. In fact, supply-side enforcement can push the drug market toward more potent and dangerous substances. Fentanyl emerged after crackdowns on prescription opioids and heroin, for example. In recent years, U.S. diplomatic coordination with China has proved far more effective. Convincing China to target illegal online sales of fentanyl precursors led to less fentanyl being produced, a less potent drug supply, and, alongside proven health solutions, contributed to the decrease in fatal overdose.
For more than 25 years, DPA has been fighting to end the drug war and build something better in its place. A world where people can get care when they need it. Where freedom belongs to all of us. Where we respond to drug use and drug harms with on-demand care, compassion, and real solutions, not more punishment.
DPA has current campaigns to restore people’s rights and invest in health approaches, not punishment.