strategy

The White House’s newly released strategy for tackling the nation’s drug and addiction crisis calls for a number of ambitious public health approaches that some experts say are laudable but will be hampered by the administration’s own actions.

The sweeping 195-page National Drug Control Strategy, published May 4, advocates for making access to treatment easier than getting drugs, preventing young people from developing addictions in the first place, increasing support for people in recovery, and reducing overdose deaths.

Those broad goals are widely supported by public health researchers, addiction treatment clinicians, and recovery advocates.

But accomplishing such goals will be difficult in the face of the administration’s mass layoffs of federal employees, cancellation of research and community grants, attacks on organizations and practices that serve people who use drugs, and cuts to Medicaid, the state-federal health insurance program for low-income people that is the largest payer for addiction and mental healthcare nationwide.

Many components of the National Drug Control Strategy are “things that we would agree with and that we fully support,” said Libby Jones, who leads overdose prevention efforts at the Global Health Advocacy Incubator, a public health advocacy group.

But there are “disconnects in what the strategy says is important and then what they’re actually going to fund,” she said of the Trump administration. “Those inconsistencies feel particularly loud in this strategy.”

The White House’s National Drug Control Strategy, released every two years, is a touchstone document meant to lay out the federal government’s coordinated approach to what in recent decades has been one of the country’s defining problems.

Since 2000, more than 1.1 million people have died of drug overdoses. Although deaths have decreased recently, the numbers remain elevated compared with earlier decades, and research suggests overdose death rates among Black Americans and Native Americans are disproportionately high.

The strategy document published this week is the first of President Trump’s current term. In keeping with the administration’s approach to addiction issues, it places heavy emphasis on law enforcement efforts to reduce the supply of illicit drugs. The document repeatedly refers to the ongoing “war” against “foreign terrorist organizations” — the Trump administration’s term for drug cartels — and touts increased enforcement at U.S. borders.

It also outlines plans to implement artificial intelligence technologies to screen for illicit drugs brought into the country and wastewater testing to detect illegal drug use nationwide.

The second half of the strategy focuses on reducing the demand for drugs through public health prevention efforts, addiction treatment, and support for people in recovery. It promotes the role of religion in recovery and calls for the widespread use of overdose reversal medications, such as naloxone.

In a news release, the White House’s Office of National Drug Control Policy called the document a “roadmap” that will “continue dismantling the drug supply and defeating the scourge of illicit drugs in our country.”

The Trump administration did not respond to requests for comment about how the strategy aligns with its other actions.

In December, Trump signed a reauthorization of the SUPPORT Act, which continues several grants related to treatment and recovery and the requirement for Medicaid to cover all FDA-approved medications for opioid use disorder. In January, he announced the Great American Recovery Initiative, including a $100-million investment to address homelessness, opioid addiction, and public safety.

However, few details have been provided about the initiative, and in January, about a month after the SUPPORT Act passed, billions of dollars in addiction-related grants were abruptly terminated and reinstated within a frantic 24-hour period.

That “whiplash” left “a sense of instability and uncertainty in the field,” said Yngvild Olsen, a national adviser with the Manatt Health consultancy. She led substance use treatment policy at the Substance Abuse and Mental Health Services Administration, or SAMHSA, under the Biden administration and left about six months into Trump’s second term.

That insecurity was exacerbated by the president’s 2027 budget request, which proposes cuts to several addiction and mental health programs and the consolidation of key federal agencies working on those matters. Jones’ group and nearly 100 others in the field have signed a letter asking Congress to reject the proposals, as it did with similar requests last year.

The national drug strategy adds new, potentially contradictory information to this confusing landscape.

Increasing Access to Treatment

One of the most significant public health goals in the strategy, mentioned at least half a dozen times, is to make it easier to get treatment than it is to buy illegal drugs.

National data underscores the necessity: More than 80% of Americans who need substance use treatment don’t receive it.

The administration’s actions on health insurance may make it difficult to improve that statistic.

Medicaid is the main source of healthcare coverage for adults with opioid use disorder. When implemented, the Medicaid work requirements in Trump’s One Big Beautiful Bill Act are projected to strip that coverage from about 1.6 million people with substance use disorders.

The last time Medicaid rolls were purged — after COVID-era protections expired — many people who had been receiving medication treatment for opioid addiction stopped it and fewer people started treatment, according to a study published last year.

Olsen, who is also an addiction medicine doctor, said she loves the strategy’s emphasis on making treatment readily available to anyone who wants it. But she said that’s “hard to really imagine when now people may have to pay for it themselves because they may be losing their Medicaid insurance coverage.”

One analysis estimated the upcoming Medicaid changes could lead 156,000 people to lose access to medications for opioid use disorder and result in more than 1,000 additional fatal overdoses per year.

People with private insurance may be affected too.

The Trump administration has refused to enforce Biden-era regulations aimed at bolstering mental health parity, the idea that insurers must cover mental illness and addiction treatment comparably to physical treatments. And recently, the administration said it would redo those regulations altogether, raising fears that addiction treatment could become increasingly unaffordable.

The administration did not respond to specific questions about how it reconciles its actions on Medicaid and parity with the goal of increasing treatment.

Prioritizing Prevention

The strategy highlights preventing addictions before they begin as one of the keys to reducing demand for drugs. It calls for “promoting a drug-free America as the social norm” and implementing school and community-based programs that are backed by science.

“Investing in primary prevention, before drug use starts, saves lives and resources,” it says, citing several studies about the cost-effectiveness of such programs.

Yet, the president’s budget proposes cuts to these types of programs, and federal layoffs have decimated the agencies that would implement such work.

The White House’s most recent budget request proposes cutting roughly $220 million from SAMHSA’s Center for Substance Abuse Prevention and nearly $40 million from the Drug-Free Communities program.

Since the new administration started, SAMHSA has lost about half of its staff, and the Centers for Disease Control and Prevention is down about a quarter.

“It’s not clear to me that they’re really going to be able to have the funds or the people to be able to carry that out,” Olsen said of the strategy’s prevention goals.

Another wrinkle appears in the strategy’s discussion of marijuana. The document points to marijuana use as one of the drivers of increasing drug use disorders and reports that “convergent evidence from multiple sources” suggests cannabis use increases the risk of psychosis. It calls for developing new tools to treat marijuana withdrawal and addiction.

However, just two weeks ago, the White House moved to reclassify medical marijuana to a lower tier of scheduled substances and is moving to hold a hearing to do the same for marijuana broadly.

“The administration, on the one hand, is moving in a direction of liberalizing access to cannabis,” Jones said, “but at the same time, in the strategy, it talks about the dangers of doing so.”

“There’s a disconnect there that just makes you question: Which one do you believe?” she added.

The administration did not respond to specific questions about its marijuana policies.

Stopping Overdose Deaths

One of the more surprising elements of the National Drug Control Strategy comes in the last paragraph of the final chapter. It focuses on public drug-checking programs, which often involve using test strips to help people who use drugs determine whether there are more-dangerous substances, such as fentanyl or xylazine, in the batch they bought. That helps them determine whether or how to safely use those drugs.

“Rapid test strips and similar technologies that detect fentanyl and other drugs are an important tool that should be legal,” the strategy document says.

However, SAMHSA announced in a recent letter that it would no longer pay for test strips, as part of the Trump administration’s “clear shift away from harm reduction and practices that facilitate illicit drug use.”

The administration has similarly attacked harm reduction programs in an executive order and its budget requests. It did not respond to specific questions about how this position interacts with the drug control strategy.

Regina LaBelle, a Georgetown University professor who served as acting director of the Office of National Drug Control Policy during the Biden administration, wrote about the contradiction in a blog post: “It is the height of rhetoric over reality to champion a tool while simultaneously cutting off the funding used to acquire it.”

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WASHINGTON — When Homeland Security Secretary Markwayne Mullin was questioned by senators during his confirmation hearing about his vision for implementing President Trump’s mass deportation agenda, he said his goal was to keep his department off the front pages of the news.

To some degree, he has. Gone are the social media video clips of now-retired Border Patrol commander Greg Bovino clashing with protesters. Mullin’s predecessor, Kristi Noem, made her first trip as secretary to New York City to make arrests with Immigration and Customs Enforcement. In contrast, Mullin went to North Carolina to review hurricane recovery efforts.

The Republican administration appears to be recalibrating its approach to a centerpiece policy that helped bring Trump back to the White House, moving in many ways away from aggressive, public-facing tactics toward a quieter approach to enforcement. Despite that shift, the administration insists it is not backing down from its lofty deportation goals.

“Clearly they’ve stepped back from the, for want of a better word, the Bovinoist tactics of before,” said Mark Krikorian, the president of the Center for Immigration Studies, which advocates for immigration restrictions. “But it’s not clear this means they’re actually stepping back from immigration.”

The Trump administration launched a series of immigration enforcement operations last year in mostly Democratic-led cities, which drove up arrests in large-scale sweeps. The crackdown sparked clashes between protesters and enforcement officers and led to the shooting deaths in Minneapolis of two U.S. citizens.

Since then, the president’s hard-line anti-immigration agenda has lost popularity with voters and there have been no new high-profile city-based operations launched, raising questions about the administration’s strategy.

“We’re still enforcing immigration laws. We’re still deporting illegals that shouldn’t be here. We’re still going after the worst of the worst — but we’re doing it in a more quiet way,” Mullin said in an interview April 16 with CNBC.

Immigration arrests have dropped, but deportation goals remain

ICE arrests have fallen in recent months, and the number of people in immigration detention has dropped from a high of roughly 72,000 in January to 58,000 this week, according to data obtained by The Associated Press.

But in a sign of its continued determination, ICE in budget documents says it plans to remove 1 million people this fiscal year and the next compared with roughly 442,000 people last year. The agency also has plenty of money to carry out its mission, with Congress granting the Department of Homeland Security more than $170 billion for Trump’s immigration agenda last year.

The administration aims to have enough space to detain roughly 100,000 people this fiscal year, which would more than double the average daily number held in ICE detention last year. The administration has already expanded its detention capacity with the purchase of 11 warehouses across the country.

“They are working on really building a juggernaut of a system,” said Doris Meissner, who headed the U.S. Immigration and Naturalization Service, a predecessor to ICE, during President Bill Clinton’s Democratic administration and is now a senior fellow at the Migration Policy Institute.

White House spokesperson Abigail Jackson said there had been no change to Trump’s strategy.

“President Trump’s highest priority has always been the deportation of illegal alien criminals who endanger American communities,” Jackson said.

ICE did not respond to repeated requests for comment.

Stripping away legal protections to ramp up deportations

Advocates for immigrants are bracing for the Trump administration to turn its attention more intently to stripping away protections for migrants with temporary legal status to remain in the U.S. while their cases are being adjudicated.

In one example of this, the number of green cards approved by U.S. Citizenship and Immigration Services dropped by half over the course of a year under the Trump administration, according to an analysis by the Cato Institute, which supports immigration into the U.S. Humanitarian visas for refugees or people who qualified for asylum saw the biggest declines.

USCIS spokesman Zach Kahler said the drop was due to increased vetting of applicants by the administration.

The Trump administration has also pushed to strip Temporary Protected Status from hundreds of thousands of people, with a key case weighing whether it’s overstepped its power to do so being heard at the Supreme Court this week.

Advocates see it as a way to send a chilling message to immigrant communities and make more people vulnerable to deportation. It also enables the department to operate without the public spectacle of workplace raids or home arrests.

ICE has also focused over the past year on creating agreements with jurisdictions around the country that allow local and state law enforcement to carry out an expanding array of immigration enforcement tasks, ranging from checking the immigration status of people in their jails to incorporating immigration checks during routine traffic stops.

These agreements, known as 287g, have grown from 135 in 20 states before Trump took office to more than 1,400 in 41 states and territories now.

Some states, most noticeably Florida and Texas, have mandated various forms of cooperation between local law enforcement and ICE.

Meissner, from MPI, said Trump’s border czar, Tom Homan, is likely to prioritize further discussions about how cities and states can cooperate with ICE.

“At the end of the day, some of this may very well succeed in increasing the numbers,” Meissner said.

Calls to enforce work restrictions

Conservatives who want more deportations say the only way to truly crack down on illegal immigration is to make it so difficult for the migrants to work that they’ll leave on their own.

The Trump administration has already taken steps to make life harder for people in the country illegally including limiting who can live in public housing by immigration status, sharing Medicaid information with ICE and requiring people in the country illegally to register with the federal government.

Krikorian, of the Center for Immigration Studies, said the Social Security Administration could send out letters alerting employers when an employee’s name doesn’t match their Social Security number. Authorities could repeatedly and consistently carry out audits of I-9 forms, which companies are supposed to fill out and submit to the federal government showing that new hires are legally able to work. And they could require banks to collect citizenship information on customers.

Whatever the strategy going forward, the administration is facing heavy pressure not to back away from its goals.

“The numbers are too low,” said Mike Howell, part of the Mass Deportation Coalition, which launched a playbook for how the administration can actually get to a million deportations a year by using tactics such as worksite enforcement.

“The deportation numbers are just too low,” Howell said, “and they need to be much higher, and they can be much higher.”

Santana writes for the Associated Press. AP writers Lisa Mascaro and Will Weissert contributed to this report.

April 29 (Asia Today) — China expressed opposition Wednesday to Japanese Prime Minister Sanae Takaichi’s “free and open Indo-Pacific” initiative, calling it an attempt to promote bloc confrontation.

Chinese Foreign Ministry spokesman Lin Jian made the remarks at a regular briefing in response to reports that Takaichi may present a revised Indo-Pacific strategy during a visit to Vietnam this weekend.

“Exchanges between countries should not target a third party or harm the interests of a third party,” Lin said. “Japan uses the slogan of being ‘free and open,’ but in reality it is stirring up confrontation between camps and creating a small, exclusive group.”

Lin said such actions run counter to the shared desire of regional countries and the international community for peace, development and cooperation.

“They will be difficult to win support,” he said.

According to Japan’s Foreign Ministry, Takaichi is scheduled to visit Hanoi on Friday and meet with To Lam, general secretary of the Communist Party of Vietnam, and Prime Minister Le Minh Hung.

Diplomatic sources in Beijing said the talks are expected to focus on strengthening the two countries’ comprehensive strategic partnership, including in economic security fields such as energy, critical minerals and science and technology.

Takaichi is also expected to deliver a speech outlining Japan’s foreign policy direction, including its Indo-Pacific strategy, around the time of the meetings.

— Reported by Asia Today; translated by UPI

© Asia Today. Unauthorized reproduction or redistribution prohibited.

Original Korean report: https://www.asiatoday.co.kr/kn/view.php?key=20260429010009593

WASHINGTON — Polls show that record numbers of Americans think the country is on the wrong track. Anxious voters find no shortage of corroboration. Seeming proof of national decline is everywhere–the savings-and-loan bailout, an imperial Congress, overpaid executives at the top of underperforming companies, record murder rates in cities, declining school quality, an intractable drug epidemic, spiraling health-care costs and a flat economy riddled with deep pockets of regional recession. We haven’t felt good about ourselves, our country or our future since the Gulf War.

President George Bush’s decline in the polls mirrors this trend. As long as voters were concerned about foreign policy, his high standing compensated for lower ratings on domestic affairs. The Cold War’s end has changed the issue mix of presidential races forever.

The recession is an immediate problem, but that will decline in importance when the growth most economists predict resumes this spring. But the recession masks a deeper fear that our post-Cold War inheritance is a declining standard of living, with high-paying jobs and prosperity flowing overseas. That fear will not recede quickly.

With the recession ending by spring, campaign planners will be tempted to heave sighs of relief and run a status-quo candidacy against the uncertainties of a switch to the Democrats. That would be a serious mistake.

For Bush will never have more fertile ground to lay out a new GOP agenda that addresses the deep fear voters have about the future of America. He can capitalize on the public’s thirst for certainty by laying out a set of ambitious goals–in government, in jobs, in schools and in social progress.

He can start with government. A recent Gallup poll shows 20% blame Bush for the economy’s condition, but 54% blame Congress. Support for term limits and a Trumanesque campaign to fix what’s wrong with Congress will not only pay political dividends, but give him a governing coalition for a second term. Beginning with this week’s State of the Union, Bush should challenge Congress to pass his economic recovery program within 100 days and return it to him for signature. He should also push legislation on health-care reform, education and crime by similarly challenging Congress. To dramatize the push for excellence, he might consider national middle-class merit scholarships for college.

Nor should he give up on trade, despite the Japan trip. Presidential involvement in a few trade confrontations will make his claim to fight for American jobs more credible. Where unfair trading practices are found, executive action on import relief should be swift.

By establishing his vision for the post-Cold War future, contrasting his own activism with Democratic and congressional obstruction, showing that he thinks free trade should benefit us as well as our partners and fighting hard for the middle class–in essence charting a course the country thinks takes us in the right direction and gets us off the wrong track–he’ll win not only reelection but a mandate.

It’s also important to understand this is not the 1984 reelection. Compression of the primary calendar means there are fewer days between the first Iowa caucuses, Feb. 10, and Super Tuesday, March 10, and the Democratic winner-take-all rules could give a front-runner enough momentum to be the apparent nominee by April. There is little prospect for a protracted Democratic primary battle like 1984’s between Gary Hart and Walter F. Mondale.

Because the Democrats won’t be tearing each other apart as long, Bush should engage the Democrats early. But he needs to shore up his own vulnerabilities before he begins to contrast with the Democratic nominee. He needs to sharpen his middle-class message, starting with the economy and people’s fears about the future.

This should be done well before the summer Democratic convention, when the Democratic ticket will have a solid week of national television coverage to engage in Bush-bashing.

It’s also critical to understand this is not 1988. The Democratic nominee will also have learned a lesson from Michael S. Dukakis–define your candidacy before your opponent gets a chance to define it negatively for you. It’s highly unlikely the ’92 Democratic nominee will be kept on the defensive for months as was Dukakis.

This year’s presidential election takes place in politically uncharted territory. It is the first contest of the post-Cold War era, probably the last election with a World War II veteran running for President. World events, from Eastern Europe’s velvet revolutions of 1989 to last summer’s failed Soviet coup, have irrevocably reshaped America’s political landscape.

Foreign policy and defense no longer matter much to voters. Communism’s death also buried anti-communism as an issue. With few external threats, Americans see old relationships through a new prism. They supported the post-war alliance with Japan for mutual security; without the Cold War, that same relationship looks one-sided.

To win reelection, it’s critical to understand what this dramatic shift means. The old rules are gone–now is the time for a new political order in American campaigns. For four decades, we’ve elected presidents against a Cold War backdrop. Now that we’ve won the Cold War, we need a new presidential agenda that’s relevant for the ‘90s.

This is a very similar situation to the one that surrounded Red Bull’s former head of strategy, Will Courtenay, who is now McLaren’s sporting director.

It emerged at the 2024 Singapore Grand Prix that Courtenay had signed to join McLaren when his contract ended, and Red Bull emphasised that he would not be allowed to leave before 2026.

They did not specify exactly when in 2026, and BBC Sport has been told that negotiations were held that led to him starting work at McLaren on 1 January this year.

Despite that, for the entirety of last year, Courtenay stayed in his previous role, even though Red Bull were fighting McLaren for the drivers’ championship.

For now, the same thing will happen with Lambiase – he will continue in his role as Red Bull’s head of racing and race engineer to Verstappen for the foreseeable future.

However, just because Red Bull’s statement announcing his departure said he would not be joining McLaren until 2028 does not necessarily mean that will be the case.

McLaren’s statement said Lambiase would join “no later than 2028”. That means they will be hoping to come to an agreement with Red Bull that shortens that timeframe.

It’s worth pointing out, meanwhile, that McLaren have emphasised that Lambiase is joining to provide support for team principal Andrea Stella, not ultimately replace him.

Stella has until now been fulfilling the role to which Lambiase has been appointed, that of chief racing officer, in addition to that of team principal.

Stella said last week: “Zak (Brown, the chief executive officer of McLaren Racing) and I have built a flat team structure, in which it is essential to ensure all leaders are properly empowered, but at the same time, we must guarantee there is always the necessary level of long-term support.

“It goes without saying that, with this approach, the dual role I currently hold could not be sustainable in the long run.”

McLaren have indirectly – but very clearly – rejected what are said to be inaccurate reports that Stella is on his way to Ferrari.

Stella said in a statement issued by McLaren on Friday: “Some of the recent rumours, including those regarding astronomical salaries and mythical pre-contracts, have made me smile.

“It almost seems as though the ‘silly season’, which usually begins before summer, has arrived early!

“I’m quite used to this sort of thing by now and I take with a smile. It almost looks as if some envious pastry chef has tried to spoil the preparation of a good dessert at the McLaren patisserie. However, we do know very well how to distinguish the good ingredients from the poisoned biscuits.”