Health
Trump’s Focus on Punishing Drug Dealers May Hurt Drug Users Trying to Quit
President Trump has long railed against drug traffickers. He has said they should be given the death penalty “for their heinous acts.” On the first day of his second term, he signed an executive order listing cartels as “terrorist organizations.”
But many public health and addiction experts fear that his budget proposals and other actions effectively punish people who use drugs and struggle with addiction.
The Trump administration has vowed to reduce overdose deaths, one of the country’s deadliest public health crises, by emphasizing law enforcement, border patrols and tariffs against China and Mexico to keep out fentanyl and other dangerous drugs. But it is also seeking huge cuts to programs that reduce drug demand.
The budget it submitted to Congress this month seeks to eliminate more than a billion dollars for national and regional treatment and prevention services. The primary federal agency addressing drug use, the Substance Abuse and Mental Health Services Administration, has so far lost about half its workers to layoffs under the Trump administration and is slated to be collapsed into the new Administration for a Healthy America, whose purview will reach far beyond mental illness and drug use.
And if reductions to Medicaid being discussed by Republicans in Congress are realized, millions of Americans will be unable to continue, much less start treatment.
The White House did not respond to requests for comment. The budget itself says that ending drug trafficking “starts with secure borders and a commitment to law and order” and that it is cutting addiction services deemed duplicative or “too small to have a national impact.”
Those cuts are agonizing, public health experts say, because they come just as the country is making sustained progress in lowering the number of fentanyl deaths. Many interventions may be contributing to that progress, including greater availability of the overdose reversal spray naloxone; more treatment beds, sober housing and peer counseling; and declines in the strength and quantity of the illicit drug supply, they say. But studies so far have not demonstrated convincingly which of those factors merit greater focus and investment.
“It would be a tragedy if we defund these programs without fully understanding what’s working and then our overdose rate starts to climb again,” said Dr. Matthew Christiansen, an addiction medicine physician in Huntington, W.Va., a city once labeled ground zero for the opioid crisis.
A letter signed by more than 320 behavioral medicine academic experts, sent Monday to congressional leaders, decried the cuts, including those to “community-based naloxone distribution, peer outreach programs, drug-use-related infectious disease prevention programs and drug test strip programs.”
The president’s budget calls for ending grants for “harm reduction,” a strategy to prevent disease transmission and keep drug users alive that has become largely accepted by mainstream addiction treatment providers.
The budget derides federal financial support for “dangerous activities billed as ‘harm reduction,’ which included funding ‘safe smoking kits and supplies’ and ‘syringes’ for drug users.”
That language is a callback to false reports in 2022 that a $30 million federal harm reduction grant could be used to purchase pipes for smoking crack and meth. In fact, a small portion of that grant, designated for “safer smoking kits,” was for supplies like alcohol swabs and lip balm. The grant also supported programs in states that permit sterile syringe exchanges, effective in reducing hepatitis C and H.I.V. infection rates.
“You can’t just tell people to stop using drugs with a snap of the fingers,” said Dr. Christiansen, a former director of West Virginia’s drug control policy. “These are tools to reduce the harm of opioids while also helping them be successful long-term.”
According to the federal agency’s annual survey of substance use, in 2023, 27.2 million Americans ages 12 or older had a drug use disorder, 28.9 million had alcohol use disorder, and 7.5 million had both.
The budget does leave intact block grants for states to combat addiction and mental illness. But without the agency’s additional grants, hands-on training and monitoring, in addition to possible Medicaid reductions, states will not be able to afford the many medical and social services required to prevent and treat addiction, Dr. Christiansen said.
David Herzberg, a professor of drug policy and history at the University at Buffalo, said that Mr. Trump’s almost single-minded linking of the nation’s drug problems with border issues harks back to late 19th-century America, when the government associated opium dens with Chinese immigrants. Fearing the incursion of Chinese workers and inflamed by press reports of Chinese men using opium to lure young white women into prostitution, Congress severely restricted Chinese immigration.
Then as now, Mr. Herzberg said, political conservatives found that targeting foreign drug suppliers was a muscular means of advancing broader agendas.
In contrast with highly publicized drug seizures, people who chronically use drugs have become afterthoughts, usually visible only as street irritants, their addiction perceived to be the result of their own choices, he said. Elected leaders who advocate for their welfare risk being tarred as soft on crime.
“If politicians are going to stick their necks out for them, I would be shocked,” Mr. Herzberg said.
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Just four minutes of daily strength exercises can dramatically improve mobility, balance and leg strength in older adults, per new research from the Penn State College of Medicine.
Standard public health guidelines recommend at least 150 minutes of moderate exercise per week. However, the study suggests that fewer than one in five older adults meet the recommended muscle-strengthening guidelines.
The research team designed a home-based program called Functional Activity Strength Training, or FAST-2. They evaluated 97 sedentary participants 65 and older, with an average age of 74.
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Before entering the study, these individuals were averaging just 18 minutes of total physical activity each week.
The older adults were randomly split into two groups, with one group performing the daily exercise routine and the other serving as a control group that received no intervention, according to the study’s press release.
Just four minutes of daily home strength training can significantly improve mobility, balance and leg strength in older adults, according to a Penn State College of Medicine study. (iStock)
Participants performed four basic movements for 30 seconds each, separated by 30-second rest intervals. The entire routine lasted exactly four minutes. The circuit consisted of push-ups, chair stands, two-arm resistance-band rows and stair stepping.
To keep the routine accessible, researchers provided written explanations and simple modifications. For example, participants could perform push-ups against a kitchen counter or wall, or use their hands on their knees for support during chair stands.
Participants were also given four elastic resistance bands and an adjustable step platform.
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“Exercise is actually really complicated, because you have to decide how many repetitions, how far, how many sets, how much rest and how many times per week,” co-author Smita Dandekar, associate professor of pediatrics at Penn State College of Medicine, said in the press release.
“It’s hard work … so if we can make it short, we’re part [of the] way there.”
The program consisted of four basic movements: push-ups, chair stands, resistance-band rows and stair stepping. (iStock)
As the participants grew stronger, they were encouraged to progress to higher levels of difficulty, such as transitioning away from modifications or increasing the height of the stepper.
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After 12 weeks, the results suggested that a tiny dose of regular exercise could yield noticeable physical benefits. In a 30-second chair-stand test, the exercise group performed an average of 4.2 more repetitions than the control group.
“These indicators … give you a sense of whether or not you’re going to be able to be active in the future.”
The adults doing the exercises also shaved 2.3 seconds off their time during a test measuring how they could stand up and sit down five times consecutively. Furthermore, they extended their one-legged balance time by an average of 3.6 seconds.
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The researchers emphasized that these specific measurements are critical medical indicators of an older adult’s future health.
By keeping the routine ultra-short, researchers eliminated common barriers like time constraints and exhaustion, resulting in an exceptionally high 81% workout completion rate. (iStock)
“These indicators predict your future ability to go into a nursing home, your future likelihood of falling and of developing difficulty walking,” noted lead author Christopher Sciamanna, professor of medicine and of public health at Penn State College of Medicine, in the press release.
“They give you a sense of whether or not you’re going to be able to be active in the future.”
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While traditional home exercise programs generally see low engagement, the participants in this study successfully completed their workouts on 81% of the tracked days, according to the researchers.
After 12 weeks, exercising seniors gained the ability to complete an average of four more chair-stand repetitions than those who did not exercise. (iStock)
The study had several noted limitations. As it tracked a relatively small sample size of fewer than 100 individuals over a brief 12-week time frame, it is unknown whether these mobility gains can be sustained long-term.
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Additionally, the researchers did not specify the exact dropout rates or detail how the routine might affect seniors who already relied on assistive devices like walkers or canes.
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Because the final trial results reflected a specific group of participants who met the entry criteria, further investigation is required to determine whether the short routine can safely benefit older adults facing more severe physical limitations or cognitive decline.
The study was published in the journal PLOS One.
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Jill Smokler, founder of Scary Mommy, has died at age 48 after a battle with glioblastoma, an aggressive form of brain cancer.
The popular “mommy blogger” had been fighting the disease for the past two years, according to an announcement posted on ScaryMommy.com on Monday.
The stay-at-home mother of three launched the blog in 2008 as a place to share the “joys and pitfalls” of parenting, according to the article.
As Scary Mommy expanded from a personal blog into a major parenting brand, Smokler built a following with her honest, often self-deprecating take on motherhood. She went on to speak at blogging conferences, author bestselling books, appear on national television programs and earn three Webby Awards, her biography states.
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“Jill spent her life telling the truth about motherhood — that it could be wonderful and impossible in the very same breath — and in doing so, she gave millions of women permission to stop pretending and feel a little less alone,” her family shared in a statement following her passing.
Jill Smokler, founder of Scary Mommy (pictured in 2018), has died at age 48 after a battle with glioblastoma, an aggressive form of brain cancer. (Lloyd Fox/Baltimore Sun/ZUMA Press Wire / Shutterstock)
“She was funny, fearless, generous and entirely herself. More than anything she built, Jill was proudest of her three children, Lily, Ben and Evan. We are heartbroken to lose her, and endlessly proud of the mark she left on the world.”
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Smokler’s first sign of the disease was in April 2024, when she experienced a sudden seizure. She then underwent surgery to remove a brain tumor, after which she didn’t recognize her own children, she previously shared with Today.
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“I am definitely grateful that I don’t remember the looks on their faces when I didn’t recognize them,” she said. “That must have been gutting.”
Smokler was diagnosed with glioblastoma, the most common malignant primary brain tumor in adults and one of the deadliest forms of brain cancer. There is currently no cure.
About 13.9% of all brain tumors are glioblastomas, according to the American Brain Tumor Association. (iStock)
Following surgery, the blogger underwent radiation and chemotherapy, during which she was open about her treatment side effects, including fatigue and hair loss. Additional surgeries and clinical trials followed, according to previous interviews.
“Thank you, Jill, for everything. May you rest in peace,” the Scary Mommy post concluded.
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About 13.9% of all brain tumors are glioblastomas, according to the American Brain Tumor Association. More than 12,000 new cases are diagnosed in the U.S. each year.
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Median survival is approximately 12 to 18 months after diagnosis, even with treatment. Only about 5% to 7% of patients survive five years after diagnosis, data shows.
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