Securitisation, narcoterrorism and a drug-free America: The US drug strategy takes a hard turn

The Trump Administration’s new National Drug Control Strategy, released last week, marks a sharp ideological and operational departure from the more health-oriented approach that had been promoted in recent years, in particular under the Biden Administration. Framed around the objective of ‘defeat[ing] the scourge of illicit drugs’ and achieving a ‘drug-free life’, the new Strategy revives a deeply problematic ‘war on drugs’ rhetoric – prioritising law enforcement, militarisation and abstinence-based messaging over evidence-based public health interventions.

This shift is not merely rhetorical. The announcement of the Strategy explicitly celebrates the recent military strikes in the Caribbean Sea and Eastern Pacific Ocean that killed more than 190 people suspected of ‘narcoterrorism’ as a successful effort to stop the flow of drugs into American territory. This ‘narco-terrorist’ narrative serves to dehumanise people involved in the drug supply chain and seeks to justify extreme violence, including extrajudicial killings. These operations have been condemned by the International Narcotics Control Board (INCB), the Office of the High Commissioner for Human Rights (OHCHR), and the UN Special Rapporteur on counter-terrorism and human rights. The latter has been unequivocal in warning that conflating drug trafficking with terrorism is both legally and conceptually flawed, and risks seriously undermining international law and human rights protections.

Echoing the US-led resolution adopted at this year’s Commission on Narcotic Drugs (CND), a major focus of the Strategy is placed on ensuring that the ‘global supply chain’ is not being used to transport drugs and precursor chemicals. While the Biden Administration had prioritised multilateral diplomacy through UN fora and initiatives such as the Global Coalition to Address Synthetic Drug Threats, President Trump’s Strategy pivots toward ‘bilateral counterdrug initiatives and international partnerships’ designed primarily to ‘advance U.S. counterdrug priorities’. In other words, international cooperation is increasingly framed not as a shared global responsibility, but as an extension of US security interests.

Perhaps one of the most concerning changes concerns health. The previous US drug strategy had explicitly endorsed evidence-based prevention, harm reduction, and voluntary treatment and care interventions. Harm reduction has almost disappeared entirely from the new Strategy. The only remaining reference aligned with this approach is the objective of ‘strengthening rescue and overdose response’, including expanding naloxone availability and overdose response training.

These measures are essential, and welcome. But they sit within a broader framework that sidelines proven public health interventions in favour of abstinence-oriented approaches centred on ‘the healing power of faith’ and ‘national media and education campaigns that reinforce a drug-free America as the social norm’. This is despite overwhelming evidence that mass media drug-free campaigns have historically shown limited to no effectiveness in reducing drug use, while often increasing stigma and promoting unethical or fear-based messaging.

The Strategy does promise to expand access to treatment for people using all types of drugs, including through peer support services. However, treatment goals appear narrowly focused on recovery and abstinence, with little recognition that people use drugs for different reasons, and that people with drug dependence may require different forms of support. And yet, the Strategy makes no acknowledgement of the need to expand low-threshold services, substitution therapy, or harm reduction programmes beyond naloxone distribution.

There is also a striking contradiction at the heart of this Strategy. On the one hand, the Strategy pledges to expand access to treatment and improve the acquisition and use of accurate data to address ‘emerging threats’. On the other, the Trump Administration’s proposed 2027 federal budget includes sweeping cuts to the National Institutes of Health (NIH), which have played a critical role in documenting and responding to the overdose crisis. Similar cuts have targeted the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Centers for Disease Control and Prevention (CDC), both of which fund prevention, treatment and recovery programmes nationwide. This risks reversing much of the hard-won progress on overdose prevention and public health at a time when sustained investment remains direly needed.

Finally, and in line with the Trump Administration’s disregard for fundamental human rights, the Strategy makes no reference to the need to address systemic racism in drug law enforcement (in another marked departure from the priorities of the Biden-Harris administration), nor to the necessity of ensuring gender equality, especially in access to life-saving services for women who use drugs.

Far from representing a rights-based and evidence-informed response to drug-related challenges, the 2026 Strategy recycles a harmful ‘drug-free America’ approach, and the punitive logic of the so-called ‘war on drugs’ to serve US geopolitical interests and advance broader security agendas. History tells us that this approach will ultimately be costly, counter-productive and put more lives at risk both domestically and abroad.