Heather Saunders

Since the opioid epidemic was declared a public health emergency in 2017, it has claimed more than half a million lives. While the epidemic was initially driven by prescription opioids and heroin, it has evolved in recent years, to be dominated by illicit synthetic fentanyl—a substance significantly more potent than morphine. By 2023, most counterfeit opioid pills contained a deadly dose.

Alcohol use disorder (AUD) is the most prevalent non-tobacco substance use disorder in the United States and over half of US adults (54%) say that someone in their family has struggled with an alcohol use disorder. Federal data show that 1 in 10 Americans (ages 12+) had an AUD in the past year and over 40% of drinkers reported binge drinking in the past month, yet only one-third of adults view alcohol addiction as a “crisis,” compared to over half who see opioids as such.

President Trump recently signed an executive order on homelessness, mental health, and substance use that leverages federal funding priorities and other administrative tools to encourage states to ban public drug use, remove unhoused people from public spaces, and broaden civil commitment laws to permit involuntary psychiatric civil commitments in more circumstances.