The Overdose Crisis No One Wants to Talk About

​The United States is still in the throes of this devastating emergency. So why has all discussion of it faded from the campaign?

Years after it was declared a public health emergency, the overdose crisis continues to impact the nation in profoundly tragic ways. In 2023, more than 107,000 people in the United States died of a drug-related overdose. For people aged 18–45, the leading cause of death may be fentanyl-related drug overdose; each week, dozens of teens die of an overdose across the country. Overdose death rates have increased for Black, Hispanic, Asian, and Native Americans. Families from rural West Virginia to the streets of the Bronx have something sorrowful in common: They all find themselves grieving a loved one.

But if you’ve been paying attention to this year’s presidential campaign, you wouldn’t really think it’s that big an issue. The Republican Party platform has no section about tackling the overdose crisis, while the Democratic Party offers three small paragraphs that address the Biden administration’s work in expanding treatment—and increasing the use of naloxone—while promising this work will continue under a Harris administration.

And while you may not hear about overdose deaths themselves, both parties have extensively referenced the drug that is causing them—fentanyl. The Republican Party platform makes mention of the drug, and the Democrats reference it 16 times in their own platform. But instead of tying the synthetic opioid to the ongoing public health crisis, politicians have cynically entangled “fentanyl” in an entirely different issue: It’s being used to hype up the ongoing political culture war involving border security and immigration.
In multiple ads touting her border security chops, Kamala Harris promises that as president she will crack down on fentanyl, including by investing in fentanyl detection technology to block it from entering the country. The Republicans, meanwhile, directly implicate migrants, with Donald Trump frequently saying that migrants are responsible for an increase in fentanyl overdoses. All of this has damaging impacts on what people believe about asylum-seekers—a 2022 poll, for instance, found that many Americans, especially Republicans, believe that migrants are smuggling fentanyl across the U.S. border. This, of course, is a flat-out lie: Most fentanyl enters the country through ports of entry and is carried by U.S. citizens.
Predominately talking about overdoses as a border security issue not only falsely ties people seeking asylum to overdose deaths but also overshadows real solutions to this crisis, while inhibiting their potential effectiveness. Fentanyl is a dangerous drug, but it is talked about as if it was a “weapon of mass destruction” and treated like a threat to national security—like anthrax, rather than something that contributes to overdoses and substance use disorders. What this misses is how fentanyl impacts the drug supply and who uses drugs in the United States.

On the one hand, fentanyl is found in pressed pills and can sometimes be mixed into drugs like cocaine (usually inadvertently). For people who have no prior exposure to fentanyl, say a teenager buying pills, such a dose can be deadly. There are also people who regularly use fentanyl (heroin is almost impossible to get in the U.S. nowadays) and are used to the dosages. If they don’t use fentanyl, they can go into withdrawal. At the same time, the drug supply is constantly changing, and new, more potent drugs can emerge—putting regular users at risk of overdosing. This is a complex and multifaceted problem, and it affects different people in a range of ways.

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