A new joint report from Human Rights Watch and the Drug Policy Alliance shows thousands of people are being deported every year for drug offenses that in many cases no longer exist under state laws, harming and separating immigrant families.

Punitive federal immigration laws separate families, destabilize communities, and terrorize noncitizens, all while overdose deaths have risen and drugs have become more potent and available.

Congress should reform immigration law to give immigration judges discretion to make individualized decisions. States should ensure drug reforms apply to non-citizens as well.

'Disrupt and vilify': The war on immigrants inside the US war on drugs

For over a century, U.S. drug policy has prioritized punitive approaches under the guise of stopping drug use and production. The results have been drugs becoming cheaper, more available, and potent, record-high overdose deaths, and increasing violence from drug trafficking organizations. The drug war is a failed strategy, one that has come with high human and financial costs after over a trillion dollars in spending. To save lives and promote healthy communities across the globe, it is urgent that the U.S. government shift its drug policy and funding towards health-focused strategies.

The U.S. has exported and sustained prohibitionist drug policies abroad.

U.S. drug policy has sought to stigmatize and punish those involved with illicit substances. This approach has extended abroad, where the U.S. has used its political muscle and leverage to create an international framework firmly rooted in prohibition and punishment. This approach demonizes drugs and the people who use them and aims to disrupt the supply of drugs. Despite record-high levels of funding for this approach, evidence today shows it has been a failure. Drugs are more available and potent than ever, and the U.S. continues to navigate an overdose crisis.

The three international drug control conventions championed by the U.S. are premised on:

eliminating the cultivation of marijuana, poppy, and coca (used to produce heroin and cocaine respectively); and,

preventing the transit of drugs to countries where people use them.

The centrality of drug control in U.S. foreign policy was solidified during the Nixon administration when the Drug Enforcement Administration (DEA) was established to wage an “all-out, global war on the drug menace.” The U.S. sought to deal with issues related to drug use at home by blaming countries where cocaine, heroin, and other drugs originated. They also adopted efforts to halt the flow of drugs deemed to be illicit into the United States. This approach was further entrenched during the Reagan administration, when drugs were declared a national security threat and U.S. foreign policy committed to the eradication of illegal drugs.

Legislative measures like the Anti-Drug Abuse Act of 1986, calling for a “drug free America,” codified drug control as a priority in foreign policy and beefed up overseas drug control efforts. In 1988, Congress made the Pentagon the “single lead agency” for detecting and monitoring illegal drugs coming into the United States. They leveraged foreign aid to enforce compliance with U.S. drug policies, mandating cooperation and adherence to UN conventions. Non-compliant countries faced the loss of U.S. aid and significant barriers to international financial assistance, extending the country’s punitive drug policy influence globally.

The consequences of prohibitionist drug policies have increased poverty, human rights violations, organized crime, and more potent drugs.

Beyond the drug war: A health-first approach to global drug policy

This feature zooms into the drug deaths crisis in British Columbia, now the leading cause of death for people aged 10 to 59 in the province. Declared a public health emergency in 2016, this crisis has pushed over 16,000 people into premature death and continues to worsen due to a toxic and unpredictable drug supply.

The short documentary outlines the origins and evolution of the crisis, the challenges with current responses, and difficulties in moving toward decriminalised frameworks.

Advocates, health and legal experts, and bereaved parents highlight the urgent need for a safe supply, expanded access to treatment and policies that are grounded in public health rather than punishment.

Canada: Everything you need to know about B.C.'s toxic drug crisis

This environmental scan examines the current state of harm reduction (HR) education in Canadian nursing programs, highlighting significant gaps in preparing nurses to work effectively with people who use drugs (PWUD). While nursing codes of ethics and professional standards explicitly align with HR principles, our findings reveal that HR education remains inconsistently integrated into nursing curricula across Canada.

If covered at all, HR education is often embedded within other courses rather than recognized as a core component. This results in uneven exposure to HR content among students, leaving many nursing graduates unprepared to implement HR approaches in their practice. The inclusion of HR education is also heavily dependent on individual faculty interest and initiative. Stigma toward substance use and a lack of faculty readiness to teach this content remain major barriers. 

Curriculum constraints further limit the depth of HR education. With an already overcrowded curriculum and minimal emphasis on HR in entry-to-practice guidelines and licensing exams, instruction on HR is often superficial. The lack of this education has a direct impact on patient care, perpetuating stigma, and discrimination in healthcare settings.

Environmental scan on the current state of harm reduction education in nursing

Drug seizures were perceived by officers as a means to increase safety for PWUD.

Public health recognized an increased risk of overdose for PWUD following seizures.

Public health is concerned about building and maintaining the trust of PWUD.

PWUD understood drug seizures to increase drug market instability.

PWUD saw seizures as removing drug culture knowledge and rupturing social networks

A growing number of studies suggest that police efforts to disrupt illicit drug markets through the removal of illicit drugs can result in unintended harms to people who use drugs by increasing overdose risks. However, little is understood about the perceptions, expectations, or experiences of those who implement, experience, and/or are impacted by these seizure events.

We conducted semi-structured interviews (N = 54) with police, public health and local nonprofit professionals engaged in overdose prevention efforts, and people who use drugs (PWUD) in Indianapolis, Indiana—a city where drug seizures have been associated with excess overdose—to examine how each of these groups perceive these events. We use a journey mapping framework to analyze expectations for each of these personas around the shared scenario of drug seizures.

Law enforcement drug seizures are routine and are perceived by police as interconnected, longitudinal attempts to dismantle drug supply networks. Public health and local nonprofit professionals described potential harms stemming from drug seizures but reported lacking the shared information and inter-agency collaboration necessary to provide a meaningful response. PWUD reported negative health consequences and increased risk of overdose following drug seizure events. PWUD use multiple strategies to reduce perceived harms from drug seizures.

Seizing drugs whenever, wherever, or with whomever they are found has become an accepted policing practice in the United States, ostensibly to reduce risk of drug-related harms. This study offers a new perspective to the growing evidence that this standard practice may result in a myriad of negative public health outcomes for the community. Research, such as this, that engages the lived experiences and perceptions of directly impacted people, is essential for understanding and mitigating these harms. Those most impacted by drug seizures – PWUD – should be at the center of developing, implementing, and evaluating public health and harm reduction efforts to reduce the harms associated with drug seizures.

Journey mapping drug seizures among police, public health and local nonprofit professionals, and community members who use drugs

On 20 January 2025 the United States announced a 90-day freeze on US foreign aid which has had a devastating impact on people living with and affected by HIV, on the people and organizations supporting them and on the global response to HIV as a whole.

Community organizations have been particularly impacted by the freeze in funding. Community healthcare workers are losing their jobs, clinics are having to be shut down and, as a result, people in need of HIV testing or prevention or who are living with HIV and dependent on daily antiretroviral medicine are unable to access the life-saving HIV services they need.

On 10 February, UNAIDS convened an emergency meeting with community organizations to monitor the impact of the unfolding crisis. Community groups reported that HIV services around the world are facing serious challenges. Some are grinding to a halt. Supplies of antiretroviral medication, pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP) and condoms have been disrupted, leaving many without essential tools of HIV treatment and prevention.

HIV testing kits are increasingly scarce and outreach services – essential for connecting people in need of HIV testing – are being suspended. As a result, HIV and sexually transmitted infection testing are disrupted, threatening detection and prevention efforts.

“The damage is immediate and severe,” said one advocate. “People who rely on [U.S.-funded] programmes for [safety and] survival are suddenly left with nothing.”

The US pause in administering foreign assistance while it reviews recipients is not just a bureaucratic delay; it is a direct threat to continued progress against AIDS and will quickly erode decades of hard-won gains in the global HIV response. It will destroy many community organizations without which the world cannot close the gaps in HIV testing, prevention and treatment.

The US Government has invested more than US$ 100 billion to date in the global fight against AIDS with the US accounting for around 73% of donor funding for HIV worldwide; millions of people at risk for and living with HIV rely on US funded clinics to stay healthy in the face of HIV.

How the shift in US funding is threatening both the lives of people affected by HIV and the community groups supporting them

Toronto, ON | March 31, 2025—In a small victory for those advocating for evidence-informed services, one Toronto supervised consumption site facing forced closure April 1, 2025 will keep its doors open as that deadline passes tomorrow. But the reprieve—granted via a 

 from the Ontario Superior Court – brings no relief for additional sites across Ontario who will still be required to close. 

The Court’s decision, released Friday, suspends the application of location restrictions within Ontario’s 

 until 30 days after the case has been decided. The Court granted the injunction on the grounds that sites’ closure and resulting increased risk of unsupervised drug use risks irreparable harm, threatening the health and lives of people who use drugs. 

Despite this recognition, the injunction does not cover the Act’s requirement for municipally operated or supported sites to obtain provincial approval. Given this, at least one site in Peel Region must still close. Further, the injunction has no impact on Ontario’s denial of funding to all sites. Without such funding, most sites will be unable to sustain their vital work, even if technically permitted to operate.

“In one sense, we are relieved. The Court has recognized the evidence that the Ontario government chooses to ignore: closing supervised consumption sites will drive deaths and harms,” says DJ Larkin of the Canadian Drug Policy Coalition. “But it is deeply upsetting that despite this recognition, thousands of people at risk of harm will still lose this lifeline. Our response to harm as a caring, inclusive community should always be to provide the support and choices people need to stay healthy and well. We must chart a path that is rigorously grounded in public health principles, upholds 

 rights, and protects against the perpetuation of stigma.”

This temporary injunction provides time for the Court to assess whether the Act violates 

 rights and is outside of Ontario’s constitutional jurisdiction, a decision that may take several months. Though the injunction allows all sites impacted by the Act’s location restriction to continue operations, its limited scope, combined with the province’s decision to withdraw or reject funding for existing sites, means it is too little, too late for many communities. 

“Most people believe everyone deserves access to healthcare and well-being, whether they use drugs or not,” says Michael Parkinson of Waterloo Region Drug Action Team. “Supervised consumption sites are one proven way to improve everyone’s health and safety. While the injunction is intended as a temporary reprieve, the deadly reality is its scope is limited and the province remains openly hostile. We are extremely distressed for the Kitchener applicant who sought relief in the Court and has not found it, despite the injunction, and the thousands of others across Ontario who depend on consumption sites. We urge the Ford government to respect the injunction and expedite the continuance of these services.”

Nearly all sites slated to close have accepted funding to transition to the new HART Hub model, which the province promised would be operational by April 1. Ontario explicitly forbids the provision of supervised consumption services through HART Hubs and has threatened to withdraw funding from organizations that offer these services. Some sites transitioning to HART Hub locations have 

 that they will be unable to open in time due to delays from the province. 

“It is shameful: Ontario has put service providers in an impossible position,” says Zoë Dodd of Toronto Overdose Prevention Society. “We are in a toxic drug crisis and the court agrees that people could die from these closures. Providing lifesaving overdose prevention services is essential. Preventing disease transmission is essential. Through this process the Ford government has ignored its own evidence. They are using funding as a weapon.”

Interveners in the case spoke to the increasing toxicity of the unregulated drug supply and described the harms to come to people should sites close. Others noted that Indigenous and Black communities, women, and people experiencing homelessness will bear disproportionate harm.

“We have been working together to keep people safe from preventable harms amid devastating loss,” says Colin Johnson of the Toronto Harm Reduction Alliance. “Why anyone who cares about their fellow Ontarians could agree to the closing of these sites knowing the good they do is beyond me.”

Ontario passed the Act in December 2024, bypassing committee study and limiting debate. The Act’s location restrictions were intended to come into force on April 1, 2025, which would have required at least ten sites within 200 metres of a school or childcare centre to close: five in Toronto and one each in Kitchener, Hamilton, Guelph, Thunder Bay, and Ottawa. In its application to the Ontario Superior Court, The Neighbourhood Group argued that people at severe risk of harm would lose access to a range of services and any closure would result in suffering.

The Ontario Superior Court agreed, concluding it “is foreseeable that many more will overdose, and some of those will die…that there will be an increase in the spread of bloodborne diseases. Death and disease that would have been prevented will now not be prevented, because those who would have used an SCS will now consume drugs in less safe settings. The other health and social services provided by SCSs and for which SCSs are a gateway will no longer be accessed at the same rate. Given the number of users that are affected by substance use disorder, homelessness, and other marginalized characteristics, the impact will be felt by the most vulnerable.”

“This injunction, though limited and temporary, is a recognition that evidence matters in legislation, and the evidence tells us these sites keep our communities safer,” says Sandra Ka Hon Chu of HIV Legal Network. “At a time when at least seven people 

 each day in Ontario due to the toxic unregulated drug supply, at a bare minimum we must ensure our laws are guided by the evidence available. Now, we need the province to respect the spirit of the injunction, fund these sites, and authorize municipalities who wish to do the same.”

Canada: Despite Ontario Superior Court injunction recognising irreparable harm, most supervised consumption sites face closure

Last year, the state ended a trailblazing law decriminalizing possession. Drug users in some counties are now in and out of jail, without lawyers, struggling to get treatment.

At 7.45am on a cool February morning in Medford, Oregon, six police officers pulled up to a desolate road lined with tarps and a shopping cart and began making arrests.

The officers directed four adults to sit on the sidewalk, handcuffing them behind their backs and rifling through their pockets. They were being detained for illegal camping, but the officers were also searching for evidence of drugs.

“Love you!” a husband and wife shouted at each other as they were separated to be taken to jail.

Officer Paul Verling placed one 43-year-old woman in the back of his car while his team tested a confiscated glass pipe for drug residue. He told her she could potentially avoid jail if she entered drug treatment.

The woman said she had been using methamphetamine to cope with homelessness and would be grateful for treatment. But once Verling ran her name through the system, he discovered she had a warrant for a probation violation. That made her ineligible for “deflection”. She, too, would be going to jail, he said, possibly for a month.

“You wanna engage in some rehab when you get out?” he said.

“I’m glad we had this talk today,” Verling said, as he took her out of the car to escort her into a jail enclosure.

US: Oregon abandoned its radical drug law. Then came the mass arrests

On March 28, President Donald Trump announced Sara Carter as his pick for “drug czar.” Carter, who will need to be confirmed by the Senate, has a background as a journalist and Fox News contributor, with no direct drug policy or public health experience.

“From Afghanistan to our Border, Sara’s relentless pursuit of Justice, especially in tackling the Fentanyl and Opioid Crisis, has exposed terrorists, drug lords, and sex traffickers,” Trump said in a statement. “As our next Drug Czar, Sara will lead the charge to protect our Nation, and save our children from the scourge of drugs.”

Carter’s website describes her as a “national and international award-winning investigative reporter whose stories have ranged from national security, terrorism, immigration and front line coverage of the wars in Afghanistan and Iraq.” Besides her most recent role contributing to FOX News, she has written for outlets including the Washington Times, the Washington Examiner and USA Today. Her past reporting on the US-Mexico border has focused on undocumented immigration, secret tunnels and trafficking routes, and the involvement of Mexican officials in the drug trade.

“Drug czar” is the informal name for the director of the White House Office of National Drug Control Policy (ONDCP). According to the White House, the office “leads and coordinates the nation’s drug policy so that it improves the health and lives of the American people,” managing the National Drug Control Strategy and budget. The ONDCP works with 19 federal agencies and a $44 billion budget, “as part of a whole-of-government approach to addressing addiction and the overdose epidemic.”

The office also distributes money and oversees the High Intensity Drug Trafficking Areas Program (HIDTA)—regional joint task forces involving federal, state and local police—and the Drug-Free Communities Program, which provides grants to prevent youth substance use.

What will Sara Carter of Fox News bring as the US's new 'drug czar'?

Americans from all walks of life are deeply concerned about addiction, overdose, and the impact of fentanyl. Families across the U.S.—whether from cities, suburbs, or rural communities— desperately want to protect their loved ones and keep them alive.

When it comes to solutions, Americans broadly agree that access to treatment, the opioid/fentanyl reversal medication naloxone, and other health services are critical for saving lives and offering a path to recovery.

Yet, the Trump Administration’s and Congress’s proposed federal funding cuts pose an immediate and catastrophic threat to these vital services. By slashing Medicaid and public health grant programs, Trump’s cuts will directly hinder access to treatment, naloxone, and vital health services. The results could be devastating: more lives lost to overdose, increased suffering, and addiction spiraling out of control. We cannot let these cuts go through—every second counts.

Kassandra Frederique, Executive Director of the Drug Policy Alliance, answers urgent questions to help us understand the immense threat posed by Trump’s federal funding cuts and what can be done to protect our loved ones and ourselves.

US: Trump’s funding cuts jeopardize fentanyl overdose prevention and recovery

The US government has officially designated several Latin American organized crime groups as terrorist organizations, but the move will do little to help attack these complex criminal networks.

US Secretary of State Marco Rubio announced February 20 that the Venezuelan mega-gang Tren de Aragua, the MS13 street gang, and the Sinaloa Cartel, Jalisco Cartel New Generation (Cartel Jalisco Nueva Generación – CJNG), Gulf Cartel, Northeast Cartel, Familia Michoacana, and United Cartels in Mexico would be declared “foreign terrorist organizations.”

The official designation stemmed from an executive order US President Donald Trump signed on his first day in office announcing his intention to make this decision.

“The Cartels have engaged in a campaign of violence and terror throughout the Western Hemisphere that has not only destabilized countries with significant importance for our national interests but also flooded the United States with deadly drugs, violent criminals, and vicious gangs,” Trump said at that time.

The new designations are likely to put further strain on US-Mexico relations, which are already tense due to Trump’s threats to impose tariffs on Mexican goods and his statements claiming Mexico’s government is controlled by criminal interests. Experts consulted by InSight Crime cautioned that this measure is far from a cure-all for the threats posed by transnational criminal networks and may actually complicate joint efforts to fight them.

“If the question is how to effectively weaken, combat, and dismantle criminal networks in Mexico, then the starting point needs to be addressing them for what they are,” said Stephanie Brewer, director for Mexico at the Washington Office on Latin America (WOLA).

“Mexican criminal groups are very powerful and cause horrific levels of violence and suffering, but they are not pursuing the type of political ends that a terrorist organization pursues,” she added.

US authorities already have a number of legal tools at their disposal to prosecute criminal leaders, impose financial sanctions, and seize assets. While the US can now impose stiffer penalties on the people they target and obtain warrants under the Foreign Intelligence Surveillance Act (FISA) to carry out their own electronic surveillance, Brewer told InSight Crime that the foreign terrorist designation does not significantly increase the tools needed to combat these groups and risks unintended consequences.

“The concern is that this could open the door to both criminal prosecutions and immigration consequences for a wide range of everyday people, organizations, and businesses on both sides of the border that might find themselves inadvertently caught up in the framework of providing material support to terrorist groups,” she added.

What’s more, the move is based on the premise that these are monolithic groups when they are highly complex, horizontally-integrated organizations with no clear lines separating who is part of the network and who is not. Their use of violence is based on protecting economic interests, not obtaining political objectives or imposing an ideology.

“The designation fundamentally misunderstands how these criminal operations work,” said Cecilia Farfán-Méndez, an expert on organized crime.

North America

'Disrupt and vilify': The war on immigrants inside the US war on drugs

Beyond the drug war: A health-first approach to global drug policy

Canada: Everything you need to know about B.C.'s toxic drug crisis

Canada: Everything you need to know about B.C.'s toxic drug crisis

Environmental scan on the current state of harm reduction education in nursing

Journey mapping drug seizures among police, public health and local nonprofit professionals, and community members who use drugs

How the shift in US funding is threatening both the lives of people affected by HIV and the community groups supporting them

Canada: Despite Ontario Superior Court injunction recognising irreparable harm, most supervised consumption sites face closure

US: Oregon abandoned its radical drug law. Then came the mass arrests

What will Sara Carter of Fox News bring as the US's new 'drug czar'?

US: Trump’s funding cuts jeopardize fentanyl overdose prevention and recovery

What you need to know about the criminal groups the US just labeled ‘terrorists’