Mr. Trump, before your tariffs

In the late 1990s, a drug called OxyContin, created by Purdue Pharma, flooded doctors’ offices across the United States. The company, owned by the billionaire Sackler family, assured the public that this synthetic opioid was “safe and non-addictive” for treating chronic pain. However, behind that narrative was a relentless marketing machine: doctors were offered luxury trips and bonuses for prescribing high doses, while patients were misled with brochures that downplayed the risks. The mission was to normalize its use.

By 2007, the DEA had begun detecting alarming patterns: pharmacies in small towns were dispensing millions of pills, and distributors like McKesson prioritized profits above all else. The issue was this: the pharmaceutical industry mobilized its allies in Congress whenever the DEA attempted to take action. A key moment was the Affordable Care Act (ACA) passage in 2010. Buried within this law—supposedly designed to expand healthcare access—was a clause practically written by the pharmaceutical industry and its congressional allies. Democrat Marion Berry, who later became a pharmaceutical lobbyist, introduced a provision requiring the DEA to “collaborate” with companies before suspending their distribution, even if there was clear evidence of financial misconduct.

In 2016, Congress passed the Ensuring Patient Access and Effective Drug Enforcement Act, introduced by Republican Tom Marino and supported by Republican Marsha Blackburn and Democrat John Sarbanes. Marino, who received over $100,000 in industry donations, defended the bill as a “balance between access to medication and law enforcement.” The reality? This law raised the burden of proof for the DEA: the agency now had to demonstrate an “imminent threat” to take action—a vague and ambiguous standard that effectively tied its hands.

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Meanwhile, companies like Cardinal Health and AmerisourceBergen continued shipping truckloads of opioids to corrupt clinics, fully aware that the DEA was powerless to stop them. At the same time, firms like Insys Therapeutics perfected the art of bribing doctors. Its founder, John Kapoor, devised a scheme to pay physicians “speaking fees” for fake conferences in exchange for prescriptions of his fentanyl spray, Subsys. Between 2010 and 2017, according to data from OpenSecrets.org and the Federal Election Commission (FEC), Republicans and Democrats received $2.5 million in legal donations from Insys.

Mr. Trump:

You insist on blaming China and Mexico for illegal fentanyl, ignoring the fact that the vast majority of people with addiction started with prescription pills in the U.S. While you threaten the world with tariffs and sanctions, Congress refuses to legislate on addiction treatment or investigate pharmaceutical companies that continue to push opioids. If, instead of spreading xenophobic rhetoric, you addressed the real causes—poverty that drives self-medication, lack of healthcare access, and a regulatory system riddled with corruption—perhaps this crisis would be significantly smaller.