Vivian Qu is the Chinese film-maker who has directed three features and also produced the [noir drama Black Coal, Thin Ice](https://www.theguardian.com/film/2015/jun/04/black-coal-thin-ice-review-diverting-downbeat-noir) which in 2014 won Berlin’s Golden Bear. Now she brings this crime melodrama to Berlin, an engaging if tonally uncertain high-wire adventure that satirises China’s hopeless addiction to gangster capitalism. It is also acidly unsentimental about the bread-and-circuses escapism of the country’s booming film and TV industry with all its period-costume wuxia nostalgia. It’s an appealing film, though it contains some strangely broad comedy and is also, in a couple of violent moments, a bit naive about exactly how easy it is for a young woman physically to fight off a big strong guy. Above all, Qu gives us a rather amazing set-piece scene on the set of a wire-fu action movie, a scene that feels real in a way that the rest of the film really doesn’t, for all that it is watchable. Fang Di (Wen Qi) is a tough woman employed as a stunt double on a movie set, playing the black clad, sword-wielding ninja bouncing over terracotta rooftops and whizzing through the air in long shot. For the closeup, the preening star in the same outfit steps in while Fang Di staggers over to get a coffee at the craft table. The work is exhausting and dangerous and Fang Di is doing it to pay off her family debts to mob matriarch Madame Wang. Desperate for more cash, she takes on a gruelling night shoot in which, attached to a wire harness, she has to be submerged under murky water to fly up into the air. The callous director demands this shot to be repeated endlessly, despite Fang Di’s obvious distress – and seeing that there are too many ripples from the last take, he commands she stay under the water for 15 seconds before the camera rolls, instead of the almost-safe three. Just at this unimaginably low point in Fang Di’s life, her long estranged cousin Tian Tian (Liu Haocun) appears; she is being pursued by the mob, having fallen into debt and drug addiction at the hands of the same criminals who supplied drugs to Tian Tian’s notoriously parasitic and waster dad, the source of all the family’s despair. Now Fang Di and Tian Tian have to evade the same duo of hatchet-faced tough guys, as well as a local cafe owner from their home town who the mobsters have bullied into joining them. There are entertaining, incidental scenes mocking the craziness of show business; looking to graduate away from stunt work, Fang Di auditions for a drama, doing an absurdly written scene, and bursts out laughing in the middle of the dialogue, to the director’s outrage. And there is a moment of pure (and implausible) farce when the gangster tough guys, taking a wrong turn in the movie studio, are inveigled into taking part in a hospital drama and a war epic. It’s amusing, but the silliness doesn’t entirely work. All this is interspersed with flashbacks showing the two young women’s former intimacy and the painful anguish of their family dysfunction, establishing a mood of sadness that is underscored by the final, desolate scene of their early childhood. A flawed, but involving spectacle. Girls on Wire screened at the [Berlin film festival](https://www.theguardian.com/film/berlinfilmfestival).

At Guinea’s only private drug rehabilitation clinic, Dr Marie Koumbassa and her 15-person team are so convinced that drug use is a national emergency that they work for no pay. Every week, SAJED-Guinée (Service for Helping Young People in Difficult Situations due to Drugs) receives dozens of distress calls from relatives of addicts who are then taken to the facility in the working-class Conakry neighbourhood of Dabompa. In richer areas of the city, cocaine is the drug of choice. Elsewhere, the prevalent substances are tramadol, crack and – in a recent trend – kush, [a deadly mix](https://theconversation.com/kush-what-is-this-dangerous-new-west-african-drug-that-supposedly-contains-human-bones-220608) of cannabis, fentanyl, tramadol, formaldehyde and [reportedly human bones](https://www.theguardian.com/global-development/2023/sep/13/its-like-smoking-poison-sierra-leones-youth-battle-addiction-to-a-mystery-drug). People who smoke it have been known to collapse, cause themselves bodily harm or even die. “People come here from the madrasa \[Islamic schools\] and tell us that scholars told them: ‘Take this, you will read well and quickly learn’,” Koumbassa said, referring to kush. “It actually destroys them.” The team first encountered kush in Conakry last March. Its use has now spread so much that patrons of nightclubs and lounges are known to be mixing it into shisha pots. [](https://www.theguardian.com/world/2025/apr/20/kush-guinea-rehab-clinic-drug-epidemic#img-2) Dr Marie Koumbassa. Photograph: Eromo Egbejule/The Guardian Unlike its neighbours Guinea Bissau – seen as a “narco-state” – and Sierra Leone, which is the regional hub for kush, drug abuse and trafficking are not readily associated with the more culturally conservative Guinea. But experts say a crisis is under way, fuelled by a growing market operated by cross-border trafficking syndicates. “The gangs in Sierra Leone have always moved to Guinea \[when necessary\], said Kars de Bruijne, senior research fellow with Dutch thinktank Clingendael’s conflict research unit. “If a gang member committed a crime in Sierra Leone or was otherwise being looked for they would go to Guinea and hide out. “Similarly, we are aware of boats that sometimes move materials including drugs from Guinea to Sierra Leone. There’s really a lively cross-border informal trade.” Data about the drug abuse and trafficking situation is hard to come by, but according to [a UNODC report](https://www.unodc.org/westandcentralafrica/en/westandcentralafrica/press/world_drug_report_2024.html), at least 5.6 tonnes of cocaine were seized off the coast of Guinea between January 2019 and June 2024. Earlier this year, Guinean authorities said they [found seven suitcases](https://www.bbc.co.uk/news/articles/cn4zzq1vk87o) containing suspected cocaine in a car belonging to the Sierra Leonean embassy.  Inside the war on kush: The drug ‘mixed with human bones’ taking over Sierra Leone – video Staff at SAJED say there is a serious lack of awareness about remedies and therapy. Still, the nonprofit has handled more than 500 cases since 2019, when Koumbassa opened the centre after returning inspired from workshops for psychologists in Abuja and Accra. “We have patients who come from everywhere, from within the country, as well as students returning from places like America and France,” said Yamoussa Bangoura, the centre’s head of psychotherapy. “We want to extend our operations to Boké \[a city near Guinea-Bissau\], and all the regions. But we don’t have the means.” Many factors are to blame for the drug epidemic, including poverty and porous borders. Some social workers think demonstrators against the junta that seized power in a coup in 2020 began taking drugs to give themselves the confidence to take to the streets. Some say the junta’s all-encompassing focus on holding on to power has distracted it from daily affairs of the state. The scale of the problem has overwhelmed Guinea’s meagre capacity for treating addicts. The country only has two known state-run centres catering to substance abuse. During the Covid-19 pandemic, one was closed for a time, overcrowding the other. SAJED’s own resources are extremely limited. It can only take around a dozen patients at a time. The facility is mostly funded by the people who worked there, but it also receives small grants from private donors and the sale of fruits within the compound that patients help water daily to keep them engaged. Sales of medication for treatment provides another source of revenue, but most of the patients are poor, so the clinic gives the medication to them for nothing. [](https://www.theguardian.com/world/2025/apr/20/kush-guinea-rehab-clinic-drug-epidemic#img-3) Staff at SAJED say there is a serious lack of awareness about remedies and therapy. Photograph: Eromo Egbejule/The Guardian Rented from a member of the Guinean diaspora at a heavily discounted rate, the compound consists of a single-storey building with cubicles inside that serve as kitchen, laboratory and pharmacy. There is also a small emergency room and one bedroom each for men and women, as well as a common room with a TV. “People fear to come in sometimes because of the look of the building,” said Bangoura. People suffering from depression and alcohol addiction are also welcome at the clinic. One of those currently at the facility is Diallo Mahmoud, a 32-year-old whose alcohol addiction began as a teenager drinking with elders. Over the last three years, he moved to Abidjan and Brazzaville in search of work, drowning his failures in alcohol. After breaking a bottle on someone’s head in a fight at a Conakry nightclub, his siblings called SAJED. These days, he and other patients at the clinic discuss life together, anticipating a different direction when they are discharged. “After I leave here, I’ll not drink again and I’ll preach that to people,” Mahmoud said. Stories like his keep the clinic staff going, even when the road seems rough. “We have come to understand that drug consumption is recurrent in our homes, and the layer it consumes the most is the youth, the future of the nation,” said Koumbassa. “If we don’t help them get out of it, it will be a problem for the nation.”

Just two years ago, the US was suffering through the worst stretch of its long-running drug overdose crisis. More than 110,000 Americans had [died](https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm) in the previous 12 months from an overdose — almost twice the number of people who died in all of the Vietnam War. But late last year, the country got some unexpected good news: Overdose fatalities had [fallen](https://www.dea.gov/press-releases/2024/12/16/overdose-deaths-decline-fentanyl-threat-looms) by 10 percent. It was the first drop of any kind since 2018, but here’s the really good news: While in 2018, deaths only plateaued for a few months before rising again, the current decline appears to be sustaining and even accelerating. According to the most recent national data from the Centers for Disease Control and Prevention, deaths in 2024 were [down](https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm) a whopping 26 percent, to less than 81,000 over the preceding 12 months. New county-level CDC data [reveal](https://www.cdc.gov/nchs/nvss/vsrr/prov-county-drug-overdose.htm) some communities in the states hit hardest by the opioid epidemic — such as West Virginia, New Hampshire, and Ohio — have seen deaths fall by 40 percent to 50 percent over the past year. Too many people are still dying preventable deaths, but the decline nonetheless represents a significant improvement in a problem that has bedeviled public health officials since [the opioid epidemic](https://www.vox.com/the-highlight/2024/1/16/24033590/treatment-opioid-addiction-crisis-2024) began to take off in the 2000s. [Nobody is quite sure](https://www.npr.org/2025/03/24/nx-s1-5328157/fentanyl-overdose-death-drugs) — and several of the experts I spoke to fear the downturn could be temporary. But there are a few plausible explanations. First, the pandemic is over. Overdose deaths [rose sharply](https://pmc.ncbi.nlm.nih.gov/articles/PMC8856931/) during 2020 and 2021, likely for a combination of reasons. People were more isolated, for one, and health care providers were overwhelmed. That’s no longer the case. People who use opioids and other deadly drugs also now know about the particular risks of [fentanyl](https://www.vox.com/science-and-health/2017/5/8/15454832/fentanyl-carfentanil-opioid-epidemic-overdose) and other synthetic opioids and are being more cautious. There is [the contentious theory](https://opioiddatalab.ghost.io/are-overdoses-down-and-why/#5-depletion-of-susceptibles) that the pool of potential victims has shrunk: More than 1.5 million Americans have died from overdoses since 2000, and many of the people who were most vulnerable to becoming dependent on opioids and overdosing may have, sadly, been among that group. It is also possible that people are shifting away from opioids like heroin and fentanyl and toward other drugs that are less deadly. More people are [taking](https://nida.nih.gov/news-events/news-releases/2024/08/cannabis-and-hallucinogen-use-among-adults-remained-at-historic-highs-in-2023#:~:text=Cannabis%20and%20hallucinogen%20use%20among%20adults%20remained%20at%20historic%20highs%20in%202023,-Vaping%20among%20younger&text=Past%2Dyear%20use%20of%20cannabis,the%20Monitoring%20the%20Future%20survey%20.) nonlethal drugs such as cannabis and psychedelics, and the use of cocaine and other illicit stimulants has also been [growing](https://www.pewtrusts.org/en/research-and-analysis/fact-sheets/2024/08/stimulant-use-is-contributing-to-rising-fatal-drug-overdoses); they still present a public health risk, especially with [reports](https://www.uclahealth.org/news/release/overdose-deaths-fentanyl-laced-stimulants-have-risen-50-fold) of cocaine laced with fentanyl, but these substances lead to fewer deaths on average. The US has also invested billions of dollars into public health campaigns to reduce overdose deaths. We are not only increasing users’ awareness about fentanyl, for example, but some public health departments have also provided millions of free testing strips so people who use opioids can easily check whether what they are using could quickly and unexpectedly kill them. Access to opioid addiction treatments like methadone and buprenorphine, too, has been greatly expanded through government and philanthropic investments. And perhaps most importantly in the prevention of unnecessary overdose deaths, [naloxone](https://www.vox.com/policy/2023/3/30/23663064/narcan-overdose-fentanyl-drug-where-to-get) — Narcan, the nasal spray that rapidly reverses opioid overdoses — is [omnipresent](https://www.vox.com/even-better/353129/you-can-help-reverse-the-overdose-epidemic). You can find it in vending machines in police stations, libraries, and public schools around the country. Nearly 70,000 lifesaving doses were [administered](https://momentousrecoverygroup.com/rehab-blog/what-is-narcan-the-life-saving-tool-in-the-fight-against-the-opioid-crisis/) in 2021 by emergency responders. “Increased naloxone distribution has saved countless lives by reversing opioid overdoses in real time,” Jessica Hulsey, founder of the Addiction Policy Forum, told Vox. This was a hard-fought public health victory: While some people have at times [objected](https://pmc.ncbi.nlm.nih.gov/articles/PMC7153573/) to placing a drug overdose treatment in a public health setting, the harm-reduction argument that we should make these interventions widely available to save as many lives as possible has largely won out. Even as the good news rolls in, President Donald Trump’s health department is currently working on plans to reduce federal spending on opioid treatments by millions of dollars. A draft budget, recently obtained by [several news organizations](https://www.washingtonpost.com/health/2025/04/16/hhs-budget-cut-trump/), including Vox, would specifically terminate programs that supply Narcan to health centers, doctors, and first responders, as well as programs to train first responders on how to use the drug during an overdose emergency. Other programs focused on drug abuse treatment and support would also be eliminated, according to the document. To be clear, this is only a draft document, and the president’s budget, even when finalized, is rarely adopted exactly as it is written. Congress will have its say, and lawmakers have shown support for substance abuse treatment in recent years. But the proposal nonetheless raises the risk that the US will take a step backward after finally making progress in reducing the toll of opioids. If the programs were to ultimately be eliminated, some day, a health center might not have Narcan on hand when a patient comes through the front door experiencing an overdose. Or an EMT might find their supply runs out, and they don’t have any naloxone spray available when an overdose call comes in. The move by the Trump administration to cut these successful programs would seem to undermine their own goals to curb the opioid crisis. HHS Secretary Robert F. Kennedy Jr., who has spoken openly about his own heroin addiction, [said](https://wpln.org/post/rfk-stumps-for-overdose-prevention-in-nashville-as-tennessees-death-rate-declines/) just days ago that “we need Narcan” — even as his department drafts plans to cut it. In his first term, Trump [promised](https://www.nytimes.com/2017/10/26/us/politics/trump-opioid-crisis.html) to end the opioid epidemic, and he [signed](https://www.pewtrusts.org/en/research-and-analysis/articles/2018/10/24/president-trump-signs-bipartisan-bill-to-fight-opioid-crisis) some of the first significant legislation to provide federal funding to combat it before the pandemic sent overdose deaths soaring. Now, within the early days of his second term, Trump [framed](https://www.vox.com/politics/402530/trump-tariffs-canada-mexico-explanation) his tariff policy around the goal of stopping fentanyl or its ingredients from being smuggled into the US. “The recent drop in overdose deaths is extremely welcome news, yet there is still a colossal amount of work to be done,” Andrew Kessler, the founder of Slingshot Solutions, a consulting firm focused on mental health and substance abuse, told Vox. “Just as with HIV, Covid, or any other public health emergency, the keys are investments in research, practicing prevention, and evidence-based treatment. It is a tried-and-true formula that should not be deviated from.” See More: * [Health](https://www.vox.com/health) * [Health Care](https://www.vox.com/health-care) * [Policy](https://www.vox.com/policy) * [Politics](https://www.vox.com/politics) * [Public Health](https://www.vox.com/public-health) * [Trump Administration](https://www.vox.com/trump-administration)

The state of Oregon, which has long struggled with one of the [worst drug-addiction crises in the US](https://www.theguardian.com/us-news/2025/apr/01/oregon-drug-recovery-programs), last year announced $20m in [grants](https://www.theguardian.com/us-news/article/2024/aug/31/oregon-drug-recriminalization-law) to help connect people to substance-use services. The funds, the governor and lawmakers said, would go to counties to support a “treatment first” approach, encouraging jurisdictions to get drug users into recovery programs, instead of arresting and jailing them. Some local governments, however, have spent the taxpayer-funded grants to beef up law enforcement. Budget documents obtained by the Guardian through public records requests reveal that several counties have put the money toward hiring prosecutors, acquiring police gadgets and police vehicles, and covering sheriff costs. Washington county, the state’s second-largest jurisdiction, budgeted twice as much of its funds for police and district attorney salaries as it did on community programs, while two other counties used the money for laser devices that are meant to detect drugs but have been criticized as useless. Counties have said their law enforcement investments are geared toward getting people treatment. But some recovery organizations and advocates for people with addiction said the spending was a misuse of funds meant to help people in need, and an example of governments prioritizing policing over investing in services to address an urgent public health crisis. The state has [ranked](https://www.kgw.com/article/news/health/oregon-worst-in-nation-for-addiction-treatments-locals-rally-in-salem/283-b2e5b42b-218e-4b2c-9ec5-f3ce9fca8c74) last in the nation for treatment access while overdoses have surged to [five deaths a day](https://www.opb.org/article/2024/12/13/deaths-from-drug-overdoses-surged-nearly-33-in-oregon-last-year/). The counties’ spending choices also come as addiction service providers across the state are [grappling](https://www.salemreporter.com/2025/04/07/bridgeway-ends-plan-for-recovery-home-as-local-treatment-providers-brace-for-state-funding-cuts/) with significant [budget cuts](https://www.klcc.org/health-medicine/2025-03-27/walk-in-addiction-recovery-service-in-eugene-risks-shutting-after-drastic-state-funding-cuts), with some non-profits [forced](https://www.kgw.com/article/news/health/oregon-measure-110-drug-treatment-detox-inpatient-withdrawal/283-5c570fd2-c7ff-4d55-98f9-5eb29829e4d9) to put would-be patients and clients on long [waitlists](https://www.oregonlive.com/politics/2025/01/oregon-lawmaker-wants-to-expand-emergency-housing-program-for-people-navigating-drug-addiction.html) before they can get help. The funding controversy stems from the state’s high-profile flip-flop on drug policy. In 2020, Oregon voters passed a first-in-the-nation ballot measure to decriminalize possession of small amounts of drugs, aimed at treating addiction as a disease instead of a crime. But the radical initiative [faced a fierce backlash](https://www.theguardian.com/us-news/2024/feb/21/oregon-drug-law-measure-110-backlash) and was blamed for rising rates of fentanyl overdoses, public drug use and homelessness – even though studies [show](https://www.opb.org/article/2023/09/27/oregon-drug-decriminalization-measure-110-overdose-deaths/) there were a [range](https://www.opb.org/article/2023/09/27/oregon-drug-decriminalization-measure-110-overdose-deaths/) of [factors](https://www.pdx.edu/criminology-criminal-justice/measure-110-research) contributing to these problems. [Lawmakers reversed course](https://www.theguardian.com/us-news/2025/mar/31/oregon-new-drug-law-arrests) with a bill enacted last fall that recriminalized drugs, allowing police to again arrest people for carrying small quantities. However, legislators [promised](https://www.oregon.gov/gov/Documents/2024_4_01_Signing_Letter_HB_4002.pdf) the law would not be a return to “business as usual” of the war on drugs and instead set up a $20m program called “deflection”, which would allow police to refer people facing possession charges to services rather than enter the criminal legal system. Legislators gave the state’s 36 counties wide discretion on how to implement the new law, or whether to create deflection programs at all, and the decentralized approach has allowed for significant variations in spending. Washington county, located west of Portland, got a $1.5m deflection budget approved last year. Nearly $700,000 of it was allocated to salaries for new law enforcement positions: $283,487 for a high-level deputy district attorney; $116,664 for a legal specialist in the district attorney’s office; and $257,335 for a sheriff’s lieutenant. It also included $40,000 for overtime for the sheriff’s office. The county, meanwhile, allotted $360,000 total for community peer mentor services meant to directly help people get services and treatment. “These funds are limited. It’s a zero-sum game,” said Grant Hartley, a public defender. Hartley is the metropolitan public defenders director for Multnomah county, the region that includes Portland, and he sat on a committee that reviewed the deflection grants, though he didn’t have a vote. “When you spend money on a district attorney position, that might be two or three case managers you can’t hire, or a contract of services you can’t make.” Washington county’s new law enforcement positions would be focused on implementing deflection, officials said in budget documents. However, data shows that few people have been successfully directed to treatment. From September through early May, the county filed more than 1,000 drug-possession misdemeanor cases now allowed under recriminalization, the highest number in the state. Only roughly 75 people have been referred to deflection, as of April, the latest available records. [](https://www.theguardian.com/us-news/2025/may/19/oregon-addiction-spending#img-2) Roberto Paredes of El Jardín, a non-profit that serves people with substance-use disorders, does outreach in Hillsboro, Oregon, on 27 February. Photograph: Amanda Lucier/Guardian County officials, including the district attorney, Kevin Barton, set up [strict eligibility requirements](https://www.washingtoncountyor.gov/addictions/deflection-program#toc-who-is-eligible-and-not-eligible-for-the-program-) for deflection, disqualifying people who had any other charges pending or were on any supervision, such as probation. Since people targeted for possession arrests are often unhoused with criminal records, the program has been inaccessible to many who would benefit, advocates said. “The district attorney wants to think we can still arrest our way out of the problem,” said Fernando Peña, director of El Jardín, a non-profit that serves people with substance-use disorders and operates Oregon’s only recovery drop-in centers dedicated to Latinos, including one in Washington county. “Substance-use disorder is a public health issue. We need services to deflect people to.” Representatives for Washington county’s deflection program and the district attorney’s office did not respond to inquiries. Other counties that prioritized law enforcement salaries to institute deflection included: Clackamas, with $259,200 for a senior district attorney; Harney, which budgeted $83,052 for the district attorney’s office and sheriff, making up 55% of its grant; Yamhill, which allotted $124,304 for a district attorney whose job included “pursuing criminal charges” against people who weren’t successful at deflection, and $4,267 for a district attorney office “remodel”; Union, which allocated $70,000, nearly half its budget, for a district attorney job; and Crook, which allocated $129,000, or 86% of its budget, for a sheriff’s position. The budgeting decisions were approved by the state grant review committee for deflection. The interim director of the Oregon Criminal Justice Commission, which convenes the committee, declined to comment. Gadgets and vehicles -------------------- Budget line items in other counties have raised eyebrows. Clatsop county budgeted $71,000 of its deflection funds for two TruNarc “spectrometers”, handheld devices that are marketed for detecting narcotics. The county said TruNarc would allow law enforcement to “scan directly through plastic bags or glass containers” to “reduce exposure”, “increase officer safety … and protect first responders”. It’s unclear how the devices would be used to connect people to services through deflection. The devices were scrutinized in a [segment](https://www.youtube.com/watch?v=Io0yuH1CiA0) on the [Last Week Tonight with John Oliver](https://www.theguardian.com/tv-and-radio/series/john-oliver-recap), which investigated misuse of funds meant to stem the opioid crisis. The episode spotlighted a Wisconsin county that argued the devices protected officers from overdosing in the field, a claim rooted in the [pervasive falsehood](https://www.nytimes.com/2022/07/13/magazine/police-fentanyl-exposure-videos.html) within [law enforcement](https://www.argusleader.com/story/news/politics/2024/01/21/south-dakota-house-passes-bill-on-exposure-to-fentanyl-but-how-often-does-that-happen-cdc/72247000007/) that mere exposure to fentanyl can be dangerous or fatal. “This is the epitome of the funds being used to supplement law enforcement dollars. When you put out a grant without any meaningful restrictions, saying it can be spent on anything related to deflection, this is what you end up with,” said Hartley. “TruNarc was requested because of a myth about the dangers of fentanyl exposure. And by paying for it, you’re endorsing the myth.” Polk county also spent $76,000, or 32% of its budget, on TruNarc. Kristen Hanthorn, a Clatsop corrections lieutenant, said in an email that TruNarc was “not about officer safety”, but used to “fast-track decisions about referrals, services, and charging, if any”. The devices can be used to rule out charges, when illegal substances aren’t detected, and can yield information that can be shared with treatment providers: “We view TruNarc not as a tool of criminalization, but as one of harm reduction and service connection.” Marion county allocated $81,000 for a new sheriff’s patrol vehicle, which it said would be used to support the “addiction population”, but also “safety of our citizens beyond … the deflection program”. Danielle Bethell, a Marion county commissioner, said in an interview the vehicle had been assigned to a deputy who works in unhoused communities and is focused on getting people help: “We’d rather people go into treatment than jail … We really believe in connecting people to services,” Bethell said. Marion has one of the [highest number](https://olis.oregonlegislature.gov/liz/2025R1/Downloads/CommitteeMeetingDocument/303226) of deflection referrals in Oregon. Bill Stewart, a Clackamas county prosecutor funded by the grants, said the majority of his job was overseeing deflection and other efforts to get people in the criminal system into treatment, but he also continued to prosecute crimes, often tied to homelessness. The district attorney’s office has relationships with community groups and police agencies and was in the best position to oversee the new program, he said. “The most cost-effective thing we can do is get people housed and treated,” he said. Clackamas county, which has logged 900 drug-possession arrests since last year, has had 47 people enter deflection, with two completions so far, he said. More people are entering treatment after they have been charged, he said. Brandi Johnson, director of LoveOne, a non-profit that partners with Clackamas county on deflection, said she was initially skeptical of funds going to the district attorney, but said it had worked well: “We have open communication. We’re able to say: ‘What is actually going to help this person move forward?’” Representatives for the other county deflection programs did not respond to inquiries. Andy Ko, director of Partnership for Safety and Justice, an Oregon criminal justice reform group, said he was concerned that using the grants to fund additional prosecutors and other law enforcement investments encourages the same punitive responses to the drug crisis that have long failed. “To keep more people alive, we have to act differently,” he said. “This is supposed to be about helping people through a crisis. That’s what the public wants. If we keep doing the same thing we’ve been doing for 60, 70 years, we’re going to get the same result.” Since recriminalization and deflection began in September, through early May, police across Oregon have carried out nearly 7,000 arrests for possession. Only 723 people have enrolled in deflection as of mid-April, the latest available data, and only 88 people have completed the program. ‘We need more treatment’ ------------------------ Some counties have prioritized treatment services and community programs over law enforcement investments and seen more progress getting people help, advocates said. Lane county budgeted ​​$377,304 for low-barrier emergency housing focused on treatment, and $700,000 for a services provider to handle case management, a contract that went to Ideal Option, a firm that provides addiction medication. A team of navigators supports people entering deflection, getting them housing, clothing and food, then assessing their treatment needs, signing them up for healthcare and creating a plan for their recovery, said Chris Parosa, the Lane county district attorney. [](https://www.theguardian.com/us-news/2025/may/19/oregon-addiction-spending#img-3) A drug treatment center in Medford, Oregon, on 24 February. Photograph: Amanda Lucier/Guardian “If we were going to do a program deflecting people away from the criminal justice system, it didn’t make a lot of sense to house it in the sheriff’s office or DA’s office,” said Parosa. “We wanted to get people to our peer navigators and from there to programming they need to address their personalized issues.” He said he did not see any need to hire more district attorneys, adding: “If this worked well, we wouldn’t do any prosecutions.” He budgeted for a paralegal in his office to track data and progress of the program. State representative Jason Kropf said he was pursuing legislation meant to increase accountability for deflection budgets, including by tying funding allotments to how effectively counties were deflecting people out of the criminal system. Paul Solomon served on the deflection grant review committee and is chair of the Criminal Justice Commission, which has tracked data on the program. He said he hoped to see more guardrails on how the funds are spent moving forward. The state, he said in an email, was making progress toward prioritizing services over the criminal justice system, but should invest more in treatment. “While law enforcement plays an important role in public safety and community engagement, I believe we are not yet investing enough in the treatment side of the deflection equation,” he said. “Deflection only works if people have somewhere safe to go and someone they trust to walk with them. That means funding community-based providers and peer navigators who understand the lived experience of recovery. It also means ensuring people have housing and access to consistent care – not just in urban centers, but across all regions of Oregon.”

A gaggle of former US Navy Seals open up about their post-traumatic stress in this absorbing if somewhat formulaic documentary by Jon Shenk and Bonni Cohen. Ultimately, it is something of an advertisement for a new therapeutic protocol that involves the veterans taking the hallucinogens [ibogaine](https://www.theguardian.com/society/2023/jan/23/ibogaine-iboga-drug-addiction-psychedelic-gabon) (derived from an African shrub) and [5-MeO-DMT](https://www.theguardian.com/lifeandstyle/2022/sep/10/celebrity-shoe-designer-patrick-cox-on-his-psychedelic-toad-awakening) (derived, like something out of a William S Burroughs novel, from a river toad); a treatment that, to hear the subjects here describe it, can work miracles on the battle-scarred, suicidal minds of its users. Currently, the treatment is only available at a Mexican clinic because the drugs have not been cleared by the US Food and Drug Administration, but a bunch of boffins connected to [Stanford University’s Brain Stimulation Lab](https://bsl.stanford.edu/) are studying its clinical effects and the film works hard to make everything look as legit as possible. To be clear, we’re not necessarily questioning the drugs’ efficacy, but this particular film seems barely interested in the cognitive science and lets interviews with scientists with interesting glasses and fancy vocabularies stand in as guarantors that it all actually works. More persuasive is the testimony from the half dozen men we meet, who bravely discuss their pain and distress while the cameras roll. What the former soldiers experienced in the theatre of war, especially in Afghanistan in the early 2000s, has left many feeling like husks of their former selves and bedevilled by constant thoughts of suicide. One soldier testifies that the abuse he experienced as a child, which significantly contributed to his decision to become a soldier in the first place, was an even bigger component of the trauma he carried and something he could only face while under the influence of these psychedelics. Since few things are duller than watching someone else having an experience on drugs, the film opts to illustrate the trips with tasteful animation featuring images of our subjects spinning in space, surrounded by the memories that assault their senses. At one point, we get to see a soldier’s vision of spending hours on a couch watching the sitcom Malcolm in the Middle, a detail that seems deliciously amusing and against the mostly sombre grain of the film. That solemnity is underscored by the music, which seems mostly comprised of plangent Philip Glass-style chords played on violins repeated ad infinitum, a style of musical shorthand that immediately signals tragic cycles of pain. In Waves and War is on Netflix from 3 November. _In the UK and Ireland, [Samaritans](https://www.samaritans.org/) can be contacted on freephone 116 123, or email [[email protected]](mailto:[email protected]) or [[email protected]](mailto:[email protected]). In the US, you can call or text the [988 Suicide & Crisis Lifeline](https://988lifeline.org/) at 988 or chat at [988lifeline.org](https://988lifeline.org/). In Australia, the crisis support service [Lifeline](https://www.lifeline.org.au/) is 13 11 14. Other international helplines can be found at [befrienders.org](http://www.befrienders.org/)_

 The U.S. military has carried out at least 22 attacks on suspected drug boats so far this year, leaving more than 80 people dead, [according to an analysis by NPR](https://www.npr.org/2025/11/12/nx-s1-5604895/trump-venezuela-drug-boat-strikes). During a speech this week in Pennsylvania, President Trump said the strikes are making Americans safer. "Every boat that gets hit, we save 25,000 American lives and when you view it that way, you don't mind," [Trump said.](https://www.youtube.com/watch?v=I8WJz5A1Q7Y) But most experts on criminal cartels and deadly street drugs say military strikes on speedboats in the Caribbean and Eastern Pacific will have little or no impact on overdose deaths in the United States. "Killing a drug mule has minimal effect on the flow of drugs, or the systems of criminal organizations," said Vanda Felbab-Brown, an expert on drug trafficking and addiction at the Brookings Institution. According to Felbab-Brown, the street drug fentanyl, which accounts for the vast majority of U.S. drug deaths, isn't produced in Venezuela, or smuggled in boats being targeted. "Whatever actions are taken in the Caribbean have no effect on fentanyl," she said. Cartels operating in the Caribbean region are heavily involved in cocaine trafficking, Felbab-Brown said, but much of that illegal product goes to countries other than the United States. Others shared the view that the military strikes are likely to be ineffective and could even be counter-productive. "All we're doing is making the cartels come up with more potent and powerful forms of drugs to smuggle," said Jeffrey Singer, a drug policy expert at the Cato Institute. His fear is that more cartels will shift drug production away from cocaine - a risky but far less lethal street drug – and will pivot to dealing deadlier synthetic substances such as fentanyl, methamphetamines and nitazenes that can be produced and smuggled more easily. "The added risk makes it necessary for them to do that," Singer said. The Trump administration's [national security strategy, released last month](https://www.whitehouse.gov/wp-content/uploads/2025/12/2025-National-Security-Strategy.pdf), elevated the fight against "narco-terrorists" to a key Defense Department priority, calling for "the use of lethal force to replace the failed law enforcement-only strategy."  But many critics say the deadly strikes are based on unverified, false, or wildly exaggerated claims. Last month, for example, Trump justified the use of military force against alleged traffickers by saying "300 million people died last year from drugs, that's what's illegal." In fact, drug overdose deaths in the U.S. have been dropping since at least 2023 and accounted for about [76,000 fatalities](https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm) in a 12-month period according to the latest provisional data from the Centers for Disease Control and Prevention. Most experts believe historic improvements have been accomplished largely through better public health services and medical treatment for people experiencing addiction. They also credited more aggressive law enforcement, [which led to a drop in fentanyl smuggling from Mexico last year](https://www.npr.org/2024/09/30/nx-s1-5124997/fentanyl-overdose-opioid-btmps-drug-cartel-xylazine-tranq-mexico-china). Cocaine, the drug predominately trafficked through the Caribbean, accounted for roughly [22,000 U.S. deaths in 2024](https://www.cdc.gov/nchs/pressroom/releases/20250514.html#:~:text=Table_title:%20Release%20Table_content:%20header:%20%7C%20DRUG%20TYPE*,8%2C006%20%7C%20(ESTIMATED%20DEATHS%202023):%2010%2C511%20%7C), according to the latest provisional CDC data, a sharp decline from the year before. Felbab-Brown and Singer also believe any deterrent effect of a "get tough" approach by the U.S. military will be lost because of what they view as Trump's pattern of freeing and pardoning high-level drug traffickers, gang leaders, and corrupt officials linked to the cartels.  "Actions such as pardoning the former president of Honduras leads to the question, what is the point of the policy?" said Felbab-Brown. Juan Orlando Hernández was convicted in federal court last year in New York on drug trafficking and weapons charges. Trump's decision to free him [drew a sharp rebuke from Democratic Sen. Tim Kaine](https://www.npr.org/2025/12/02/nx-s1-5628382/trump-pardons-honduran-ex-president-juan-orlando-hernandez) of Virginia, who called the move "shocking." "He was the leader of one of the largest criminal enterprises that has ever been subject to a conviction in U.S. courts, and less than one year into his sentence, President Trump is pardoning him, suggesting that President Trump cares nothing about narcotrafficking," Kaine said Sunday on CBS' _Face the Nation._ Since returning to the White House, [Trump has also pardoned](https://www.npr.org/2025/05/31/nx-s1-5415939/trump-pardons-drug-kingpins-even-as-he-escalates-the-u-s-drug-war) the former leader of a drug gang called the Gangster Disciples and the creator of a criminal website called Silk Road used to traffic deadly drugs., His administration [also returned key MS-13 drug gang informants to El Salvador](https://www.npr.org/2025/10/21/nx-s1-5580555/why-the-state-department-handed-u-s-informants-over-to-el-salvador). During his first term, [Trump also freed a high-level Mexican military official](https://www.npr.org/2021/05/03/993059731/u-s-mexico-efforts-targeting-drug-cartels-have-unraveled-top-dea-official-tells-), Gen. Salvador Cienfuegos Zepeda from U.S. custody and dropped all criminal charges, despite evidence of his close ties to what was then one of Mexico's deadliest drug cartels. "I find it really difficult to understand. There is no steady principled focus on counter-narcotics policy," said Felbab-Brown. [Asked by Politico about the decision](https://www.youtube.com/watch?v=rVV1tbNZf_A&t=1657s) to pardon the former Honduran president, despite evidence he aided violent drug traffickers, Trump suggested without providing evidence that Hernández's prosecution by the U.S. Justice Department was politically motivated. "There are many people fighting for Honduras, very good people that I know, and they think he was treated horribly, and they asked me to do it, and I said I'll do it," Trump said. The Trump administration's militarized approach to drug interdiction does have support from some conservative drug policy experts. "We now need drastic action," said Andrés Martínez-Fernández at the Heritage Foundation. He acknowledged drug deaths have ebbed from record levels, but said Trump's decision to designate cartels as terrorist organizations was long overdue. "Military action and these designations, beyond them being appropriate, are really necessary to confront these threats," Martínez-Fernández told NPR. Martínez-Fernández said concern over Trump's repeated pardons of high-level drug gang leaders is "fair, to a degree," but he believes the use of targeted pardons along with military and diplomatic pressure may leverage better cooperation against the drug cartels from governments in the Western Hemisphere. Felbab-Brown, at Brookings, said she too believes Trump's approach to the drug war has pressured some foreign leaders, including Mexican President Claudia Sheinbaum, to take more aggressive action against the cartels. "The threat of tariffs as well as the designation of the cartels as foreign terrorist organizations created significant pressure on the Sheinbaum administration to push ahead on counter-narcotics cooperation," Felbab-Brown said, but added that the overall impact on drug trafficking will be minimal. In an email to NPR, White House spokeswoman Anna Kelly disputed the idea that military strikes are ineffective at disrupting the flow of drugs into the U.S. "The President is right – any boat bringing deadly poison to our shores has the potential to kill 25,000 Americans or more," Kelly said. The statement echoes a claim repeated by Trump administration officials that street drugs might at some point be used as a chemical weapon, or a weapon of mass destruction, potentially killing large numbers of U.S. citizens. [The Wall Street Journal reported last month](https://www.wsj.com/politics/national-security/justice-department-drug-boat-strike-memo-83711582?mod=e2tw&mod=e2tw) that a secret U.S. government memo authorizing military strikes in the Caribbean described fentanyl as a potential chemical weapon threat. NPR has not been able to independently verify the contents of the memo. [During a public appearance last month](https://www.youtube.com/watch?v=eKpseo58Hww&t=2s), U.S. border czar Tom Homan told Axios that he took part in a Department of Homeland Security briefing where officials discussed formally classifying fentanyl as a WMD. "When I left that briefing, it was my understanding that they would push that recommendation up to the secretary," he said. During a cabinet meeting with Trump earlier this year, Attorney General Pam Bondi argued that seizures of illegal drugs by federal agents during the first hundred days of Trump's second term had already "saved, are you ready for this media, 258 million American lives." Drug policy researchers interviewed by NPR described that assertion by Bondi as wildly exaggerated. While street drugs can be deadly, even the highest-risk substances such as fentanyl kill only a small percentage of people who purchase and consume them from dealers. Most experts say these substances would be difficult to weaponize. NPR could find only [one documented instance](https://pmc.ncbi.nlm.nih.gov/articles/PMC9866636/#sec3-toxics-11-00052) of fentanyl being used as a weapon in 2002 by the Russian government. Critics of the military strikes against suspected drug smugglers interviewed for this story said they knew of no cases in the U.S. where fentanyl or other illicit drugs were used as a weapon. They also said there's no evidence street drugs are being used by drug cartels - which are profit-driven criminal enterprises - to destabilize the U.S. or sow terror. "I don't know how you could equate smugglers, selling something illegal to people who want to buy it, as an act of war," said Singer with the Cato Institute, who said suspected criminal drug dealers should be arrested and put on trial – not killed in military strikes. Trump administration officials, however, say they're convinced military strikes will eventually lead to fewer drug deaths. "Killing cartel members who poison our fellow citizens is the highest and best use of our military," said Vice [President JD Vance in a post on social media](https://x.com/JDVance/status/1964341094226743787?lang=en).