By Coryn Mayer, Federal Policy Lead, United Fentanyl
The Trump administration’s July 24, 2025 executive order Ending Crime and Disorder of America’s Streets represents a significant policy shift. As communities prepare to implement these changes, several practical questions emerge that deserve careful consideration.
When examining the broader policy landscape, several concurrent changes create an intriguing puzzle. H.R. 1 and the proposed budget include adjustments to various programs including drug trafficking and victim services funding within the Department of Justice; substance use disorder and overdose prevention initiatives across federal agencies; Medicaid eligibility requirements and paperwork processes, and federal student loan maximums affecting healthcare workforce development.
These changes raise fascinating questions about resource allocation. If civil commitment and institutional placement become primary approaches, the math becomes quite compelling to consider.
Current data offers some perspective on costs. Incarceration averages $44,090 per person annually, while “Housing First” programs cost approximately $29,105 per person per year for individuals with SUD and SMI. The CDC’s 2022 survey found that only 25.1% of people with opioid use disorder receive any medication-assisted treatment, despite extensive research showing its effectiveness.
These figures prompt interesting questions about efficiency and outcomes. When treatment facilities don’t offer all three FDA-approved medications for opioid use disorder, or don’t utilize contingency management strategies, one wonders about the gap between available tools and actual implementation.
Perhaps the most intriguing question is how success will be measured. Will it be the number of encampments cleared? The reduction in visible public drug use? Long-term recovery rates? Overdose statistics? Cost per successful outcome?
The relationship between immediate visible changes and lasting systemic improvements often proves more complex than initial appearances suggest. Communities implementing these policies will likely develop their own metrics for evaluating effectiveness.
Everyone agrees that people shouldn’t suffer on sidewalks, that overdose deaths should decrease, and that mental illness deserves treatment. The question isn’t whether change is needed—it’s which changes will produce the outcomes we all want to see.
As these policies unfold, communities will have opportunities to observe what works, what doesn’t, and what unintended consequences emerge. The data they generate will undoubtedly inform future policy decisions.
The fundamental question remains: After the sweep, where do people go, how long will they stay, and will treatment be available to those who suffer from addiction? The answer to these questions may determine whether this policy shift becomes a model for other communities, or a cautionary tale about implementation without adequate preparation.
Time will tell which story emerges.
