substance use disorder (SUD) and the Opioid/Fentanyl Overdos…

substance use disorder (SUD) and the Opioid/Fentanyl Overdose Crisis: Presidential Agenda Comparison (Trump vs. Biden) with Obama Context Tamatha Sue Garner Walden University NURS 6050: Policy and Advocacy for Improving Population Health Instructor Name March 4, 2026 Introductory Paragraph Substance use disorder (SUD)particularly opioid and fentanyl-related overdoseremains a persistent population health concern with major impacts on mortality, family stability, workforce participation, and healthcare costs. Federal attention has intensified as synthetic opioids have driven overdose deaths to historically high levels (U.S. Department of Health and Human Services [HHS], 2026). This paper compares how the current sitting president (Donald J. Trump; term beginning January 20, 2025) and the previous administration (Joseph R. Biden Jr.) approached the SUD/overdose crisis, with brief contextual references to the Obama administrations opioid response investments. Part 1: Agenda Comparison Grid Population Health Concern Selected SUD with emphasis on opioid/fentanyl overdose deaths. This includes prevention, harm reduction, treatment (including medications for opioid use disorder [MOUD]), recovery supports, and drug supply reduction. Agenda Comparison Grid (Trump vs. Biden) Category Current/Sitting Administration: Trump (2025present) Previous Administration: Biden (20212025) How the administration approached the issue Emphasized drug supply reduction and enforcement, including federal drug policy priorities released by ONDCP focused on urgent first-year steps to reduce illicit drug harms. Recent federal actions have framed fentanyl as a national security threat. Published the 2022 National Drug Control Strategy emphasizing evidence-based prevention, harm reduction, treatment, and recovery, paired with supply reduction efforts (especially fentanyl). Key policy levers ONDCP Drug Policy Priorities (executive agenda setting and interagency coordination). Policy signals strongly oriented toward enforcement and trafficking disruption. ONDCP National Drug Control Strategy (targets and performance system; federal coordination across agencies). Allocation of resources / investments Documented first-year steps and interagency coordination priorities through ONDCP. (Specific budget totals vary by fiscal year and appropriations; ONDCP priorities indicate resource direction but do not alone equal appropriated funding.) Strategy included measurable targets and coordinated federal actions; the Administrations approach explicitly supported expansion of prevention, harm reduction, treatment, and recovery capacity. Public health framing Predominantly security/enforcement framing (e.g., fentanyl treated as an extraordinary national threat). Strong public health framing (reducing overdose deaths through harm reduction + MOUD + recovery supports while also addressing supply). Brief Obama Context (supporting comparison and staying power on the agenda) The Obama administration elevated opioid misuse as a national priority and proposed substantial federal investments to expand treatment access; for example, a White House fact sheet described $1.1 billion in new funding over two years (proposed) to expand access to treatment for prescription opioid and heroin use. Obama also signed the Comprehensive Addiction and Recovery Act (CARA) in 2016, expanding federal grant programs and supporting treatment-related workforce capacity. Part 2: Agenda Comparison Grid Analysis 1. Administrative agency most responsibleand why HHS would be the most helpful lead administrative agency for addressing SUD/overdose because it houses the nations primary public health and treatment infrastructure (e.g., SAMHSA for behavioral health systems and services, and CDC/NIH for surveillance and evidence). HHS also maintains a dedicated federal overdose prevention focus and summarizes the magnitude of the overdose crisis using national data. While ONDCP coordinates drug control policy at the White House level, HHS is typically the central agency for treatment capacity, prevention, harm reduction, and recovery supportsthe levers most directly tied to reducing deaths and improving access to care. 2. How the issue gets on the presidential agendaand how it stays there SUD/overdose gets on the presidential agenda when three forces align (problem visibility + viable policy solutions + political will). In practical terms, it rises when overdose mortality trends, fentanyl supply shocks, and high-profile events create sustained urgency (HHS continues to report overdose burden as a national crisis). It stays there when: Data continue to show high mortality and system strain, keeping the problem visible. Federal strategies institutionalize targets and reporting, creating accountability that persists beyond election cycles (e.g., national strategies and performance objectives). Bipartisan legislative interest remains (e.g., fentanyl-related scheduling debates and related congressional action). 3. Entrepreneur/champion/sponsor choice Champion/Sponsor: Dr. Nora D. Volkow (Director, National Institute on Drug AbuseNIDA). Dr. Volkow is a strong champion because she is a long-standing national scientific leader in addiction, stigma reduction, and evidence-based policy translation, and she directs the federal institute most closely associated with addiction science. A champion with scientific credibility can help sustain bipartisan support by emphasizing outcomes (reduced deaths, improved recovery) rather than ideology. Part 3: 1-Page Fact Sheet (for Legislator/Staff) SUD/Opioid-Fentanyl Overdose Crisis: Why It Belongs on the Legislative Agenda Issue summary: The U.S. continues to experience a severe overdose crisis, driven largely by synthetic opioids (including fentanyl) and polysubstance use, with major consequences for public safety, families, and healthcare capacity. Federal public health agencies report overdose deaths at historically high levels, underscoring the urgency of sustained action. What policy action should prioritize (recommended agenda items) 1. Expand access to evidence-based treatment (MOUD) and recovery supports o Fund MOUD access, retention, and recovery infrastructure in community settings (including rural and underserved areas). 2. Strengthen harm reduction and overdose prevention capacity o Support naloxone access and evidence-based community interventions aligned with national strategy goals. address prescription drug abuse and heroin use. Following are the instructions: The Assignment: (1- to 2-page Comparison Grid, 1-Page Analysis, and 1-page narrative) with a title page. This is an APA paper. Use 2-3 course resources and at least 2 outside resources. Part 1: Agenda Comparison Grid Use the Agenda Comparison Grid Template found in the Learning Resources and complete the Part 1: Agenda Comparison Grid based on the current/sitting U.S. president and the previous president, and their agendas related to the population health concern you selected. Be sure to address the following: Identify and provide a brief description of the population health concern you selected. Explain how each of the presidential administrations approached the issue. Identify the allocation of resources that the presidents dedicated to this issue. Part 2: Agenda Comparison Grid Analysis Using the information you recorded in Part 1: Agenda Comparison Grid on the template, complete the Part 2: Agenda Comparison Grid Analysis portion of the template, by addressing the following: Which administrative agency (like HHS, CDC, FDA, OHSA) would most likely be responsible for helping you address the healthcare issue you selected and why is this agency the most helpful for the issue? How do you think your selected healthcare issue might get on the presidential agenda? How does it stay there? An entrepreneur/champion/sponsor helps to move the issue forward. Who would you choose to be the entrepreneur/champion/sponsor (this can be a celebrity, a legislator, an agency director, or others) of the healthcare issue you selected and why would this person be a good entrepreneur/ champion/sponsor? An example is Michael J. Fox is champion for Parkinsons disease. Part 3: Fact Sheet Using the information recorded on the template in Parts 1 and 2, develop a 1-page fact sheet that you could use to communicate with a policymaker/legislator or a member of their staff for this healthcare issue. Be sure to address the following: Summarize why this healthcare issue is important and should be included in the agenda for legislation. Justify the role of the nurse in agenda setting for healthcare issues. Assignment document should include: Title page Introductory paragraph Agenda comparison grid and analysis Fact sheet Summary/conclusions References