As a healthcare worker who served for years as a senior clinician at the nation’s first overdose prevention center in New York City and now works as an addiction specialist in the South Bronx — the borough with the second-highest overdose rate in the country — I am disgusted by Trump’s latest executive order: Ending Crime and Disorder on America’s Streets. This order claims to offer a solution to the epidemic of overdoses in the United States, yet it will only make substance use and overdoses worse. It’s a thinly veiled declaration of war against the poor and against the homeless. It’s also an attack on those using substances in what mainstream society would deem “unhealthy” ways, those we often call “addicted” or whom medicine would frame as having “substance use disorders.” In reality though, Trump’s new order is part of a war effort to hide the cruel failures of capitalism by punishing and incarcerating its victims.
Trump’s executive order starts right off the bat with a lie. Trump claims that prior programs failed because they didn’t address the “root causes” of homelessness. However, Trump and the right are not concerned with root causes. The real causes of this crisis — the opioid crisis induced by big pharma, the housing bubble based on speculation that keeps apartments empty while rents skyrocket, mental health and healthcare systems organized to extract maximum profit from bodies and not to maintain health or well being — are all products of capitalism. Trump’s “answer” is not to address these systemic failures, obviously, but instead to hide them out of sight. His call for “shifting homeless people into long-term institutional facilities,” even seemingly against their will, is not an act of compassion. It’s social cleansing, it’s an attempt to sweep poverty out of sight so that the machinery of profit can continue to churn unabated that way the “good” citizens don’t have to be “bothered” with having to see what the problems that the system creates. These efforts aren’t anything new. Similar efforts come from both parties as part of attempts to sweep the problems of capitalism to hidden corners. Whether it was Mayor Adams’ attempt to make it easier to institutionalize homeless folks to hide the encampments, or Mayor Bloomberg’s efforts to give homeless people one way tickets to anywhere but New York City. These measures only end up worsening the problem, displacing people, and further destroying lives.
The order’s attack on harm reduction is similarly dishonest. Trump mocks safe consumption sites and Housing First initiatives as failures, ignoring the overwhelming evidence that they are lifesavers. At OnPoint NYC, where I’ve worked, harm reduction staff reversed over 700 overdoses in our first year alone and over 1700 since 2021. Study after study after study confirms what we see every day: these programs prevent deaths, reduce public health hazards, and get people into treatment without force. Modeling studies have shown that harm reduction increases people’s lives by years and reduces deaths with immediate results. Meanwhile punitive policies — the same types Trump proposes — have been shown to have no benefit and can actually be extremely harmful. Harm reduction works precisely because it rejects the punishment mentality to which Trump subscribes.
The new executive order’s critique of Housing First is equally cynical and deserves a response. Having worked as a case manager in a Housing First program in the South Bronx, I’ve seen firsthand how this approach stabilizes lives faster and more effectively than punitive alternatives. Research consistently shows that Housing First programs do not increase substance use or related harms — they simply give people the security they need to rebuild their lives. But Trump isn’t interested in data. His suggestion to “improve competition” for domestic funding is a euphemism for privatization, another scheme to commodify human suffering.
This executive order isn’t about public safety. It’s about attacking and scapegoating. As so many more struggle to survive the daily abuses and indignities of life under capitalism, Trump is doubling down on the horror. This is why his new “Big Beautiful Bill” increases funding for ICE and the further militarization of our streets while cutting social services and healthcare. Indeed, Trump’s plan seems to be to push the public toward blaming homeless folks or those struggling with substance use or mental health issues for the chaos created by capitalism itself.
To my fellow harm reduction professionals and folks in the mental health and substance use fields: don’t be quiet now. Others may pray that having our heads down will keep us safe from attack, but history shows it won’t. At the same time, appealing to Democratic politicians, or any capitalist politician for that matter, is no solution either. As I have argued before:
<blockquote> Both parties are complicit in upholding the capitalist system that perpetuates this crisis. Democrat Governor Hochul’s inaction around this topic in the past is a glaring example. Hochul’s refusal to declare a public health emergency around overdose deaths, her failure to allocate opioid settlement funds to expand overdose prevention centers (OPCs), and her reluctance to push forward the Safer Consumption Services Act are all decisions that have and will continue to cost lives.<blockquote>
And this inaction then creates space to be filled by the Right, pushing policies like we see in Trump’s recent order. History demonstrates that both Republicans and Democrats have always worked together to sustain the very systems that criminalize the poor, particularly those in Black and brown communities, while funneling funds into the profitable prison industrial complex.
At the same time there may be a tendency to try to seek our organizations’ leaderships for protection at this time. But simply look at OnPoint’s current plight. Workers there are fighting for a union contract, but their boss, a supposedly “progressive” beacon in the harm reduction community, continues stonewalling. If an organization’s top management won’t even battle on behalf of its workers, how can we expect them to resist Trump’s assaults?
The only safety net we have in this fight is each other alongside the communities we serve every day. If they do decide to go to try to close OnPoint, or Project Weber/RENEW — a new OPC in Rhode Island — or any other harm reduction program, or housing program alike, it will be up to workers and the participants and patients we work with to put up a fight — not nonprofit leaderships, not capitalist politicians.
The way forward is to organize. Organize workers, patients, and communities. Organize for a world in which housing, healthcare, and harm reduction are human rights, not privileges extended and withdrawn at the discretion of the ruling class.
The post Trump’s War on the Homeless: A Harm Reduction Worker and Addiction Specialist’s Response appeared first on Left Voice.