Trump, Tariffs, and Drug Overdose Deaths

Plus Trump's 2024 talk with Theo Von on addiction

Feb 07, 2025

I will just jump right into it.

4 Feb 2025, WSJ: How Fentanyl Became Central to Trump’s Tariffs:

President Trump has declared that the illegal transit into the U.S. of migrants and drugs, chiefly fentanyl, is a national emergency, and he has targeted Mexico, Canada and China with tariffs to force them to halt the flow.
How fentanyl became part of the tariff equation comes down to the production and smuggling of an opioid that has caused the overdose deaths of hundreds of thousands of Americans.
The U.S. has long pressured Mexico, by far the main source of fentanyl, to do more to halt the drug’s production and export, and the money-laundering activities that are vital to the drug trade. Canada entered the picture because of the growing presence of Mexican cartels there.
Trump agreed Monday to delay tariffs on Canada and Mexico but proceeded with 10% levies on China aimed at what he describes as Beijing’s failure to prevent illegal fentanyl from entering America.

This is the graph the WSJ ran:

This is somewhat misleading, in terms of not showing how shocking the increase was.

They started the graph in 2015, which hides the big step up in trend in that year specifically.

As well, the 2024 data do not include the final 4 months of the year, at the very least. You have to read the footnote to realize that.

I will show below that it does seem that drug OD deaths are trending downward in 2024, but the graph above is still misleading. One could try to trend and give projection for a full-year 2024 estimate of drug OD deaths or some other adjustment. But by omitting 4-months’ worth of deaths, the graph makes it look like there was a substantial drop-off in drug ODs.

As for Canada:

U.S. border patrol seized 43 pounds of fentanyl at the border with Canada last year, a fraction of what was seized at the southern border. However, a series of drug busts in Canada have spotlighted how Mexican cartels and other organized crime groups have begun operating labs there.
In October, Canadian police busted a fentanyl “superlab” in British Columbia and seized hundreds of pounds of fentanyl and methamphetamine. The lab had enough chemicals to operate for weeks and produce 95 million lethal fentanyl doses, police said.

The lethal dose and the “effective” recreational dose are pretty close (not to be confused with the dose used in surgery). From the DEA:

Producing illicit fentanyl is not an exact science. Two milligrams of fentanyl can be lethal depending on a person’s body size, tolerance and past usage. DEA analysis has found counterfeit pills ranging from .02 to 5.1 milligrams (more than twice the lethal dose) of fentanyl per tablet.
42% of pills tested for fentanyl contained at least 2 mg of fentanyl, considered a potentially lethal dose.
Drug trafficking organizations typically distribute fentanyl by the kilogram. One kilogram of fentanyl has the potential to kill 500,000 people.

And more:

Comparison between 12 months-ending January 31, 2020 and the 12 months-ending January 31, 2021 during this period:
Overdose deaths involving opioids rose 38.1 percent.
Overdose deaths involving synthetic opioids (primarily illicitly manufactured fentanyl) rose 55.6 percent and appear to be the primary driver of the increase in total drug overdose deaths.

Let me go to an interlude, which has to do with Trump’s 2024 campaign.

Trump with Theo Von on Addiction and Sobriety

I knew about Trump’s older brother Fred, who died young due to his alcoholism. It relates to Trump’s own practice of never drinking alcohol.

But I didn’t see this, from August 2024:

This is from a longer podcast episode with Theo Von and Trump, but I want only this part.

Donald Trump was born in 1946, and his older brother Fred, Jr., was born in 1938. Thi was an 8-year difference, so Donald looked up to his older brother. But things went awry.

Fred was an alcoholic and died from a heart attack at age 42 as a result. Yes, that’s really young. My dad died from a heart attack at 38 (a combination of smoking and unfortunate genetics). This sort of thing has a large impact.

Updated Drug Overdose Death Trends in the U.S.

First, as we have the finalized data for 2023, let’s look at the age-adjusted death rates for (unintentional) drug overdose deaths:

The main thing to note is that, sure, the rate slightly decreased in 2023.

Very slightly.

But here is a more relevant note:

Even after that slight decrease, the total increase in drug OD deaths leads to an age-adjusted death rate that’s over 50% higher in 2023 than in 2019.

Now, I couldn’t give you a 2024 rate, due to how data are reported for “external” cause of death.

But if you want to see some 2024 drug OD death trends:

During 2024, drug OD deaths started to trend downwards. They were still well above 2019’s levels.

I am also suspicious of the rapid drop-off.

Spreadsheet

Drug Ods High Level Trend 1999 2024 2025 02 06

35.7KB ∙ XLSX file

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Potential Effect of Recent Deals?

I am always watching the mortality stats.

I was watching them years before the pandemic. I will watch them well after the Trump administration (if I’m still alive).

I don’t know if Trump is really targeting the fentanyl “trade”, such as it is. It has been the primary driver of recent increases in drug OD deaths.

The drug OD deaths dropped off, slightly, during 2023, at least on a rate basis. It seems there was a large drop-off in drug OD deaths in 2024, but we will see where finalized stats land. There may have been other things going on.

Because the thing is, of course, one may shift around causes of death, but it is difficult to shift around the total number of dead.

I am a patient person, and can see what will happen with fentanyl deaths. I hope there are positive results.

But it will take a lot to get us back to just pre-2015 levels.