As overdose deaths fall, complacency becomes the greatest threat

Opinion>Opinions - Healthcare The views expressed by contributors are their own and not the view of The Hill As overdose deaths fall, complacency becomes the greatest threat Comments: by Jim Crotty, opinion contributor - 06/24/26 8:30 AM ET Comments: Link copied by Jim Crotty, opinion contributor - 06/24/26 8:30 AM ET Comments: Link copied

Title: Opioid Crisis Image ID: 22301524666631 Article: FILE—A photojournalist takes pictures of the exhibits on "The Faces of Fentanyl" at DEA headquarters before a press event at DEA headquarters, Arlington, Va., in this file photo from Sept. 27, 2022. Heading into key elections, there have been assertions that the drug might be handed out like Halloween candy, something the U.S. Drug Enforcement Agency's head has said isn't true. And some candidates for elected office frame the crisis as mostly a border-control issue, though experts say the key to reining in the crisis is reducing demand for the drugs.(AP Photo/Gemunu Amarasinghe, File)

FILE—A photojournalist takes pictures of the exhibits on “The Faces of Fentanyl” at DEA headquarters before a press event at DEA headquarters, Arlington, Va., in this file photo from Sept. 27, 2022. (AP Photo/Gemunu Amarasinghe, File)

For people of a certain age, recent reports that the Office of the Director of National Intelligence and other intelligence agencies are experiencing deep cuts or even elimination are unsettling.

For those of us born in or around the 1980s, 9/11 was the singular, defining event of our generation. Most of us still remember where we were when the attacks happened and live with the long shadow it cast in the years that followed.

The creation of the Office of the Director of National Intelligence was one of several post-9/11 reforms, along with the establishment of the Department of Homeland Security, designed to prevent another catastrophic intelligence failure. While its official mission is to lead intelligence integration across 18 parts of the intelligence community, its deeper purpose is to ensure the U.S. never again fails to identify emerging threats before they are fully formed.

Years ago, I interviewed for a role in the office’s National Counterterrorism Center, the entity charged with leading the nation’s counterterrorism efforts and widely regarded as a model for information sharing and collaboration across the government. During the interview, one of the panelists asked me what I considered to be the greatest terrorist threat to the U.S. At the time, ISIS was ascendant, and groups such as al Qaeda and Boko Haram remained serious, if diminished, threats, along with domestic extremist movements. That was probably the answer they expected.

Instead, I argued that the clearest danger to the U.S. wasn’t any particular terrorist group, but complacency. As time passed and memories faded, so too did the sense of urgency and vulnerability that defined the years after 9/11. And with that, we risk returning to the conditions that made 9/11 possible.

This dynamic is not unique to counterterrorism. Today, we are beginning to see the same pattern emerge in the country’s response to the drug crisis, even as the illicit drug market becomes more deadly and unpredictable.

Although overdose deaths have declined significantly in recent years, more than 70,000 Americans died from overdoses in the most recent 12-month period, and overdoses remain the leading cause of death for Americans aged 18 to 45. Meanwhile, federal funding for prevention, treatment and recovery programs faces growing uncertainty. And new, highly toxic substances like medetomidine, nitazenes and orphines — a class of synthetic opioids 10 times more potent than fentanyl — continue to enter the illicit drug supply.

It is difficult to fix public attention on complex public health issues, particularly in an era marked by quick fixes, same-day delivery and 24-hour news cycles.

In 2022, Americans were already becoming inured to the crisis of powerful synthetic drugs like fentanyl and methamphetamine becoming endemic. More recently, Stanford addiction researcher Wayne Kepner suggested we may be approaching a “stable floor” — the moment when the overdose death rate “stops being treated as an emergency and starts being treated as the cost of doing business in modern society.” We are indeed fighting a “war on urgency,” and the battle for public attention is fierce.

While overdose deaths are falling, it is far too soon to “spike the football,” “take our foot off the gas” or “declare victory.” The challenge now is ensuring those admonitions are matched by continued investment in the strategies that got us to this point.

We know that evidence-based prevention programs reduce the likelihood that young people will begin using drugs. We also know that harm reduction measures — including syringe service programs, naloxone and drug-checking tools — save lives and reduce the spread of infectious disease. And we know that medication-assisted treatment for opioid use disorder, including buprenorphine, methadone and naltrexone, helps people achieve and sustain long-term recovery.

Now is the time to double down on the full spectrum of prevention, harm reduction, treatment and recovery efforts to build on this momentum and save more lives.

If 9/11 and the Global War on Terrorism taught us anything, it is that progress can breed complacency just as easily as it breeds confidence. The drug crisis may be entering a new phase, but it is far from over. Tens of thousands of Americans are still dying every year, and the illicit drug market continues to evolve.

We should acknowledge and celebrate the gains we have made, but we must also remain vigilant. The greatest threat to sustaining these gains is not fentanyl, nitazenes or whatever drug comes next — it is complacency.

Jim Crotty is the former deputy chief of staff at the U.S. Drug Enforcement Administration. He currently serves as an adjunct professor at American University’s School of Public Affairs, sits on the advisory board of United Against Fentanyl, and is a member of the Global Initiative Against Transnational Organized Crime Network of Experts.