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Want to Resist Trump? Treat the Homeless With Compassion
If you don’t want to acquiesce to the president’s way of doing things, might it not finally be time to make eye contact with those neighbors of ours who are homeless?
Sep 14, 2025
The federal takeover of Washington, DC rightfully attracted extensive media coverage, but an executive order called “Ending Crime and Disorder on America’s Streets,” quietly issued on July 24, received remarkably little attention. Perhaps it didn’t make a splash because it wasn’t specifically about policing (or, for that matter, National Guarding), but more generally about how we should treat people who already exist on the outermost fringes of society, human beings who have long been reduced to labels like “addict” or “homeless.”
Indeed, the Trump administration is counting on us to renounce those living on the streets, while struggling with their mental health or the cost of housing (or both). And if history is any guide, that may be exactly what most of us do. While the current moment may feel shocking in so many ways, the president’s order to end what he’s labeled “disorder” represents a further development of norms that have been in place for all too long. They are also norms that we have the power to change.
Identifying a very real crisis, the president’s July 24 executive order noted that “the number of individuals living on the streets in the United States on a single night during the last year of the previous administration—274,224—was the highest ever recorded.” The order went on to state that the majority of those who are unhoused have a substance use disorder, with two-thirds reporting that they have used hard drugs at some point in their lives. What followed was the administration’s solution: “Shifting homeless individuals into long-term institutional settings… will restore public order.” Precisely which institutions was unclear.
One thing we know is that the use of substances is often connected to past trauma or current hardship, including oppression and poverty. Regardless of that reality, not just the president but all too many of us tend to believe that people who use drugs are undeserving of our compassion or support. In 2021, a national survey found that 7 of every 10 Americans believed that those who use drugs problematically are “outcasts” or “non-community members.” (And yes, those were the terms used.)
The president’s executive order fuses drug use and homelessness into a single issue without revealing that homelessness can cause or exacerbate substance use disorder—because people use drugs to cope with privation. As addiction expert Gabor Maté has said, “Don’t ask why the addiction, ask why the pain.” Much like those of us who reach for wine or social media in order to escape, when people who are unhoused use drugs, they are usually searching for a way to make life tolerable. At the same time, they come to be regarded by their peers as non-community members, making it so much less likely that this nation will fight the president on his plans to round them up and erase them from our world entirely.
Meanwhile, many of us with homes never pause to consider our common habit of avoiding unhoused people in every possible way. We cross the street, shift our gaze, anything to avoid the briefest glimpse of their humanity—perhaps terrified to see ourselves in them. Here’s a thought, though: If you don’t want to acquiesce to the president’s way of doing things, might it not finally be time to make eye contact with those neighbors of ours who are homeless? Might it not be time to acknowledge their humanity and, in doing so, recover some of our own?
“Arbitrary and Prolonged Detention”
The Los Angeles nonprofit LA Más helps residents build security through collective economic power and home ownership. As Helen Leung, its executive director, put it recently: “Families who’ve been in their neighborhoods for generations are getting priced out. Vendors who work multiple jobs are sleeping in their cars. Kids have classroom friends disappear mid-semester because rent went up again.” She noted that immigrants and working-class households in particular are experiencing acute displacement pressure, which ultimately pushes some to become houseless—and now they find themselves in the crosshairs of the president’s July executive order.
That order proposes the vast expansion of a practice that has been around for a very long time. In recent years, in fact, in states across this country, there has been an uptick in involuntary commitment, a trade term for the forced institutionalization of people who are unwell—or, now, simply unhoused.
Evidence suggests that rounding up masses of unwell people and institutionalizing them will do anything but benefit public safety, while endangering the individuals who are locked up.
Elected officials of all political stripes, including the current president, have claimed that involuntary commitment is an evidence-based way to treat mental illnesses, including addiction. Research does show that, in certain cases, involuntary commitment can be beneficial. But in all too many cases, it’s both ineffective and inhumane. A recent report by the Federal Reserve Bank of New York found that the institutionalization of individuals who were involuntarily hospitalized in “judgment call cases”—meaning cases where one physician might recommend hospitalization, while another would not—nearly doubled the risk of death by suicide or overdose. It also nearly doubled the likelihood of that person later being charged with a violent crime, perhaps because such institutionalization disrupted employment, subjecting people to still more dire economic circumstances. (Again, don’t ask why the addiction, ask why the pain.) Even a recent essay in the New York Times advocating forced treatment conceded that it must be well funded and thoughtfully carried out—conditions that are virtually certain to be unmet in the current climate.
In other words, evidence suggests that rounding up masses of unwell people and institutionalizing them will do anything but benefit public safety, while endangering the individuals who are locked up. On-the-ground data also indicates that, even before US President Donald Trump focused on that tactic, such commitment was unequally applied, with Black and Hispanic people more likely than White people to be institutionalized against their will.
“We’re not operating with an optimal treatment system, mandatory or voluntary,” according to Regina LaBelle, director of the Center on Addiction Policy at Georgetown University and the former acting director of the White House Office of National Drug Control Policy. “We’re starting from a really bad system. And so pushing people into a really bad system will end really badly.”
In response to the president’s executive order, the American Bar Association published a statement saying that it raises grave constitutional and civil rights issues and “paves the way for arbitrary and prolonged detention.”
Housing Is a Human Right
A response to the president’s executive order, published in the Psychiatric Times, a journal for psychiatry professionals, noted that it “invokes fear of people with psychiatric illnesses, talks of indiscriminate incarceration of people who have not committed a crime, as well as collection and sharing of sensitive health information with law enforcement, and yet proposes no actual solutions.”
Unfortunately, the president and his crew undoubtedly do regard the involuntary commitment of unhoused people as an “actual solution.” Indeed, many people who have homes or apartments feel unhappy at the sight of human beings living on the streets of their neighborhood and want something done about it. But the underlying problem isn’t that people live on the street or use substances in public in order to tolerate despair. As Helen Leung put it, “When someone loses their housing, it’s not because they need to be institutionalized—it’s because we’ve allowed housing to become a commodity instead of a human right.”
“What works best is making sure that we have affordable housing for people,” says LaBelle. New research out of Philadelphia, for instance, found that a program of cash assistance for housing costs more than halved the odds of participants becoming homeless.
But our prevailing housing system—in which the purpose is less to provide shelter than to generate profits for those who own real estate—has resulted in rents or costs that are beyond reach for increasing numbers of Americans. And as if such a state of affairs weren’t bad enough, President Trump now plans to make “alternative” investment assets, including real estate, available to anyone with a 401(k). If he succeeds in doing so, far more people will compete to own real estate for the purposes of turning a profit, which will undoubtedly raise real estate prices yet more, driving rents higher still.
Notably, his July 24 executive order provides law enforcement with the vague instruction to institutionalize people who “cannot care for themselves,” which could result in a kind of real estate roulette. In essence, those who lack the cash to pay for housing at market rates—no matter how high those rates rise—could be deemed unable to care for themselves, and therefore would become eligible to be rounded up and taken… where?
Very Much Precedented
On one matter there is widespread agreement: There’s already a distinct shortage of mental health services, especially for those who can’t pay for them.
“Our current system does not provide for long-term institutionalization,” noted the Psychiatric Times in its response to the president’s executive order, which itself does nothing to expand the inpatient capacity of treatment facilities or increase funding for mental health services. The administration actually slashed funding for such programs this spring and has approved cuts to Medicaid, a program that currently funds 24% of all mental-health and substance-use care in the United States.
It’s easy to blame Trump, but far harder to engage in self-reflection: How have I participated in the dehumanization of unhoused people or those who use drugs?
So where will people be taken? Health and Human Services Secretary Robert F. Kennedy Jr. has proposed rural camps for addiction recovery, but that (controversial) policy would require substantial new funding, rather than cuts, to healthcare. The president and Congress do seem to have an appetite for increasing funding for military and enforcement programs. The hastily constructed immigration detention facility in Florida known as “Alligator Alcatraz” offers a nightmarish example of how this administration pursues the development of new carceral space.
Already, immigrants are being rounded up and institutionalized, a practice likely to be expanded to still more of our neighbors. While all of this may feel unprecedented, it’s all too precedented. This nation has a long history of institutionalizing people who have not committed a crime, including Indigenous people and those with mental health struggles. It’s easy to blame Trump for all that’s now happening, and he certainly bears enormous responsibility, but he’s not responsible for everything.
He is not, for example, responsible for the longstanding and pervasive stigma attached to people who are unhoused or mentally unwell or both, which has pushed all too many of us in the wealthiest nation on Earth to live in isolation and poverty and even to perish. It’s easy to blame Trump, but far harder to engage in self-reflection: How have I participated in the dehumanization of unhoused people or those who use drugs? Do I have the capacity to recognize the humanity in everyone without exception?
ICE (Like Stigma) Now Operates in the Shadows
Perhaps it seems that acknowledging the humanity of those who have so long been dehumanized is far too little and too subtle to make a difference now. And it’s true that we need much more than that, including strong collective action to create housing that people can afford and that’s accessible to those who have experienced addiction and criminalization. But it’s also true that nonjudgmental support from peers makes a difference in the lives of those who are struggling, raising the odds that they may heal and go on to live fruitful and connected lives.
In the past half-year of Donald Trump’s second term as president, raids by masked US Immigration and Customs Enforcement (ICE) agents have become a fixture of American life. ICE now operates in the shadows—and that’s how stigma works, too. Stigma toward people who use drugs or who live without homes is a corrosive force that makes it acceptable to withhold compassion, care, and connection from certain of our neighbors. But unlike forces equipped with military-grade tactical gear, stigma can be overcome by any individual who chooses to witness and affirm the humanity of all our neighbors. And in our present American world, doing so is surely a revolutionary act.
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We Need to Double Down on Harm Reduction, Not Walk Away From It
We have come too far to turn our backs on what works when it comes to sound, life-saving drug policies. Now is the wrong time to politicize practical, proven responses to this medical emergency.
Sep 04, 2025
We lost more than 80,000 Americans to overdose last year, making it the leading cause of death for adults aged 18 to 44. But, for the first time in years, we have some reason for hope: in 2024, overdose deaths dropped by 27 percent. That progress, however, didn’t happen on its own. It came from investments in harm reduction: an ecosystem of strategies including naloxone distribution, syringe service programs, medications for opioid use disorder, and housing-first programs that secured shelter for people before connecting them to care.
Unfortunately, much of that progress is in danger. In recent weeks, President Trump issued an executive order targeting the very programs that provide these services and helped bring down overdose deaths. In doing so, the administration is cutting federal funding for proven, evidence-based interventions. It is also carving out naloxone from the larger harm reduction ecosystem it belongs to, falsely suggesting that naloxone can succeed in isolation. The reality is that saving someone from an overdose requires more than just increasing naloxone’s availability. It requires a broader public health approach to reach those at risk. Without systemic support for trusted community-led networks, naloxone will not be able to reach the people who are most vulnerable.
I should know. I’ve spent the past 30 years working with people who use drugs—first addressing HIV in Central and Eastern Europe, and now as Director of Drug Policy at the Open Society Foundations, where we support harm reduction efforts globally. I’ve seen, time and again, that when we lead with evidence and compassion, we save lives.
The biggest barrier we consistently face isn’t science, but the stigma and misunderstandings associated with drug use.
Back in the 1990s, I worked on a program that supported harm reduction efforts in former Soviet countries, then the region with the highest rates of HIV among people who use drugs. The interventions were straightforward: provide sterile syringes, educate people about safe injections, and offer access to basic medical care. Whether in Tomsk, Russia, or my hometown in New Jersey, I never met a person who didn’t want to protect themselves. We were fortunate to have tools that people actually wanted. And they work. Syringe service programs cut HIV and hepatitis C infections in half. Other interventions, like methadone and buprenorphine, can lower HIV incidence by as much as 60 percent by helping people reduce or stop injecting altogether.
The biggest barrier we consistently face isn’t science, but the stigma and misunderstandings associated with drug use.
People mistakenly believe that providing sterile syringes encourages drug use or that drug treatment medications simply “replace one drug with another.” But by supporting and translating scientific research, educating medical professionals, and, perhaps most importantly, supporting people who use drugs, we’ve made great progress. These efforts have not only produced strong results but have also helped chip away at longstanding stigma.
Take, for example, the OnPoint NYC—the first overdose prevention center in the country. Since 2021, the center has reversed nearly 2,000 overdoses. Syringe exchange programs are now authorized in 37 states, the District of Columbia, and Puerto Rico. With bipartisan support, red states from Kentucky to Indiana to South Carolina are using opioid settlement funds to support critical harm reduction work. The reality that many have recognized is that harm reduction programs provide an important on-ramp to broader care. They engage people who often don’t go to traditional medical providers out of fear. People who visit syringe service programs are five times more likely to enter treatment than those who don’t. Harm reduction programs are an optimal venue for naloxone distribution since they directly reach people at risk of overdose. That’s why the Trump administration’s recent actions are so concerning. They reflect a shift away from science that has been working.
We have come too far to turn our backs on what works. We must not politicize practical, proven responses to this medical emergency. We live in a time where evidence-based public health interventions that had once been taken as givens have become political flashpoints. But we can’t let politics come in the way of saving very real lives. Too much is at stake now.
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Trump Is Straining Our Mental Health Then Gutting Support Services
Despite the administration’s cuts, there appears to be surprising agreement among people with divergent political beliefs that it’s time to expand services for those who are struggling.
Apr 27, 2025
The United States has been in the throes of a mental health and overdose crisis so severe it has spanned five presidential administrations and been classified as an official state of emergency in three of them. No one knows exactly how this emergency will play out during the current Trumpian cocktail of uncertainty, fear, and cuts to social services, but charts of the recent turbulence of the stock market suggest a relevant visual: Imagine the nervous systems of millions of already struggling Americans, along with millions more who are being pushed to the limits of what they can handle, all experiencing deep emotional crashes, briefly recovering, only to collapse again into new lows. And while it might be tempting to think that many of us aren’t affected by the present gut-wrenching emotional tumult because we appear fine and don’t seem to care about what’s happening to the more desperate among us, our recent research suggests that people do care—including, perhaps, those you’d least expect to do so.
Last year brought a widely reported piece of news in mental health. Overdose fatalities in the United States declined substantially, a notable but qualified victory. As overdose deaths fell 9% from 2021 to 2023 for white Americans, such deaths increased 12% for people of other races, according to a Reuters analysis of data from the Centers for Disease Control and Prevention. Street drugs continue to kill more than 84,000 people in the United States annually, and overdoses remain the leading cause of death among Americans ages 18 to 44.
In such a devastating moment, in all corners of American society, people are in ever greater need of mental health services, just as funding for them is being slashed.
In other words, many young Americans and people of all ages attempt to numb difficult, even unbearable feelings, and sometimes that numbing is fatal. Depending on who you are, your preferred numbing agent might be wine, work, prescription pills, social media, street drugs, or something else entirely. But in the second age of Donald Trump, as well as long before him, all too many of us have been grappling with profound pain, whether from a sense of hopelessness about the future, oppression, trauma, grief, job loss, or general financial strain in ever more economically difficult times. Those among us who are not U.S. citizens are increasingly seized with the fear of being deported due to false, unknown, or unsubstantiated allegations and without due process. In addition to sowing terror, this has also been exacerbating an already widespread sense of loneliness, as people stay inside for fear of being detained.
Another source of despair is the urgent overseas humanitarian crisis over which noncitizens and legal permanent residents are now being seized, shackled, and imprisoned or disappeared for expressing moral protest. One (but not both) of the authors of this article has the protection of U.S. citizenship, although experts now question whether even citizenship will continue to provide protection, and so, for safety’s sake, we’re not naming that crisis or the widely shared sense of grief and powerlessness as men, women, and heartbreaking numbers of children die there. Students and people in all walks of life continue to take to the streets in protest, including the one of us who is a citizen.
Indeed, in such a devastating moment, in all corners of American society, people are in ever greater need of mental health services, just as funding for them is being slashed. May is Mental Health Awareness Month and so a ripe moment to take stock of the damage being done and to report that there appears to be surprising agreement among people with divergent political beliefs that it’s time to expand services for those who are struggling.
Dismantled?
In late January, the Trump White House issued a vague memo that put a temporary freeze on the disbursement of federal financial assistance. By early February, NBC News had reported that some health clinics were closing their doors. Then, in March, the Trump administration announced the cancellation of more than $11 billion in funding to deal with addiction, mental health, and related issues. A federal judge subsequently halted that cancellation of funds, saying such a sudden termination caused “direct and irreparable harm to public health.” The Trump administration requested a stay of the order, with plans to appeal.
By mid-April, around the same time that Elon Musk’s DOGE took over responsibility for posting federal grant opportunities for the public, Reuters published an extensive investigation on the subject. It drew on interviews with dozens of experts to conclude that funding cuts and associated layoffs were “dismantling the carefully constructed health infrastructure that drove the number of overdose deaths down by tens of thousands last year.”
In Philadelphia, where one of the authors of this article resides, the Inquirer reported that a forensic research lab that tests the nation’s illicit drug supply for new and harmful substances hadn’t received crucial funds from the federal government. That, in turn, meant the furloughing of staff and a growing backlog of untested samples. If you’ve followed news about the evolving nature of illicit and counterfeit drugs, you know that novel and dangerous molecules are continually turning up in unexpected places, whether the veterinary sedative xylazine or the more potent medetomidine found in batches of fentanyl, or as deadly levels of nitazenes in seemingly innocuous pills. Slowing or halting drug-testing is a dangerous proposition.
Meanwhile, a Philadelphia outreach program run by Unity Recovery was recently forced to shut down, while its workers who had offered services in addiction, nutrition, and other kinds of healthcare suddenly lost their jobs. At the time of this writing, the organization’s website features a red warning symbol and the message: “Due to federal funding cuts enacted on March 24, 2025, Unity Recovery has lost critical access to resources to provide peer support services.” It also notes that “information is changing rapidly”—a nod to the fact that a judge halted the cancellation of funds and no one now knows exactly how the pending cuts will (or won’t) unfold.
And while there is supposedly stark disagreement between the Trumpist and non-Trumpist halves of this country about whether such cuts should be taking place at all, extensive data from the purple state of Pennsylvania suggests there is far more agreement than anyone might have guessed.
“It Is in All Our Interests to Give Help and Support”
Over the past year, the two of us have worked on a research project that collected perspectives from thousands of Pennsylvanians about mental health, substance use, and the state’s criminal justice system. We also collected hundreds of surveys from Pennsylvanians who work in law enforcement and criminal justice. We guessed that such anonymous surveys would capture punitive viewpoints and a belief that people who use drugs should be put behind bars. And, yes, there was a bit of that, but to our surprise, on the whole, we found something quite different.
More than a quarter of Pennsylvanians said that, in recent years, they had become more sympathetic toward people who struggle with drugs or alcohol. A majority of the respondents identified stress and traumatic life events as a primary cause of problematic substance use. And most surprising of all, we found broad agreement on policy priorities across—yes, across—the political spectrum.
It’s notable that, in this purple state where the current president won more than 50% of the vote, there is majority support across the political spectrum for providing genuine assistance to people who need it.
Eighty-three percent of Pennsylvanians agreed that “addressing social problems such as homelessness, mental health, and substance use disorder” was a greater priority than “strengthening social order through more policing and greater enforcement of the laws.” That view was shared across political affiliations: 71% of respondents identifying as conservative agreed with it, as did 88% of those identifying as liberal.
Asked whether they agreed or disagreed with the statement, “It is in all our interests to give help and support to people who struggle with drugs and/or alcohol,” 68% of respondents identifying as conservative or very conservative agreed, as did 77% of liberal or very liberal respondents. Notably, there was majority support (61%) for increasing government spending for this cause. Even 54% of conservatives said they supported increasing spending to improve treatment and services for substance-use disorder.
We assumed that Americans who work in law enforcement and criminal justice would have more hardline views. Again, we were wrong. Compared with Pennsylvanians overall, over the past five years, those who work in the criminal justice system were—yes!—more likely to report feeling greater sympathy toward people who struggle with drugs or alcohol, and an overwhelming 70% of them believed that this society was obliged to provide them with treatment. Asked what services they believed could help prevent people struggling with substance use from becoming involved in the justice system, 71% said “more access to mental health treatment providers or services.”
Because much drug use in this country is criminalized, those who work in criminal justice are on the frontlines of our mental health crisis. These new findings suggest that, at least in Pennsylvania, justice system workers feel a responsibility to offer genuine help and see bolstering mental health services as the best way forward.
Of course, the opposite is happening. Yet it’s notable that, in this purple state where the current president won more than 50% of the vote, there is majority support across the political spectrum for providing genuine assistance to people who need it.
The ongoing axing of services will likely prove devastating. It leaves many feeling like there is nothing they can do. Yet, as individuals, count on one thing: We are not powerless (as we so often believe).
Looking Out for Others
When life feels scary and uncertain, as it increasingly does in the Trump era, many people respond by thinking a lot about what might happen in their world and trying to anticipate the future in order to make plans and gain at least some minimal sense of control. Both authors of this article—one of us a doctor, the other a writer—struggle with our ruminations on the state and direction of this country, which can lead us deeper into anxiety and isolation.
And while we probably can’t escape those fearful feelings (and probably shouldn’t try to), we can at least stay in touch with others instead of giving in to the common urge to withdraw. That isn’t easy, of course. Both of us find ourselves struggling to pick up the phone. But this is a time when picking up that phone couldn’t be more important. A time when so much of our world is endangered is distinctly a moment to put special effort into looking out for one another and regularly experiencing the energy that comes from human connection.
We also understand that many Americans are living on the edge. We often don’t know who among our neighbors and loved ones is wrestling with the question of whether life is worth living. (Suicide rates remain high for Americans generally and especially for those with drug and alcohol use disorders.) Right now, there is a dire need for better services, but even if every person had access to quality mental healthcare, our actions as community members would still matter. It’s sometimes possible to save the life of someone you care about just by telling them you care.
Each of us, including you, has a role to play in keeping all of us alive and safe as best we can in ever more difficult times.
From Crisis to Care
No one yet knows exactly how the Trump administration’s potentially staggering cuts to community healthcare and social services will unfold. But amid the chaos, people across this nation continue to do meaningful, lifesaving work.
The Drug Policy Alliance, a nonprofit outfit that seeks to prevent harms associated with drug use and drug criminalization, recently published a report entitled “From Crisis to Care.” It presents an intelligent roadmap for improving mental health and addressing substance use and homelessness, including investing in treatment options that are evidence-based and voluntary, as well as housing programs and community-based crisis response systems. These are anything but radical ideas. They’re grounded in research and can serve as a model for the future. Of course, funding and some political power will be necessary to accomplish such things, and that might sound farfetched in our current situation. But simple actions in the present make it more likely that such services will be launched in the future.
We can save a life by reaching out to friends and neighbors, and it’s no less important to recognize when we ourselves are struggling. Sometimes we worry about others without acknowledging that we, too, are on the edge. With that in mind, we’re writing the following words for you and every other reader but also for ourselves: When you’re struggling, contact someone you trust for support. By doing so, you’re also implicitly giving them permission to ask for help from you when they need it, and by giving and receiving help, you create a new pattern of reciprocity.
Such reciprocity has political significance. It fosters social cohesion, a precursor for coordinated action on a far larger sale.
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