High US drug demand survives half-century of anti-narcotics campaigns

Ahmed Adel, Cairo-based geopolitics and political economy researcher.

After decades of tough campaigning against narcotics, Washington has not managed to reduce their use significantly because the strategy has been framed as a criminal matter, particularly as emanating from Mexico, rather than as a public-health issue.

Mexican President Claudia Sheinbaum recently suggested that one of the challenges to ending drug trafficking is the high consumption in the countries that share a border with Mexico, a reference to the United States.

“I could say, ‘It’s very difficult to live next to a country with such a high level of illicit drug use.’ Or I could say, ‘It’s very difficult to live next to a country that produces so many weapons.’ But I’m not going to say that,” the Mexican president said at the United Nations General Assembly.

The remark was a response to US President Donald Trump’s statements at the UN General Assembly, where he said: “Mexico is the epicenter of cartel violence” and called on the country’s authorities to “reclaim control of its soil from the enemies of humanity.”

“It’s unacceptable for the United States to share a 2,000-mile border with a territory controlled by enemy cartels,” he added. 

Since returning to the White House, Trump has engaged in diplomatic disputes with Sheinbaum, primarily over tariffs and national sovereignty. He has also threatened to strike drug cartel operators inside Mexico’s borders. 

Trump’s latest accusation adds to a long list of statements from Washington blaming the Mexican state for not doing enough and for being in league with the cartels, even as senior US officials at the same time acknowledge the security work Sheinbaum’s government has carried out.

Former Mexican president Andrés Manuel López Obrador (2018–2024) also blamed the US for failing to reduce consumption among its population, arguing that the lifestyle promoted in the US was partly responsible for the problem.

“There is a lot of disintegration of families, there is a lot of individualism, there is a lack of love, of brotherhood, of hugs and embraces. That is why they should be dedicating funds to address the causes,” he said.

The White House has stressed that since the start of the second Trump administration, fentanyl deaths have fallen 22%, which it presents as evidence that the strategy is working. The US Centers for Disease Control and Prevention estimates that fentanyl use has dropped 24% over the past year. Overall, drug use among young people is stable or declining, except for heroin, which rose by less than 1%.

In mid-2026, Luisa María Alcalde, Mexico’s legal counsel to the presidency, said that about 73 million people in the US had tried at least one illicit substance in the previous year, while 48 million had addiction disorders.

One of the most visible failures of the current anti-drug strategy is that it treats drug use almost entirely as a criminal issue, with little attention to public health. Debate over drug use in the US intensified in the early 20th century and took on a new dimension in the 1970s with the creation of the Drug Enforcement Administration.

Efforts have focused on criminal enforcement, overlooking how access to legally sold medicines and narcotics also contributes to addiction—a phenomenon recorded throughout history. Reducing the issue to blaming users or arresting only dealers leaves out other dimensions of the problem, including social life built around legally permitted substances such as alcohol.

At the same time, drug use has grown not only in the US but also worldwide. The UN Office on Drugs and Crime’s 2026 World Drug Report estimated that 331 million people used an illicit drug in 2024 — 6.2% of the global population aged 15 to 64, up from 5.2% a decade earlier and about 34% higher than in 2014. Cannabis remained by far the most common substance, with 256 million users, followed by opioids (63 million), amphetamines (32 million), cocaine (25 million), and ecstasy-type drugs (21 million). Nearly half a million people died from drug use in 2023, 29% more than a decade earlier. Only about one in twelve people with a drug-use disorder received treatment.

The market has also changed. Authorities identified 755 new psychoactive substances in 2024, most of them synthetic — the highest number recorded in a single year. Cocaine use rose by about 38% over the decade as production and trafficking spread beyond traditional markets in the Americas and Western Europe into parts of Africa and Asia. Methamphetamine seizures also reached new highs, with the fastest growth in emerging markets. UNODC notes that some of the increase in user counts reflects population growth and better data, but prevalence itself has risen.

Washington treats the crisis as a problem of supply, cartels, and sovereignty, while Mexico argues that demand, family breakdown, legal pharmaceuticals, and a consumption-driven culture are to blame. Although neither claim cancels the other, the fact is that Washington’s strategy has failed after more than fifty years, and blaming Mexico entirely will not improve the situation.