VA Secretary Doug Collins said Thursday during a Senate hearing on the VA’s $488 billion budget proposal for fiscal 2027 that the VA has decided to close facilities that don’t properly care for veterans and has made changes to address longstanding issues at Augusta VA Medical Center in Georgia.

According to Collins, community-based VA outpatient clinics in McMinnville, Tennessee, and Schenectady, New York, will close this year. McMinnville will close May 31, and the Schenectady clinic will close in August, according to reports.

The closures have alarmed veterans who use the clinics and will be forced to go elsewhere for care; in some cases, they will travel more than 35 miles from the existing clinics for health services.

In the hearing before the Senate Military Construction, Veterans Affairs and Related Agencies Appropriations Subcommittee, Collins said the clinics, which were privately run, did not meet VA standards of care and will be shuttered.

According to Collins, the contractors managing the facilities were not meeting requirements and veterans were failing to get quality care.

“For years, our veterans were going and being handed off, handed off, handed off, new doctors coming in all the time … a lot of time they were not showing up, we were having to then schedule them in other places,” Collins said. “This is a problem.”

Tennessee and New York lawmakers have raised concerns about the impact of the closures on the 4,000 veteran patients in their districts and states.

In March, Rep. Scott DesJarlais, R-Tenn., wrote Collins about the McMinnville closure, saying in his district, with 46,000 veterans, patients will have to drive more than an hour to receive medical care.

“I applaud the work your administration has done to improve patient outcomes. However, I am extremely disappointed and concerned about how the VA has handled the closing of this rural healthcare clinic,” DesJarlais wrote.

During Thursday’s hearing, Sen. Kirsten Gillibrand, D-N.Y., urged Collins to consider establishing a VA-operated clinic in Schenectady or, at the very least, ensure that veteran patients at the existing facility don’t fall through cracks.

“In rural America, drive times are highly relevant. With gas prices as high as they are, this could mean much more expense for them, much more stress for them,” Gillibrand said. “Please, if you are willing to do a different type of facility at the VA site, that would be the best of both worlds.”

At the same time, the VA is working to improve the troubled VA Medical Center in Augusta, Georgia, replacing its management team in the last month, the second leadership change in 14 months.

Sen. Jon Ossoff, D-Ga., ranking member of the Senate Military Construction, Veterans Affairs and Related Agencies Appropriations Subcommittee, pressed Collins for answers on the Augusta VA, which was the subject of a VA Office of Inspector General investigation.

The VA OIG found last year that the facility had a hostile work environment, including retaliation against staff, and supply shortages that hampered veteran care.

“I sent a letter earlier this year requesting some specific information about the management of that facility, and have not yet received the detailed responses to that letter,” Ossoff said.

Collins assured Ossoff that the VA had completed the recommendations made by the OIG in its report and was working to resolve the management issues.

“Nobody’s more upset about Augusta than me. It’s my hometown, it’s my home area,” Collins said.

In response to Ossoff’s questions as to how the VA announced the closures of clinics, Collins said the Veterans Health Administration believes it has followed the law in cancelling contracts. He also noted that the VA has opened 34 clinics in the past year.

The VA has requested $488 billion for fiscal 2027, including $123 billion for medical care and services, nearly $4 billion to construct new facilities and $4.2 billion to continue rolling out the department’s new electronic health records system.

Collins told members of the committee that the restart of the medical records program in Michigan this month after a three-year hiatus has been “phenomenal.”

“A tornado hit one of our facilities — lose power — and we never lost a bit in a very new system. That is how well this is working right now,” Collins said.

Subcommittee Chairman Sen. John Boozman, R-Ark., said looked forward to receiving an update on the medical records system modernization program, which began eight years ago and is now in use at 10 VA facilities and associated clinics.

“We hope we are on track to make health records boring again,” Boozman quipped.

Four years ago, the Elizabeth Dole Foundation (EDF) and Wounded Warrior Project^® (WWP), alongside White House officials and more than a hundred partners, launched the Hidden Helpers Coalition to change that—to make sure these children, teens, and young adults are seen, supported, and set up to thrive. What began as an intentional effort to listen has grown into a coordinated endeavor that brings together schools, pediatric and behavioral health providers, youth organizations, employers, and community leaders to actively support hidden helpers and their parents. Together, we’re closing gaps that once left families to navigate impossible choices alone.

That commitment came into sharp focus during this year’s Hidden Helpers Summit at Walt Disney World in Orlando. We heard elementary, middle, and high-schoolers speak about the pride they feel in caring for a parent—and the worry they carry when pain flares or difficult memories intrude. We didn’t just hear them; we formed solutions with them. With families and partners, we introduced two practical resources designed for and with hidden helpers: a Hidden Helpers Journey Map, powered by WWP, to guide kids and caring adults through the twists and turns of the caregiving experience, and an Activity Book that helps build coping skills for younger children. These aren’t glossy brochures. They are tools born of lived experience, designed to help our young caregivers reflect on their caregiving experience, identify their strengths, and identify sources of support.

Leading through Partnership

Partnership is the point. No single organization can meet the growing needs of veterans and their youth caregivers.

At the forefront, WWP exists to reconnect every warrior with a path of hope and renewed purpose following military service. The organization believes that families and caregivers of all ages play a vital role in this journey, which is why it invests in programs that meet warriors and families where they are. WWP understands the resounding impact of a network of collaboration and care. WWP administers community grants that augment its own programming and expand mental health care, respite, and enrichment for kids, among other crucial investments.

EDF is a longtime WWP community partner and has spent more than a decade elevating caregivers’ voices into policy and practice—ultimately bettering the outcomes for those whom they care for—by helping advance reforms at the VA, improving how care teams understand and include caregivers in veterans’ treatment and recovery, and commissioning research so solutions are grounded in facts, not assumptions. The picture is clear: caregiving demands time, emotional energy, and financial sacrifice; children absorb those pressures, too. The Hidden Helpers Coalition exists to turn that reality into a national responsibility.

We have seen what works. A teacher who understands why an assignment is late after a night in the ER with Dad. A clinic that brings a social worker into the exam room so a 12-year-old doesn’t have to be the translator for Mom. An employer who offers flexibility for a therapy appointment—and a stipend that covers childcare or transportation. None of these acts make headlines. Together, they change a hidden helper’s childhood for good.

The work ahead is not abstract. It is practical and urgent. We call o leaders at every level—school boards and superintendents, mayors and governors, Congress and VA—to make hidden helpers a priority by investing in respite and mental-health supports, integrating simple identification and referrals in schools and pediatric care, and backing the community partners families already trust. We are expanding training so educators, counselors, and pediatric providers can spot caregiving stress early and connect families to help without stigma or red tape. We are scaling the Hidden Helpers Journey Map and Activity Book so they’re easy to find—in schools, community clinics, VA facilities, and online—because families shouldn’t have to hunt for support. And we are widening the circle of commitment, inviting businesses, youth organizations, local governments, and neighbors to adopt simple, concrete practices that lighten the load at home.

See Them. Support Them.

As we enter the holiday season, many of us are reminded to reflect on the often unsung heroes in our lives—the families caring for our nation’s veterans and service members. For millions of American families, the service is ongoing—at kitchen tables, in waiting rooms, and during quiet moments when a child steadies a parent’s hand. Our promise to those who served must include the children who still do. America’s youth caregivers need our support—not with sympathy, but with systems that work; not with applause, but with access; not someday, but now.

We know what partnerships can accomplish. We have seen it in policy milestones, in new tools co-designed with families, and in the relief on a child’s face when support finally arrives. With the strength of this coalition and the generosity of our supporters, we can ensure no hidden helper feels invisible, and every young caregiver has the recognition, resources, and room to be a kid. That is how a grateful nation honors service — by standing with the families who live it every day.

Note to editor: Steve Schwab is CEO of the Elizabeth Dole Foundation. Lt. Gen. (Ret.) Walter Piatt is CEO of Wounded Warrior Project.

Tuesday’s report from the VA’s Office of Inspector General is based on surveys from late March and early April that were taken at 139 Veterans Health Administration facilities. Severe staffing shortages are not necessarily an indication of vacancies but refer to particular occupations that are difficult to fill.

The surveys were taken just weeks after it was reported in early March that the VA had planned to cut 80,000 jobs — out of 484,000 — through the so-called Department of Government Efficiency, known as DOGE. The VA later reduced the figure to nearly 30,000 jobs to be cut by this fiscal year’s end on Sept. 30.

President Donald Trump’s administration said Tuesday that the surveys are unreliable because they do not reflect actual vacancies, which VA officials said were in line with historical averages. But Democratic lawmakers warned that veterans won’t get the health care they need as VA positions become harder to fill.

The surveys reflected a 50% increase in the reporting of severe staffing shortages for specific jobs, both for clinical occupations that include doctors and psychologists and for non-clinical jobs that include police and custodial workers.

Nearly all of the facilities — 94% — reported a shortage for medical officer occupations that include doctors, while 79% reported shortages for nurses. The report noted that severe shortages for medical officers and nurses have been identified every year in the report since 2014.

Pete Kasperowicz, the VA’s press secretary, stressed in an email that the report is not based on vacancies and is therefore “not a reliable indicator of staffing shortages.”

“The report simply lists occupations facilities feel are difficult for which to recruit and retain, so the results are completely subjective, not standardized and unreliable,” Kasperowicz wrote.

He said that vacancy rates for doctors and nurses are 14% and 10%, respectively, which he said are lower than most other health care systems and in line with “normal VA historical averages.”

But Jacqueline Simon, policy director for the American Federation of Government Employees, said the surveys reflect the Trump administration’s profound hostility toward the federal workforce and what she said are its plans to ultimately privatize the VA.

“This is a deliberate effort to incapacitate and to undermine veterans’ support for and approval of the care they receive in VA hospitals and clinics,” Simon said. “They’ll have to wait much longer for appointments. There won’t be specialists available. They’ll have no choice but to go to the private sector.”

Simon also noted the VA’s announcement last week that it was terminating collective bargaining agreements for most VA bargaining-unit employees, which could further hurt recruitment.

The VA said in a news release that the move will “make it easier for VA leaders to promote high-performing employees, hold poor performers accountable, and improve benefits and services to America’s Veterans.”

But U.S. Sen. Mark Warner said in a news release Tuesday that the Trump administration has made it harder for public servants to do their jobs “and ultimately harder for veterans to get the care they’ve earned.”

“We also know from recent jobs reports that applications to work at the VA are plummeting,” said Warner, a Democrat who represents the veteran-dense state of Virginia. “How do skyrocketing staffing shortages and declining applicant pools make it more ‘efficient’ for veterans to access the care and services they deserve? The answer is: they don’t.”

The organization can currently host 1,300 families per day, and has served more than 500,000 families since its inception. This week, the organization marked a big milestone, as it dedicated the 100th Fisher House, located at the Capt. James A. Lovell Federal Health Care Center in North Chicago, Illinois.

But there will be no resting on laurels, says Fisher House Foundation Chairman Ken Fisher. In fact, the lessons learned from previous Fisher Houses and how they have been used have helped shape the future of the organization.

“It was our intention to build a Fisher House wherever one was needed,” says Fisher. “The need for Fisher House started to evolve in ways that we didn’t see before.”

That evolution has been driven by advancements in health care. As medics in the field and military doctors and nurses have learned how to treat injuries that would have previously been fatal, the number of troops killed in action has declined significantly. But survivors are often coming home with injuries such as multiple amputations that have created new challenges for both their ongoing health care and what Fisher House can provide.

But opportunities have been born from those challenges, as the organization has learned from Fisher House guests and how they have adapted in unexpected ways.

Fisher pointed out that in many cases, people will stay at one Fisher House initially, but then use other Fisher Houses as they transition from DOD health care to the VA. There was one other unexpected development as well.

“We also noticed that what was happening inside the houses was something that nobody ever thought was possible, and that was the support system that was forming in each and every house that we built,” says Fisher. “And why is that? Because when you look at it, you’re putting a group of people in one place under extreme stress. That can manifest itself in different ways. But as we learned and we noticed, the families had commonality of experience.

“Not many people understood what military and veteran families are going through, and so when you put these people together, what we found was they supported each other, and this was consistent in every Fisher House that we built.”

That support system is critical, because caring for wounded service members isn’t just about their physical needs. It also means taking mental burdens away, to help both those receiving treatment and their families focus on recovery.

“So there was the healing aspect, which made families better caregivers,” says Fisher. “It also made the patients better patients because they didn’t have to worry about not only the financial burden, but where their loved ones were staying and how they were getting from point A to point B.”

The mental and emotional support are critical to wounded service members, veterans and their families, but their physical needs must be met as well. The designing, planning and construction phases focus on accommodations such as wheelchair-accessible bathrooms, balconies that can be accessed by guests with limited mobility and elevators, as well as services such as on-site laundry and playrooms for children. As the needs of those who use Fisher House have changed, the organization has incorporated those needs into its planning and construction, providing for an easier user experience — which also helps with the mental and emotional aspects of a stay at a Fisher House by removing obstacles for those with limited mobility or other health issues.

“We didn’t want anyone not to be able to use a Fisher House because it wasn’t accessible given their current situation,” says Fisher. “I’d rather have a house that had too much than not enough.”

Learning from how Fisher Houses are being used has helped the organization adapt how it supports those in need, and not just through building physical locations. The organization created a Hero Miles program, where people can donate unused frequent flyer miles to help defray travel costs; to date, more than 70,000 airline tickets have been donated through the program. The organization also has a hotel program, where it can provide lodging in local hotels if there isn’t room at a Fisher House, through donations of credit card or hotel loyalty program points. In addition, Fisher House has multiple scholarship programs, which have awarded more than $27 million to 15,000 students, and is involved in sponsoring events such as the family programs for the Warrior Games and the Invictus Games.

“The Fisher House program has tried to keep up with the needs of our families,” Fisher says. “Servicemen, women and veterans, just by paying attention to what they’re doing and what their needs were, but also by staying lean and agile and only evolving in family-oriented ways.”

Lean and agile are key concerns for Fisher House, as its core mission is focusing on providing services to those who need them. Fisher points out that the organization spends 93 cents of every dollar it raises on providing services, and has received 20 consecutive four-star ratings from Charity Navigator for its performance and stewardship of how donations are spent.

“There’s a business mindset to running Fisher House, that we view ourselves as a public company and our donors are our shareholders,” says Fisher. “And so the dividends to our donors are the metrics, are the 600,000 families that have benefited from this program, the over $600 million in savings of lodging and travel, and plus the other things that we’ve gotten involved in.

“So what’s kept Fisher House on the straight and narrow is again having that public mindset, that mindset that we’re answering to our donors and to the people that we seek to serve. And if we’re not reaching those people, then we’re not doing our job, we’re not fulfilling our mission.”

Editor’s note: This article has been updated.

Kinderspot allows parents to sublet their child care spaces at Air Force child development centers when they’re away for vacation or other reasons, connecting them to other eligible Department of Defense families who need the child care.

The app, which was the brainchild of Air Force Maj. Jacque Vasta, was launched Air Force-wide in July, following testing at a number of bases. To date, 12,361 military families are using the platform, and 12,558 child care spot rentals have been facilitated, according to Air Force officials. Nearly 22,500 weeks of child care availability have been offered.

Generally, parents are required to pay for the weeks their children are away from military child care, such as when the family is on leave or when the service member is away on temporary duty. The app allows them to save those funds. When parents successfully sublet a child’s vacant spot, they receive a credit to their account.

For example, a family planning to take a vacation this summer might be able to offer their spot on the app, and it could be picked up by another military family who needs short-term child care as they make a permanent change of station move to or from the installation.

“Kinderspot has been a major win when it comes to supporting our members and their families with child care in the Air Force,” said Lt. Col. Tyler Hough, branch chief of the Air Force Business and Enterprise Systems Product Innovation, or BESPIN, in the announcement.

The rental fees are paid directly to the center at the renter’s rate. That rate is based on the family income of the renters, not the total family income of the family who has the permanent child care space.

The child subletting the spot must be in the same age group as the child with the permanent spot. Families without a child currently enrolled at a child development center must complete paperwork to become a verified renter at their center before booking available weeks through the app.

The Kinderspot app is available for download on Apple and Android devices. The Air Force child care centers validate all users of the app to make sure they are eligible to either offer a spot or rent a spot.

None of the other service branches are currently considering adopting the app, officials told Military Times.

The Navy allows families with children enrolled full-time in child care to take 10 vacation days each year per child without having to pay for those days, said Destiny Sibert, a spokeswoman for Commander, Navy Installations Command. Their child care center may use that open space to accommodate hourly care during the child’s absence. In addition, the Navy child and youth program will hold a space for a military member who is temporarily detailed to another location at no cost if child care isn’t needed during that time, she said.

The Defense Department and service branches have been taking various steps and implementing programs to alleviate the shortage of child care for military parents.

The Department of Justice (DOJ) issued new guidance following President Trump’s Executive Order designating drug cartels and transnational criminal organizations (TCOs) as Foreign Terrorist Organizations and Specially Designated Global Terrorists. The Trump Administration’s stance represents a pivotal and long-overdue shift in US counter-narcotics and counterterrorism policy.

Cartels and other TCOs have long exploited the sovereignty of countries lacking the capacity or, in some cases, the will to control them. These groups operate with near impunity within the borders of countries like Mexico. In contrast, despite its vast resources and capabilities, the US upholds international norms that respect state sovereignty. Historically, US enforcement efforts relied on coordination with host countries to combat cartels, but this dependence has often been a double-edged sword. While collaboration is essential for effective cross-border operations, it limits the US’s ability to act decisively against these organizations when host governments are unable or unwilling to cooperate fully.

By formally naming cartels and other TCOs as existential threats to national security, the Trump administration elevated them to the same threat level as terrorist groups such as ISIS and al-Qaeda. Just as ISIS destabilized entire regions of the Middle East through violence, terror, and global criminal networks, cartels have similarly evolved into sophisticated, quasi-insurgent entities that undermine governance, fuel mass violence, and wreak havoc on both sides of the U.S.-Mexico border.

Mexican cartels and other TCOs dominate the production and trafficking of fentanyl, heroin, methamphetamine, and cocaine, accounting for over 80 percent of illicit drugs entering the US. Since the early 2000s, over 700,000 Americans have died from opioid overdoses. Beyond drugs, according to a US House Committee on Homeland Security report, in 2021, cartels earned an estimated $13 billion in human trafficking. Of equal importance, thousands of Mexicans—including politicians, students, and journalists—die in battling the counter-narco-terror conflict every year. Mexico has seen more than 431,000 homicides since 2006.

Addressing Near-Peer Competitors and Emerging Threats

President Trump’s executive order characterizes cartels as national security threats that have “functionally controlled nearly all illegal traffic across the southern border of the United States.” These groups are responsible for committing acts of violence that destabilize both Mexico and the US. New Trump directives indicate that halting the flow of fentanyl and other illicit substances is no longer sufficient and instead has shifted focus to the “total elimination” of cartels and TCOs.

In his first administration, President Trump shifted US defense priorities toward countering near-peer competitors. The Trump national security assessment recognized that the post-9/11 focus on counterterrorism, which dominated US defense policy for nearly two decades, had come at the expense of addressing challenges posed by rival nation-states like China and Russia. Trump’s national security plans formalized this pivot, declaring that “inter-state strategic competition, not terrorism, is now the primary concern in U.S. national security.”

The US needed to shift. The global war on terror had achieved significant milestones, including the decimation of ISIS and al-Qaeda’s diminished capacity to carry out large-scale attacks on US soil. The prolonged focus on counterinsurgency campaigns in Iraq, Afghanistan, and elsewhere drained the US and its allies’ resources and attention from emerging threats posed by near-peer competitors. China’s rapid military modernization and economic expansion, coupled with Russia’s aggressive actions in Ukraine and its interference in Western democracies, were seen as existential challenges to American power and influence, both of which continue to exist.

Regardless of the US defense priority pivot from counterterrorism to great power competition, cartels, and TCOs have long exploited a legal and strategic gray area, allowing them to flourish. The lack of clear categorization as traditional criminal enterprises or terrorist organizations enables these groups to operate with relative impunity. The resulting ambiguity in enforcement frameworks creates a vacuum that cartels skillfully exploit to expand influence and power. These organizations have evolved into quasi-governmental entities, controlling vast territories in Mexico, dominating drug trafficking routes, and flooding American communities with lethal substances like fentanyl. Yet, with the US drawing attention back to counterterror groups and including Cartels in TCOs in these groups, the gray area has essentially vanished.

DOJ’s Push for the Elimination of Cartels as National Security Threats

Newly confirmed Attorney General (AG) Pam Bondi issued the latest policy memo outlining its approach to prosecuting cartels and TCOs as a step toward addressing organized terrorist threats requiring the full weight of US national security resources. The memo calls for the complete elimination of cartels and TCOs, highlighting the need for a change in mindset—moving beyond mitigating the damage these groups cause and towards a more aggressive, proactive strategy. It stresses that halting the flow of deadly substances like fentanyl is no longer sufficient; instead, the US must marshal the full resources of the DOJ and empower federal prosecutors to collaborate urgently with the Department of Homeland Security (DHS) and other government agencies to eliminate threats to US sovereignty and national security.

Furthermore, AG Bondi’s directive removes what the DOJ defines as bureaucratic impedances. One of the most significant policy shifts is the prioritization of terrorism-related charges for cartel leaders. Under the new directives, prosecutors can file terrorism charges under 18 U.S.C. § 2339B alongside traditional charges like drug trafficking and racketeering. This change allows for far harsher penalties, including life sentences or capital punishment, for those leading these violent organizations. Prosecutors no longer need to go through the usual lengthy review process before filing charges that could lead to the death penalty for individuals linked to cartels or TCOs. Because these cases are considered urgent public safety threats, the process is streamlined, allowing prosecutors to act more quickly.

Secondly, the DOJ has suspended the approval requirements traditionally administered by the National Security Division for filing most terrorism charges, International Emergency Economic Powers Act charges, and seeking search warrants related to such cases. The suspension significantly accelerates the timeline for terrorism-related cases involving cartels and TCOs. Removing the need for prior authorization from the National Security Division allows prosecutors to file charges, obtain search warrants, and apply for material witness warrants more swiftly. This change eliminates delays in the traditional approval process, enabling law enforcement to act quickly in high-priority cases that pose immediate threats to public safety or national security.

Expanding Legal Tools to Combat Cartels and the Fentanyl Crisis

Under AG Bondi’s leadership, the DOJ is actively pursuing legislative reforms to strengthen its fight against cartels and address the fentanyl crisis. Historically, both Congress and the Executive Branch have been slow to respond to drug-related public health emergencies. For instance, the Food and Drug Administration took nearly a decade to address the deceptive marketing practices of Purdue Pharma, which contributed significantly to the opioid epidemic. In a 2020 press release, the DOJ announced that Purdue admitted to conspiring to defraud the US from May 2007 through at least March 2017 by obstructing the lawful function of the Drug Enforcement Administration. Purdue also admitted guilt in conspiring to violate the Food, Drug, and Cosmetic Act and the Federal Anti-Kickback Statute.

Despite escalating fentanyl-related deaths and economic harm, it was not until October 26, 2017, that Acting Health and Human Services Secretary Eric D. Hargan declared the opioid crisis a public health emergency under President Trump’s first administration. Congress followed a year later with the passage of the SUPPORT Act in 2018, a comprehensive legislative effort aimed at addressing opioid addiction through expanded Medicaid coverage, treatment programs, and harm reduction measures.

While the SUPPORT Act was a step forward, it did not sufficiently address fentanyl’s unique challenges. It neglected to focus on synthetic opioids, failed to implement adequate enforcement measures, delayed funding for harm reduction tools, and did not tackle emerging drug trends tied to fentanyl’s synthetic nature, potency, and ease of production. Congress did take additional steps and passed a temporary scheduling order to classify fentanyl-related substances as Schedule I drugs under the Controlled Substances Act.

These measures were repeatedly extended through continuing resolutions but failed to provide a permanent solution with the 2023 legislation proposal for the Halt All Lethal Trafficking of Fentanyl Act. This resolution seeks to classify all fentanyl-related substances as Schedule I permanently, impose the strictest controls and penalties for trafficking these substances, and streamline research into fentanyl analogs to understand effects and medical utilization better.

However, critics raise concerns about the legislation’s reliance on punitive measures, which could arguably exacerbate racial disparities in the criminal justice system and divert resources from public health solutions. Advocacy groups and some lawmakers call for a more balanced approach prioritizing harm reduction, treatment, and prevention alongside enforcement. Additionally, some scientists warn that permanently scheduling all fentanyl-related substances without evaluating potential benefits could hinder research into life-saving treatments for overdoses.

As of February 9, 2025, the HALT Fentanyl Act has passed the US House of Representatives but has not yet become law. Despite these efforts, critics argue that Congress’s actions have been reactive rather than proactive, allowing fentanyl trafficking and fentanyl-related deaths to escalate dramatically.

Weapons of Mass Destruction

Congress must classify xylazine, a veterinary sedative increasingly discovered in illicit drug supplies, as a Schedule III controlled substance under the Controlled Substances Act. The rising prevalence of xylazine in street drugs, often mixed with fentanyl, results in devastating public health consequences, including overdoses that remain unaffected by naloxone. Federal scheduling would standardize control across states to eliminate critical gaps traffickers exploit, enable more effective testing and interdiction efforts, and empower law enforcement agencies to act decisively.

Additionally, Congress must designate large-scale fentanyl trafficking as a weapon of mass destruction (WMD). Fentanyl’s unparalleled lethality—just two milligrams can prove fatal—and capacity for mass harm make it a clear candidate for WMD classification under federal law. Such a designation would grant federal agencies, including the Department of Defense, Department of Homeland Security, and the Drug Enforcement Agency, the authority to coordinate resources and strategies at an unprecedented level. Furthermore, this policy shift would underscore the gravity of the fentanyl crisis to international partners and adversaries, signaling a commitment to safeguarding US citizens and national security while deterring misuse by malicious actors.

Cumulatively, these legislative actions represent a comprehensive framework to combat the intertwined threats of xylazine and fentanyl trafficking. By classifying xylazine as a controlled substance and designating large-scale fentanyl trafficking as a WMD, Congress would significantly enhance the US’ ability to protect public health, strengthen national security, and assert the needed leadership in the global fight against cartels and TCOs.

Nicholas Dockery is a national security professional and military policy expert. He is a decorated Green Beret and combat veteran—awarded two Silver Stars and two Purple Hearts. He is also a White House Fellow, Wayne Downing Scholar, and a United States Military Academy and Yale University graduate.

The views expressed in this article are those of the author and do not reflect the official position of the United States Government, Department of the Army, or Department of Defense.

President Trump swiftly stepped into action during his first week since returning to the White House, declaring drug cartels pose an unprecedented national security threat, far surpassing the dangers of traditional organized crime. These cartels have waged a relentless “campaign of violence and terror” across the Western Hemisphere, destabilizing regions and flooding the United States with deadly drugs, violent criminals, and ruthless gangs. In the face of this growing crisis, United States continues to face a devastating fentanyl crisis that has evolved into a national emergency, threatening public health, economic stability, and national security. This synthetic opioid, originally developed as an intravenous anesthetic in the 1960s, has become the leading cause of death for Americans aged 18 to 45.

Over the past 25 years, more than 727,000 Americans have died from opioid overdoses, marking a tenfold increase in mortality rates from 1999 to 2022. Nearly half of these deaths occurred between 2017 and 2022, with 81,806 lives lost in 2022 alone. Synthetic opioids, primarily illegally manufactured fentanyl, contribute an estimated 90 percent of these deaths.

Global Supply Chain, Geopolitical Challenges, and the Role of Transnational Criminal Organizations

The global supply chain for fentanyl involves complex geopolitical dynamics, particularly with the Peoples Republic of China and Mexican Cartels. From 2014 to 2019, approximately 70-80 percent of confiscated fentanyl in the United States originated in Chinese labs. Today, most fentanyl is produced in Mexico using precursor chemicals sourced from China. Mexican cartels, including the Jalisco New Generation Cartel and the Sinaloa Cartel, dominate this trade by leveraging alliances with Chinese triads to access chemical precursors.

Transnational Criminal Organizations (TCOs) play a significant role in facilitating the movement of these dangerous substances, exploiting economic disparities and endemic corruption within state institutions and security forces. These organized crime groups have shifted their focus toward synthetic drugs due to their high potency and compact nature, making them easier to smuggle while yielding higher profits than traditional narcotics.

The cartels employ sophisticated tactics to evade detection, including mislabeling shipments, pressing fentanyl into counterfeit prescription pills, and exploiting regulatory loopholes. They utilize existing logistical networks to move substances through Mexican ports and into the United States via multiple routes, including land, air, and sea. Concentrated illicit activities in strategic locations suggest advantages for smuggling operations, even in high-volume legal cargo areas.

Socioeconomic Impact and Economic Toll

The socioeconomic consequences of the fentanyl crisis are profound. The National Survey on Drug Use and Health reveals a troubling trend among Americans under the age of 25, with nearly 40 percent engaging in illicit drug use in the past year. This demographic is also the least likely to seek treatment for substance use disorders, highlighting a critical gap in intervention efforts.

The crisis has disproportionately affected certain communities. During the COVID-19 pandemic, Black and Latino populations experienced the steepest increases in overdose mortality rates. In 2020, Black males in Washington, D.C., faced the highest recorded mortality rate, with 134 fentanyl overdose deaths per 100,000—9.4 times the rate for White males.

The economic toll is staggering. The US Joint Economic Committee estimated that the opioid crisis cost the country $1.5 trillion in 2020, a 37 percent increase from 2017. This figure encompasses healthcare costs, lost productivity, criminal justice expenses, and reduced quality of life for overdose survivors. The crisis has significantly impacted the US labor market, accounting for 43 percent of the decline in men’s labor force participation rate and 25 percent for women between 1999 and 2015.

Implications for National Security

The fentanyl crisis has evolved into a significant national security threat, diminishing the United States’ ability to protect its national interests. It creates challenges for military recruitment, mobilization, and vital industries. The pervasiveness of the epidemic and its ties to TCOs create vulnerabilities that foreign actors, like the PRC, can exploit. The effects of fentanyl and the necessary efforts to combat it reduce American power and strain resources, preventing their allocation to more productive and beneficial purposes.

The global nature of fentanyl production and trafficking has cemented its position as a critical component of geopolitical competition and US foreign policy. With the supply chain primarily running through China and Mexico, addressing this crisis is inherently a diplomatic challenge. U.S.-Mexico relations have been strained by decades of failed counternarcotics cooperation despite substantial investments.

Historical efforts such as Operation Fast and Furious—a covert operation allowing firearms trafficking without Mexican consent—and strategies like targeting cartel leaders have only exacerbated violence while failing to dismantle drug networks effectively. The Kingpin Strategy, designed to combat drug cartels by assassinating high-level leaders, has ironically resulted in increased violence. An analysis revealed that 415 additional deaths were associated with the plan during its first four years of implementation under Mexican President Felipe Calderón’s administration.

The Need for Comprehensive Action

The first administration of President Donald Trump focused intensely on controlling migration flows from Mexico, inadvertently granting Mexican President Andrés Manuel López Obrador’s administration significant leverage in bilateral relations. By regulating the flow of migrants to the US border, Mexico effectively deflected US pressure on other critical issues, including fentanyl trafficking and the erosion of democratic institutions. The manipulation of leveraging immigration against the US in place of assistance in combating drug warfare created a political impasse that limited US influence on Mexican policy.

The fentanyl crisis represents a nexus of public health emergency, economic disruption, and geopolitical challenge. Its impacts reverberate through communities, workplaces, and international relations with stark disparities across racial and age demographics. As fentanyl continues to reshape American society and foreign policy, it demands a response that is as robust as the crisis itself. An America First plan would include:

• Enhancing intelligence gathering and sharing capabilities to disrupt TCO operations and supply chains.
• Strengthening border security measures and interdiction efforts using advanced technologies and increased personnel.
• Implementing economic sanctions and diplomatic pressure on nations facilitating the production and trafficking of fentanyl and its precursors.
• Developing robust public health initiatives to address addiction, including expanded access to treatment and harm reduction programs.
• Investing in research and developing non-addictive pain management alternatives and improved detection technologies.
• Reforming domestic policies to address the root causes of addiction, including socioeconomic disparities and mental health issues.
• Enhancing international cooperation through multilateral agreements and joint law enforcement operations.
• Implementing strategic communication campaigns to raise awareness about the dangers of fentanyl and combat misinformation.

The fentanyl crisis represents a clear and present danger to US national security, requiring a coordinated, sustained, and comprehensive response. By leveraging diplomatic, military, economic, and social instruments of national power, the United States can work towards mitigating this threat and safeguarding its citizens and interests. The complexity and scale of this challenge necessitate innovative strategies, cross-sector collaboration, and a long-term commitment to addressing both the supply and demand sides of this deadly epidemic.

Nicholas Dockery is a national security professional and military policy expert. He is a decorated Green Beret and combat veteran—awarded two Silver Stars and two Purple Hearts. He is also a White House Fellow, Wayne Downing Scholar, and a United States Military Academy and Yale University graduate.

The views expressed in this article are those of the author and do not reflect the official position of the United States Government, Department of the Army, or Department of Defense.

They have assisted Afghans struggling through State Department bureaucracy, sent food and rent money to families, fielded messages from Afghans pleading for help and welcomed those who made it out of Afghanistan into their homes.

Scott Mann, a retired Green Beret who spent several deployments training Afghan special forces, describes the last few years as “being on the world’s longest 911 call” and unable to hang up. Many veterans, like himself, owe their lives to Afghans they worked with, he said. Now those people need help for their families.

“How do you hang up the phone on something like that?” he said.

This informal network was born in August 2021 when the Taliban assumed control of the country and U.S. forces pulled out. Past and current members of the U.S. military, the State Department and U.S. intelligence services were all besieged by Afghans they’d worked with begging for help.

Thomas Kasza was just leaving active duty where he’d spent a decade with U.S. Army Special Forces and was planning to go to medical school. Then came the evacuation. He started helping Afghans he knew.

Three years later, medical school has been abandoned and he’s the executive director of an organization called the 1208 Foundation. The group helps Afghans who worked with the special forces to detect explosives to come to America.

The foundation does things like provide housing for the Afghans when they travel to other countries for visa interviews. In 2023 they helped 25 Afghan families get out of Afghanistan. Each is a hard-fought victory and a new life. But they still have about another 170 cases in their roster, representing more than 900 people when family members are included.

To focus on the mission — getting those Afghan team members to safety — he limits the conversations he has with them.

“You have to maintain a separation for your own sanity,” he says.

By the time the last plane lifted off on Aug. 30, 2021, about 76,000 Afghans had been flown out of the country and eventually to the U.S. Another 84,000 have come since then.

But more are still waiting. There are about 135,000 applicants to a special immigrant visa program for Afghans who worked with the U.S. government and another 28,000 waiting on other U.S. refugee programs for Afghans.

The Biden administration has taken steps to streamline these processes. The State department says in fiscal 2023, it issued more SIVs for Afghans in a single year than ever before — more than 18,000 — and is on track to surpass that figure this year.

But there are risks in Afghanistan for those still waiting.

Faraidoon “Fred” Abdullah is a volunteer who talks often to those still waiting. The 37-year-old once worked as a translator for the U.S. military in Afghanistan. Using the SIV program, he left Afghanistan in 2016 for America and enlisted in the U.S. Army a year later. Abdullah said he’d lost many American friends who served in Afghanistan so it was a “dream” to wear the American military uniform.

Now he helps other Afghans trying to navigate the same program he did. He’s describes the work he does as similar to that of a social worker. The calls come at random and varying hours of the night and day, he says.

He worries attention has faded from Afghanistan as other conflicts flare: “That focus has shifted to Ukraine, Gaza, Israel and Haiti. And then we are kind of like, you know, nowhere.”

“Moral injury” is a relatively new term that is often referred to in the discussion about how many volunteers, especially military veterans, feel about the aftermath of the U.S. pullout from Afghanistan and the treatment of allies. It refers to the damage done to one’s conscience by the things they’ve had to do or witnessed or failed to prevent — things that violate their own values.

It is a concept Kate Kovarovic feels passionate about. She was the director of resilience programming for #AfghanEvac, a coalition of organizations dedicated to helping Afghans trying to leave Afghanistan.

During the evacuation and its aftermath, volunteers were focused on helping Afghans flee or find safe houses. But a few months later volunteers started realizing that they needed support as well, she says.

Kovarovic says they tried a little bit of everything to help the volunteers such as fireside chats with mental health professionals and a mental health resource page on #AfghanEvac’s website. And she helped create a Resilience Duty Officer support program for volunteers needing someone to talk.

“I personally fielded over 50 suicide calls from people,” she recalls. “You were hearing a lot of the trauma.”

Eventually she had to leave the work. She now hosts a podcast called “Shoulder to Shoulder: Untold Stories From a Forgotten War” with a retired Air Force veteran she met during the evacuation. She wants people outside the community to know that the work of helping Afghans during the withdrawal and all that has happened since has been its own front line in the war on terror.

Everyone in the movement has varying views of where this effort goes from here. Many want Congress to pass the Afghan Adjustment Act, which would provide a permanent emigration pathway for Afghans. Others would like support for volunteers’ mental health concerns. Many just want accountability.

In the meantime, the work goes on — getting Afghans to safety and helping them once they’re here.

In 2022, at Dulles International Airport, Army veteran and No One Left Behind board member Mariah Smith got to experience that moment when an Afghan woman the group had been helping and her family made it to America. Smith had gotten to know her through the process of helping her come to America and offered the woman, Latifa, a place to live.

Mariah lives in Stephens City on a farm in Virginia’s Shenandoah Valley countryside. She also owns a home in town that she usually rents out but was empty at the time. She offered it to Latifa and her family.

Mariah was amazed at the response by the town of roughly 2,000 people. Townspeople pitched in with furniture, toys and household items for the family who stayed for over a year before moving to Dallas.

Smith says it was a way to help a family who’d had everything taken from them in their home country: “It felt like being a part of, I guess, the fabric of America.”