Executive orders on foster care, addiction treatment, fentanyl, and cannabis

This continues our recap of new executive orders in the last six months.

Foster care

A new Executive Order issued in November created an initiative “Fostering the Future” to be spearheaded by First Lady Melania Trump to improve child welfare and foster systems across the country.

It calls for a modernization of child-welfare tracking systems, including use of artificial intelligence with predictive analytics to improve foster placements, and a state-level grading scale to evaluate outcomes. It also calls for partnerships between state welfare agencies and non-profits, schools, and churches to improve outcomes for those aging out of the foster system.

Some children’s rights advocates worry that increasing faith-based involvement could put LGBTQIA+ youth at risk, and point out that the order doesn’t mention any efforts to maintain or reconnect separated children with their families, despite poverty accounting for a broad portion of child neglect cases. And artificial intelligence has been proven to produce biased results–in 2022 AI was found to flag a disproportionate number of Black children for mandatory neglect investigations in a Pennsylvania county, which social workers disagreed with one-third of the time. Social workers were able to override the tool, but the discovery raised red flags as similar models were spreading across the country. Proponents are concerned about social workers’ personal biases.

Addiction treatment

The Great American Recovery Initiative was created in January and is staffed with various heads of federal agencies. They are tasked with recommending necessary steps in coordinating a federal response to addiction, increasing awareness and fostering “a culture that celebrates recovery”, advising other agency heads on how to implement programs in the public sphere including in public health, criminal justice, workforce, education, housing, and social service systems, directing grant funding, and consulting with state and local jurisdictions and tribes, community and faith-based organizations, as well as private sector and philanthropic entities.

The order was signed just weeks after the Administration announced the elimination of almost $2 billion in federal grants for substance abuse programs nationwide. The grants were reinstated within 24 hours after backlash, but there was no explanation provided about why the grants were targeted to begin with. After Trump signed this order, Health and Human Services Secretary Robert F. Kennedy, Jr. announced an initiative meant to kick off the Great American Recovery which would allocate $100 million to combat long-standing homelessness and opioid addiction, and to expand treatment that “emphasizes recovery and self-sufficiency”.

Existing addiction recovery organizations have concerns that methods of treatment detailed in Kennedy’s announcement, such as Assisted Outpatient Treatment (AOT) have produced mixed evidence for effectiveness and may shift funding away from science-backed addiction treatment and harm reduction strategies. They welcome new funding streams and national prioritization, but worry that existing programs may not be given the opportunities to engage with the new initiative.

Rescheduling fentanyl and cannabis

Trump deemed fentanyl, in illicit contexts, a weapon of mass destruction, in an Executive Order in December. Fentanyl used in an approved medical setting is not subject to this classification. Jonathan Caulkins, a professor at Carnegie Mellon University whose research focuses on drugs, crime, terror, and violence said that “neither terrorist organizations nor militaries are using fentanyl as a weapon.” The new designation could drastically intensify drug enforcement efforts both domestic and abroad.

In contrast, Trump signed an Executive Order to advance the process of re-scheduling cannabis to a lesser drug category, also in December. In April, acting Attorney General Todd Blanche signed an order reclassifying licensed medical marijuana from Schedule I to Schedule III.