Safer Solutions: What Do Supply and Demand Have to Do with Drug Policy?

“What will the federal government do about illicit drugs?” was a common question leading up to the 2024 presidential election. Both candidates’ campaign rhetoric skewed toward “war-on-drugs” and “tough-on-crime” approaches. Now, as the current administration looks to year two, the Office of National Drug Control Policy (ONDCP) is developing the 2026 National Drug Control Strategy. Built around the administration’s Drug Policy Priorities, it outlines federal policy priorities to curb drug use nationwide.

The Drug Policy Priorities offer “a comprehensive and coordinated blueprint to reduce the devastating impact of illicit drugs on American society.” R Street recently provided recommendations for translating these priorities into the 2026 National Drug Control Strategy, challenging the ONDCP to prioritize demand-reducing strategies alongside supply reduction. In a nutshell, here’s what we said:

Stopping the Flow of Drugs Alone Did Not Stop Overdoses from Increasing

We discussed why supply reduction isn’t enough to quell illicit drug use and overdose deaths in a previous Safer Solutions installment, but here’s the tl;dr version: Supply-side interventions can help decrease the flow of drugs into the country, but they cannot come close to reducing that flow to zero, especially with cheap and easily produced drugs like fentanyl. For comparison, the Department of Homeland Security estimates that only about 3 percent of the cocaine crossing land borders was seized in 2021, while estimates for other drugs were not included. Furthermore, although there’s a lot of talk about how cracking down on cartels has reduced overdoses, evidence suggests that drug overdose deaths began decreasing in most states before major operations took place at the border. This suggests that other interventions and factors were decreasing overdoses prior to these initiatives.

“Demand-side” Interventions Are Diverse—and Essential

Both prevention and treatment are important strategies for reducing demand for illicit drugs. A key strategy for reducing demand for drugs is preventing individuals from starting to use them in the first place, and prevention features prominently in the Drug Policy Priorities. Increasing “the number of individuals receiving evidence-based treatment and achieving long-term recovery” is another priority. However, accessing treatment is already enormously challenging in many places. Too many people who are ready for treatment can’t access it. Many facilities are over capacity, and services are often limited, especially in rural regions. This is particularly true for accessing medications for opioid use disorder (MOUD)—evidence-based “gold-standard” treatments for opioid use disorder. While these medications reduce demand by creating an off-ramp from drug use, they must be more broadly accessible to those who need them.

While prevention and treatment decrease demand by reducing the number of buyers, assuming these strategies will work for every person is unrealistic. For example, not every person who already uses drugs has a substance use disorder or is ready for treatment. Since evidence supporting the effectiveness of coercive treatment is lacking, how do we address the space between prevention and treatment? This is where harm reduction shines. Harm reduction decreases the health risks that can come with illicit drug use and gets people into treatment if they’re interested in quitting completely. Harm reduction is a crucial element of demand reduction because it offers incremental, achievable steps toward recovery and helps people stay alive long enough to choose to engage with treatment when they are ready.

A comprehensive approach to drug control requires prioritizing the demand-reducing strategies of prevention and treatment and the space between them. Continued promotion of prevention efforts, more accessible treatment, and harm reduction programs (e.g., naloxone distribution to people likely to witness an overdose) all complement supply-side interventions.

Policy Is Crucial to Making Demand-Side Interventions Work

Ultimately, our recommendations to the ONDCP take a holistic view of the causes of and solutions to the overdose crisis. This blend of harm reduction, prevention, and treatment could make meaningful progress toward reducing demand for illicit drugs in our communities:

• Continue support for community-based naloxone distribution programs to reduce overdose fatalities.
• Streamline prescribing and dispensing regulations at the federal level to support access to evidence-based MOUD and encourage states to update relevant legislation to match federal regulations.
• Produce guidance on novel evidence-based treatments, such as contingency management, for stimulant use disorder.
• Address the gap between prevention and treatment by incorporating mechanisms that support harm reduction service providers.
• Produce guidance outlining evidence-based interventions that can be implemented using opioid settlement funds to reduce demand for drugs.
• Reduce limitations on state block grants to enable development of localized programs that address communities’ specific needs.

Decreasing illicit drug use requires a multifaceted approach that addresses both supply and demand. Supply-side interventions are just one piece of the complicated drug policy puzzle.