RFK Jr. Says Drug Addicts Need Tough Love. Is He Right?

If Robert F. Kennedy Jr. is confirmed as the secretary of the Department of Health and Human Services in the Donald Trump administration, and if he carries out even part of his agenda, he will be a consequential—and controversial—cabinet secretary. I have deep concerns about some of his stances, including his record of objecting to vaccines, many of which are lifesaving. But in other areas, starting with addiction, his vision and values could transform lives.

Kennedy has declared that a priority of his is addressing the U.S. drug addiction crisis, which has killed nearly a million people since 1999. The lion’s share of these deaths occurred in recent years as fentanyl—the most potent drug ever used in epidemic proportions—burst onto the black market.

I am a psychiatrist who specializes in addiction. In addition to researching this subject, I am the medical director of a methadone clinic in Washington, D.C. So I have a vested interest in Kennedy’s policy suggestions. As does Kennedy himself.

He has lost a brother and a niece to overdoses. Kennedy’s own heroin addiction began when he was a teenager, following his father’s assassination. It ended when he was arrested at age 29 for felony possession and given two years’ probation. He spent time in rehab and in the decades since has regularly attended 12-step meetings.

Over the course of last year, Kennedy laid out, in speeches, interviews, and a documentary released last June called Recovering America, a heartfelt though incomplete agenda for managing the drug crisis. Here’s my analysis of his plans (and some of my own suggestions).

At the premiere of Recovering America, Kennedy summarized his approach: “The government has a role in actually pressuring the addict, to say, ‘We’re not going to tolerate you on the street anymore,’ to do tough love . . . We’re going to clean up your neighborhood . . . and if we can’t talk you into helping yourself, you are going to prison, you’re going to jail, until you choose some other option.”

Tough love is the opposite of “harm reduction,” a philosophy and practice that does not put pressure on drug users to quit. (The classic harm reduction policy is needle exchange, which is an important public health service.) But at the more radical end of the spectrum are the policies in liberal cities that allow street encampments and open-air drug markets.