Dallas, United States – Michael Watkins wipes sweat from his forehead as he walks toward a stranger’s door. It’s a scorching day in Dallas, Texas; The sun has been hammering the sidewalk for hours.
Watkins, a 50-year-old man with glasses, a goatee and gauges in both ears, doesn’t know what to expect outside the door of the one-story home. He doesn’t even know whether the person on the other end will answer or not. But these door-knocking are an important part of his job. Within 72 hours of her alleged overdose of the dangerous opioid fentanyl, Watkins shows up at a stranger’s doorstep with a brochure filled with substance abuse resources and some life-saving drugs called Narcan.
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He works for the Recovery Resource Council, an addiction treatment nonprofit that has been dealing with the fentanyl crisis in North Texas since it began more than 10 years ago. Their grassroots approach has yielded good results: In 2023, Dallas County – the largest county in North Texas – recorded 280 deaths from fentanyl. Last year this number was 203.
This is in line with the nationwide reduction in fentanyl overdoses that began several years ago, when the rate of overdose deaths in the United States was set to double between 2015 and 2023. However, some show that overall overdose deaths are once again rising, as experts warn that disruption to the fentanyl market has been repaired.
Dallas, like all major US cities, has been ravaged by fentanyl overdoses. Due to its proximity to the US-Mexico border and its extensive highway infrastructure, Dallas also has the unfortunate distinction of being a major hub in drug trafficking routes extending from Mexico to other major US cities.
Becky Devine, director of the Recovery Resource Council, says her team calls these door knocks “uninvited intrusions.”
“We want to bridge the gap between all the services available in our community during this moment of despair and isolation,” she said.
“Most of the people we meet are receptive to us reaching out, but they don’t know what they want yet. We keep getting calls over several weeks, several months that say, ‘Hey, I met you on your doorstep six, seven, ten months ago and I wasn’t ready then, but I’m ready now.'”
Recently, their work, like the work of similar nonprofits across the country, has been disrupted by the administration of U.S. President Donald Trump, just as the country was making steady progress in the fight against fentanyl.
Despite declaring fentanyl a “weapon of mass destruction”, the Trump administration has cut millions of dollars in addiction services and drug-related research across several federal agencies.
Elon Musk’s DOGE team fired a team that had rigorously tracked Americans’ drug use for decades, and in January, officials abruptly canceled nearly $2 billion in grants through the Substance Abuse and Mental Health Services Administration (SAMHSA), only to reverse the situation in a matter of days. Whiplash overwhelmed providers and deepened uncertainty in the treatment system.
What’s more, in the past year, the Trump administration has halved SAMHSA’s staff. Estimates vary as to how much money has been cut from essential treatment programs overall, but at the end of 2025, the health news website STAT reported that block grants for state health departments were cut by at least $1.7 billion, while addiction and overdose prevention funding was cut by about $350 million.
All this has happened at a time when the threat of fentanyl is increasing, the market for chemicals used in the manufacture of fentanyl is shifting on a large scale from China to India.
Chrissy Juliano is the executive director of the Big Cities Health Coalition, which represents health departments in major cities across the US. According to him, the Trump administration has created chaos on a large scale which will have far-reaching consequences.
“I think one thing that people don’t necessarily think about is that, especially in larger jurisdictions, larger counties and larger cities, a lot of the dollars that come from the federal government are then contracted out to community partners,” she said. “It’s not just the health department that can’t do anything. It’s not just the health department that is forced to lay off staff. It’s all the other pieces that come together in these jurisdictions where the partnership happens.”
weapon of mass destruction
Last year, Watkins’ organization attempted to establish an addiction resource team dedicated to Plano, one of Dallas’ largest suburbs. The team was halted due to several cuts in federal funding, including the elimination of $345 million in addiction and overdose prevention.
Watkins, for his part, is trying to be the kind of person he needed when he was at the lowest point of his addiction journey.
He once called the police on himself because, in his words, “If I went to jail, I probably wouldn’t drink any more.” Instead of lock-up, he was admitted to a hospital, where he received an offer for a state-funded treatment program. He took the representative’s business card, went home and drank alcohol for four days straight.
“But after those four days, I suddenly had this thought in my mind, ‘Yes, I’m going to die,’ and I don’t really know what to do,” he said.
He called the number on that business card and entered the treatment program. Now, 13 years later, it’s the same person offering cards and help.
“I just want to be there for people,” he said. “I want to be there to help them connect the dots.”
Experts say such initiatives are important for the US to continue the trend that began in 2023, when fentanyl overdoses began to decline nationwide for the first time in a decade. Instead, the Trump administration has focused on a militaristic approach that has frustrated health care professionals and policy experts.
Trump and his Cabinet members claim that recent military actions against Venezuela, including boat attacks that have been accused of war crimes, are part of the fight against fentanyl – yet no fentanyl comes from Venezuela. Experts say the “weapons of mass destruction” label is a political move aimed at strengthening the equally dubious claim that drug cartels are “terrorist organizations,” a term reserved for groups with ideological or political objectives.
“I’m inclined to push against hijacking words that have a specific meaning just to create an emotional impact,” Jonathan Caulkins, a professor and researcher on drugs and violence at Carnegie Mellon University, told STAT. “By those arguments, cigarettes would be a weapon of mass destruction – cigarettes kill more Americans each year than fentanyl.”
Calkins is not alone in those concerns. Others interviewed by Al Jazeera were concerned that the “weapon of mass destruction” label further stigmatizes addiction and discourages people from seeking help.
“I really don’t understand what kind of message this would send to someone who is still using,” said Kristin, a Dallas woman struggling with opioid addiction. She asked Al Jazeera to use a pseudonym due to pending legal cases related to drug use.
“Are people who have struggled with drugs in the past or used fentanyl, are they terrorists? And good luck having people talking about that with you if they’re now addicted.”
Ben Westhoff, author of Fentanyl, Inc., says military and law enforcement strategies are an important part of stemming the flow of fentanyl, especially when it involves the countries where fentanyl actually comes from.
But he emphasizes that investing in health care and local support services is equally important.
“Even though we may be seeing 20 percent fewer, 30 percent fewer deaths than during the worst part of the crisis, this is still an unprecedented number of deaths,” he said. “It’s definitely necessary to get people treatment. People need to get medications for opioid use disorder, not just after they overdose, but before they overdose.”
behind the eighth ball
Before becoming a fentanyl expert and documentarian, Westhoff was the music editor of an alternative weekly in Los Angeles. When they investigated the increase in deaths at raves in LA, they found that specific party drugs were not responsible; It was fentanyl, which mostly originated from China.
Westhoff’s subsequent research exposed the role of Chinese companies – specifically a company called Yuancheng – in producing the precursor chemicals needed to make the deadly drug. As a result of their work and pressure from the US government, China took action against those companies and Yuancheng’s CEO was convicted. A new paper in the academic journal Science – partly authored by Caulkins – argues that the decline in overdose deaths is due to Chinese action.
However, in an interview with Al Jazeera, Westhoff says this progress may be short-lived. The erstwhile chemical trade has shifted to India, which has a large and less-regulated pharmaceutical and chemical industry. Those precursors are exported to Mexico, where they are used to produce drugs that are smuggled across the US-Mexico border.
The author sees history repeating itself: for the fentanyl crisis, most of the DC and media attention was not on China, but on Mexico. Now, he says India’s role in the production of fentanyl precursors has not received enough attention – and the US has a relatively strong relationship with India, in contrast to its tensions with China.
“I think we’re definitely behind the eight ball,” Westhoff said. “I don’t think India is on the radar of many people in positions in the United States to do anything about this.”
Meanwhile, Watkins says any kind of nationwide focus or discussion on fentanyl has “died down” in recent years, perhaps because the US is not currently in the midst of a heated race for the presidency, or perhaps because of the decline in deaths.
“People are still dying,” he said, “and it’s not being highlighted the way it was two to three years ago.
When asked what he thought about classifying fentanyl as a “weapon of mass destruction”, Watkins avoided sharing a political opinion.
“Whatever the intentions behind the announcement, it’s good to pay attention,” he said. “From the administration’s standpoint, I’m hopeful that this could open up avenues for more funding.”
For them, more funding will mean a broader team and, ultimately, the chance to knock on more doors and help more people.
Back in Dallas, under that harsh sun, he took a deep breath, walked forward, and knocked on the door.
They expect them to respond, and if they do respond, they expect them to be ready to support.
But if they aren’t, he will wait. He knows that several months from now the phone may ring and someone on the other end may ask for help.
