Dallas, United States – Michael Watkins wipes sweat from his brow as he steps up to a stranger’s door. It’s a scorching day in Dallas, Texas; the sun has been hammering the pavement for hours.

Watkins, a 50-year-old man with glasses, a goatee and a gauge in both earlobes, doesn’t know what to expect beyond the door of the single-storey house. He doesn’t even know if the person on the other side will answer. But these door knocks are a critical part of his job. Within 72 hours of a reported overdose from the dangerous opioid fentanyl, Watkins shows up on a stranger’s doorstep with a brochure full of substance abuse resources and some of the life-saving medication known as Narcan.

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He works for the Recovery Resource Council, an addiction treatment nonprofit that’s been tackling the fentanyl crisis in North Texas since it began more than 10 years ago. Their grassroots approach has yielded great results: In 2023, Dallas County — the largest county in North Texas — recorded 280 deaths from fentanyl. Last year, that number was 203.

This is in line with a nationwide decrease in fentanyl overdoses that began several years ago, after the rate of overdose deaths in the United States doubled between 2015 and 2023. However, some show the number of overall overdose deaths once again climbing, as experts warn a disruption in the fentanyl market has been repaired.

Dallas, like all major US cities, has been ravaged by fentanyl overdoses. Because of its relative proximity to the US-Mexico border, and its extensive highway infrastructure, Dallas also has the unfortunate distinction of being a major hub in the drug smuggling routes stretching from Mexico to other major US cities.

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Becky Devine, the director of Recovery Resource Council, says her team calls these door-knocks “uninvited interventions”.

“We show up wanting to bridge the gap between where they are in this moment of desperation and isolation to all of the services that are available in our community,” she said.

“The majority of the people we encounter are receptive to us showing up, but they just don’t know what they want yet. We get phone calls weeks, months down the road that say, ‘Hey, I met you on my doorstep six, seven, 10 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 hindered by the administration of US President Donald Trump, just as the country was making consistent progress in the fight against fentanyl.

Despite declaring fentanyl a “weapon of mass destruction”, the Trump administration has slashed hundreds of millions of dollars in addiction services and drug-related research across multiple federal agencies.

Elon Musk’s DOGE team fired a team that rigorously tracked Americans’ drug use for decades, and in January, officials abruptly cancelled roughly $2bn in grants through the Substance Abuse and Mental Health Services Administration (SAMHSA), only to reverse course within days. The whiplash left providers scrambling and deepened uncertainty across the treatment system.

What’s more, in the past year, the Trump administration has reduced SAMHSA’s staff by half. Estimates vary as to how much money in total has been cut from essential treatment programmes, but in late 2025, the health news website STAT reported that at least $1.7bn in block grants for state health departments had been cut, as had about $350m in addiction and overdose prevention funding.

All this comes at a time when the fentanyl threat is evolving, with the market for the chemicals used to manufacture fentanyl largely shifting from China to India.

Chrissie Julianno is the executive director of the Big Cities Health Coalition, which represents health departments in major cities across the US. According to her, the Trump administration has created rampant chaos with far-reaching consequences.

“I think one piece that people don’t necessarily think about is, particularly in large jurisdictions, large counties and large cities, a lot of the dollars that they get from the federal government are then contracted out to community partners,” she said. “It’s not just the health department that can’t do something. It’s not just the health department that’s forced to lay off staff. It’s all of the other pieces that come together in these jurisdictions where there’s partnerships.”

Weapon of mass destruction

Last year, Watkins’s organisation tried to establish an addiction resource team devoted to Plano, one of the largest suburbs in Dallas. The team was put on hold because of a spate of federal funding cuts, including the elimination of $345m in addiction and overdose prevention.

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Watkins, for his part, is trying to be the kind of person he needed when he was at the lowest point of his own addiction journey.

He once called the police on himself because, in his words, “If I go to jail, maybe I won’t drink any more.” Instead of lock-up, he wound up in a hospital, where he received an offer for a state-funded treatment programme. He took the rep’s business card, went home, and drank for four days straight.

“But after those four days, all of a sudden it just dawned on me, ‘Yes, I’m going to die, and I really don’t know what to do,’” he said.

He called the number on that business card and entered the treatment programme. Now, 13 years later, he’s the one handing out cards and offers of help.

“I just want to be there for people,” he said. “I want to be there to help them connect the dots.”

Experts say initiatives like this are critical to the US continuing a trend that began in 2023, when fentanyl overdoses started falling nationwide for the first time in a decade. Instead, the Trump administration has focused on a militaristic approach that’s frustrated healthcare professionals and policy experts.

Trump and his cabinet members claim recent military actions against Venezuela, including the boat strikes that have drawn war crime accusations, are part of the fight against fentanyl — despite that no fentanyl comes from Venezuela. Experts say the “weapon of mass destruction” label is a political move meant to bolster the equally dubious claim that drug cartels are “terrorist organisations”, a term reserved for groups with ideological or political motives.

“I’m inclined to push back against the hijacking of terms that have a specific meaning just to harness the emotional impact,” Jonathan Caulkins, a professor and researcher on drugs and violence at Carnegie Mellon University, told STAT. “By those arguments, cigarettes would be weapons of mass destruction — cigarettes kill more Americans every year than fentanyl does.”

Caulkins isn’t alone in those concerns. Other people interviewed by Al Jazeera worried that the “weapons of mass destruction” label further stigmatises addiction and discourages people from seeking help.

“I just don’t really understand what kind of message that’s supposed to send to the person that’s still using it,” said Kristin, a Dallas woman who has struggled with opioid addiction. She asked Al Jazeera to use a pseudonym because of pending legal cases surrounding her drug usage.

“Are people who have struggled with drugs in the past or have used fentanyl, are they terrorists? And good luck getting people to talk about it with you if they are addicted to it now.”

Ben Westhoff, the author of Fentanyl, Inc, says military and law enforcement tactics are a crucial part of stopping the flow of fentanyl, especially when it involves the countries where fentanyl actually comes from.

But he stresses that investing in healthcare and local support services is equally critical.

“Even if we’re seeing 20 percent less, 30 percent fewer deaths than at the worst part of the crisis, that’s still an unprecedented amount of death,” he said. “Putting people in treatment is definitely what needs to happen. People need to receive medications for opioid use disorder, and not just after they have an overdose, but before they have an overdose.”

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Behind the eight ball

Before he became a fentanyl expert and documentarian, Westhoff was the music editor for an alternative weekly in Los Angeles. When he investigated a rise in deaths at raves in LA, he discovered typical party drugs weren’t the culprit; it was fentanyl, mostly originating from China.

Westhoff’s subsequent research exposed the role of Chinese companies — especially one called Yuancheng — in the production of the precursor chemicals necessary to create the lethal drug. As a result of his work and pressure from the US government, China cracked down on those companies, and the CEO of Yuancheng was indicted. A new paper in the academic journal Science — authored in part by Caulkins — argues that the Chinese crackdown led to a drop in overdose deaths.

However, in an interview with Al Jazeera, Westhoff says this progress could be short-lived. The precursor chemical trade has migrated to India, which has a large and less-regulated pharmaceutical and chemical industry. Those precursors are exported to Mexico, where they are then used to produce drugs that are smuggled across the US-Mexico border.

The author sees history repeating itself: For much of the fentanyl crisis, much of the focus from DC and the media fell on Mexico, not China. Now, he says there isn’t enough of a focus on the role India plays in producing fentanyl precursors — and unlike its tensions with China, the US has a relatively strong relationship with India.

“I think we’re definitely behind the eight ball,” Westhoff said. “I don’t think India is even really on the radar of many people in the position in the United States to do something about it.”

Meanwhile, Watkins says any kind of nationwide focus or discussion of fentanyl has “fallen off” in recent years, perhaps because the US is not currently in the middle of a heated presidential race, or perhaps because of the decrease in deaths.

“People are still dying,” he said, “and it’s not being pointed out like it was two to three years ago.

When asked what he thought of the classification of fentanyl as a “weapon of mass destruction,” Watkins avoided sharing a political opinion.

“Any attention to this is good regardless of the intentions behind the declaration,” he said. “With the administration’s stand, I am hoping that it could open more funding avenues.”

For him, more funding would mean a broader team and, ultimately, the chance to knock on more doors and help more people.

Back in Dallas, beneath that punishing sun, he took a deep breath, stepped forward, and knocked on the door.

He hopes they answer, and if they do, he hopes they’ll be open to support.

But if they’re not, he’ll wait. He knows the phone could ring months from now, with someone on the other end asking for help.