For the first time in decades, overdose deaths in the United States, which have cost more than a million lives, have started to decline.

National data compiled by the Centers for Disease Control and Prevention show roughly a 20 percent drop compared to the previous year. This breakthrough is in large part because of a push by the Biden administration for greater access to harm reduction and treatment services for people who use drugs. As Robert F. Kennedy Jr. takes up his position as secretary of the Department of Health and Human Services (HHS), he has an opportunity to build on this progress toward bringing the overdose crisis under control.

Unfortunately, based on his prior comments, Kennedy has not given us reason to be optimistic. During his presidential campaign, he vowed to address the overdose crisis by creating a network of camps or “healing” farms where individuals would be sent to recover by "reconnect(ing) with America’s soil.”

Drug treatment farms may sound idyllic, but, in practice, they are often rife with abuse.

In Kennedy’s view, people could either go to these camps voluntarily or be coerced through the threat of incarceration if they do not comply. (Bizarrely, he has also suggested that people who take some medicines for depression or anxiety, like SSRIs, might benefit from these farms too.)

Drug treatment farms may sound idyllic, but, in practice, they are often rife with abuse. Moreover, there is dubious evidence that they are even effective. In fact, America has tried this approach before. In 1935, the government opened the U.S. Narcotic Farm in Lexington, KY. It was closed 40 years later amid allegations of medical experimentation on patients. It also had a poor record of effectiveness: research found that 90 percent of people returned to drug use after leaving the confines of the facility.

Kennedy’s drug farm idea appears to be inspired by a decades-old program in Italy, where people who use drugs are made to work on a large farm. There have been accusations of abusive practices like shackling, beating, public shaming, and confinement in cages at these very farms. This is sadly not an anomaly.

Open Society Foundations, where I direct work on drug policy, has long documented abuses in centers that purportedly provide drug treatment, but where the mainstay of “treatment” is in fact forced labor. Survivors of these centers and other experts have chronicled torture and ill-treatment in settings as disparate as China, Russia, and the Dominican Republic. Numerous international organizations, including the International Labour Organisation have decried the abuses in these programs and called for them to be shut down.

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There is simply no evidence that performing manual labor somehow helps people quit drugs or reduce their risk of overdose. We know what does work: methadone and buprenorphine are fundamental to good opioid addiction treatment and are proven to cut the risk of overdose in half. (Kennedy at least gave lip service to these medications during his confirmation hearing.) Easy access to naloxone, a proven and highly effective medication that reverses opioid overdoses in real time, saves lives when distributed directly to people who use drugs. Drug checking is a newer approach that lets people test their drugs to see if they contain fentanyl or other risky substances, helping to keep them safer. Overdose prevention centers offer a safe space where people can use their drugs with trained staff nearby, ready to assist in case of an emergency and provide connections to treatment and support services.

Kennedy would do well to follow the science and fully fund these types of programs, rather than diverting funding toward “healing farms” or reverting to drug war approaches that have failed us for decades.

Kennedy is in long-term recovery from addiction himself, having quit heroin 42 years ago. His own story of remission from drug use involves him being arrested, put on probation, and then attending treatment and twelve-step meetings. Just because that worked for him, though, does not mean it is the right prescription for everyone. In fact, research tells us that opioid dependence treatment without medications puts people at greater risk of overdose than no treatment at all.

Our collective understanding of the science of addiction has drastically advanced since Kennedy stopped using drugs in the early 80s. As HHS secretary, Kennedy will oversee departments like the Centers for Disease Control and Prevention, the Substance Abuse and Mental Health Services Administration and the National Institute on Drug Abuse that control billions of federal dollars to address drug use and addiction.

In his new role, Kennedy must heed the science and expert advice and continue to fund programs proven to work. If he does not, the overdose gains of 2024 may turn out to be short-lived.

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