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President Trump on Monday signed an executive order to designate fentanyl as a “weapon of mass destruction,” dramatically escalating his fight against the drug. Trump hosted an event in the Oval Office to award the Mexican Border Defense Medal to members of the military who were dispatched to assist with efforts to crackdown on crossings at the southern border. As part of the event, he signed the order as he warned against the “scourge” of fentanyl. “No bomb does what this is doing,” Trump said, attributing 200,000 to 300,000 deaths each year to the drug. (Samuels, 12/15)

There is no doubt that, in the wrong circumstances, fentanyl can be an agent of mass destruction. In the last decade, the ultra-potent synthetic opioid has caused hundreds of thousands of Americans to die by overdose, shattering families, shortening life expectancy, and destabilizing the economy in the process. But is fentanyl a weapon of mass destruction? (Facher, 12/15)

In related news —

President Donald Trump has signed more executive orders in less than a year of his presidency than he did in his entire first term — repeatedly bypassing Congress and forcing the courts to grapple with the constitutional bounds of his power. One third of Trump’s executive orders have been explicitly challenged in court as of Dec. 12, a Washington Post analysis of data from nonprofits CourtListener and JustSecurity found. (Davies, Zakrzewski and Morse, 12/16)

More news about substance use —

President Trump said Monday his administration is “considering” reclassifying marijuana as a less dangerous drug, days after The Washington Post reported he is expected to sign an executive order telling agencies to pursue reclassification soon. Such a move would continue efforts begun by the Biden administration, which started the process to make marijuana a Schedule III drug in 2024 but did not finish it before former President Biden left office. (Weixel, 12/15)

After Nick Reiner entered his first drug treatment program around the age of 15, his turbulent life veered between rehab and homelessness, sobriety efforts and relapse. At times, it appeared as though he had achieved more stability in adulthood. But any semblance of equilibrium was shattered when Mr. Reiner’s parents, the Hollywood director Rob Reiner, 78, and Michele Singer Reiner, 70, were found stabbed to death in their Los Angeles home on Sunday. Nick Reiner, 32, was arrested on suspicion of murder and is being held without bail. (Jacobs and Sperling, 12/15)

In other mental health news —

A smartphone-delivered digital cognitive behavioral therapy (CBT) intervention improved generalized anxiety disorder symptoms in adults, a randomized trial showed. (Monaco, 12/15)

In his teens and early 20s, Tyler Adolfo showed an ability to communicate effectively. A local newspaper in Massachusetts published a front-page story about his success in a speech contest. He won his college’s talent contest with a rap performance. And in October 2021, he helped craft a campaign on behalf of his fraternity to increase awareness of sexual assault in Greek life, before speaking with a New York Times reporter about the issue. Over the next six months, Adolfo’s words kept attracting attention — except this time because they were bizarre. (Berger, 12/16)

Six midlife symptoms of depression were tied to an increased risk of dementia, prospective research from the Whitehall II cohort showed. (George, 12/15)

The U.S. Department of Veterans Affairs plans to reorganize the management structure of the Veterans Health Administration. The department aims to eliminate redundant layers of bureaucracy, ensure consistent application of policies across all facilities and empower local hospital directors, according to a Dec. 15 VA news release. (Kuchno, 12/15)

The U.S. Department of Veterans Affairs will remove about 25,000 open and unfilled positions, a spokesperson said, adding that they were "COVID-era roles that are no longer necessary." "No VA employees are being removed, and this will have zero impact on Veteran care," department spokesperson Pete Kasperowicz said. (12/15)

More on the federal reorganization —

���ϳԹ��� News: Disability Rights Lawyers Threatened With Budget Cuts, Reassignments
The Trump administration is trying to slash access to lawyers who defend the rights of Americans with disabilities, advocates say. Most of the lawyers work either for the Department of Justice or for disability rights agencies that Congress set up in every state decades ago. Many of the Justice Department lawyers quit in 2025 after being reassigned to other duties, their supporters say. And Trump budget officials proposed deep cuts to federal grants supporting the state-based legal groups. (Leys, 12/16)

On MAHA and nutrition —

The Food and Drug Administration is considering a rule change that would cut back on how often dietary supplement warnings must appear on packaging, a move experts say could make them easier to miss. Unlike prescription drugs, the FDA doesn’t review dietary supplements for safety and effectiveness before they hit the market. (Lovelace Jr., 12/15)

People susceptible to developing heart issues benefit the most from reducing their consumption of saturated fats, according to a review of research that comes as the federal government prepares to revise dietary recommendations. A paper published Monday in the Annals of Internal Medicine found that people at high risk of developing cardiovascular problems saw a reduction in major health issues including heart attack and stroke when they cut back on saturated fats. The picture was different for people without those same cardiovascular risks. (Calfas, 12/15)

Saturated fats are having a moment, one that has ensnared researchers in a political debate they never intended to enter. (Cooney, 12/15)

People with prediabetes who get their blood sugar under control may cut their risk of death from heart disease or heart failure by half, according to new research. Prediabetes, which is estimated to affect 38 percent of U.S. adults, is a condition in which blood sugar levels are elevated but don’t meet the threshold for diabetes. The research, published Friday in the journal Lancet Diabetes & Endocrinology, suggested that people with prediabetes whose glucose levels returned to normal — those who reached “remission” — had half the risk of cardiovascular death or hospitalization from heart failure two decades after reaching remission than those who did not. (Agrawal, 12/15)

A bipartisan group of senators is making a renewed push toward finding a health care solution as the hour-glass winds down to the end-of-month deadline to extend the enhanced Affordable Care Act (ACA) subsidies. Roughly 20 senators met Monday night at the invitation of Sen. Susan Collins (R-Maine), with lawmakers using a proposal from her and Sen. Bernie Moreno (R-Ohio) — which includes a two-year extension of the ACA tax credits and reforms aimed at winning over conservatives — as a jumping off point. (Weaver, 12/16)

House Republican leaders are preparing a vote this week on a healthcare bill that lets enhanced premiums for marketplace insurance plans expire, all but guaranteeing their end. Instead, the bill aims to promote association health plans, improve transparency among pharmacy benefit managers and fund cost-sharing reductions in Affordable Care Act plans that lower benchmark premiums but raise enrollees’ cost. It also includes abortion restrictions. (McAuliff, 12/15)

It’s a time of choosing for a band of vulnerable House Republicans who have long warned about the expiration of key Obamacare subsidies. Speaker Mike Johnson is barreling toward a Wednesday vote on a health care bill he and other Republican leaders are presenting as an alternative to the tax credits that are set to expire at the end of the month. They have no plans to allow a vote before then on extending the subsidies. (Lee Hill and McCarthy, 12/15)

Florida will be hit harder than any other state if ObamaCare subsidies expire at the end of the year, which is looking increasingly likely as Republicans in Congress struggle to unite behind a plan to extend the tax credits. More than 1.5 million Floridians could lose health care as monthly payments skyrocket. Average premium costs could shoot up by 132 percent, or by $521 annually, for Floridians who currently receive enhanced ObamaCare subsidies, according to the Center for American Progress. (Anderson, 12/15)

���ϳԹ��� News: One Big Beautiful Bill Act Complicates State Health Care Affordability Efforts
As Congress debates whether to extend the temporary federal subsidies that have helped millions of Americans buy health coverage, a crucial underlying reality is sometimes overlooked: Those subsidies are merely a band-aid covering the often unaffordable cost of health care. California, Massachusetts, Connecticut, and five other states have set caps on health care spending in a bid to rein in the intense financial pressure felt by many families, individuals, and employers who every year face increases in premiums, deductibles, and other health-related expenses. (Wolfson, 12/16)

���ϳԹ��� News: ���ϳԹ��� News’ ‘Letters To The Editor’: Readers Make Their Wish Lists, Checking Up On Health Care
More than a decade after the Affordable Care Act took effect, we’re still trapped in a confusing and costly health care maze (“Readers Take Congress to Task and Offer Their Own Health Policy Fixes,” Nov. 12). The ACA expanded coverage and protected people with preexisting conditions, but it also layered subsidies, narrow networks, and rising premiums on top of an already fragmented system. Millions still face deductibles so high that “coverage” often means financial anxiety instead of security. The problem isn’t our doctors or hospitals — it’s the structure. (12/16)

A little-known committee that suggests modifications to the US vaccine injury compensation program is scheduled to meet in late December, after Health and Human Services Secretary Robert F. Kennedy Jr. indicated he wants changes. The Advisory Commission on Childhood Vaccines will convene Dec. 29, its first gathering in more than a year, according to a notice posted on the Federal Register. (Nix, 12/15)

Su Wang, MD, tuned in to a meeting of federal vaccine advisers earlier this month with some trepidation. She wanted to share her experience living with hepatitis B and encourage the advisers to continue recommending vaccine for all newborns. But she was also prepared to hear vaccine misinformation from the committee, whose members were handpicked by Health and Human Services Secretary (HHS) Robert F. Kennedy Jr., a longtime anti-vaccine activist. (Szabo, 12/15)

FDA Commissioner Martin Makary said the government must show greater humility and be more transparent if it hopes to rebuild public trust in its health guidance, which he said has been badly eroded since the pandemic. In an interview with NPR's Steve Inskeep, Makary addressed recent controversy over an FDA memo that cited rare reports of child deaths linked to COVID-19 vaccinations. He said the information was not new but had not been made public, and argued that officials failed to clearly communicate how risks varied by age and underlying health conditions, even as vaccines saved many lives. (Inskeep, 12/15)

On covid and long covid —

The US Food and Drug Administration has no plans to put a “black box” warning on Covid vaccines, the agency’s top official said, despite a recent report that US regulators were preparing to add a new caution to the immunizations. CNN reported Friday that the FDA was preparing to change the safety information related to the shots to include its strongest level of warning. But on Monday, in an interview with Bloomberg TV, FDA Commissioner Marty Makary said that “we have no plans to put that on the Covid vaccine.” (Smith, 12/15)

Pregnant women who develop COVID-19 after being vaccinated are much less likely to be hospitalized, need intensive care, or deliver early compared with women who aren’t vaccinated, a study today shows. Canadian researchers who examined the medical records of nearly 20,000 women who developed COVID-19 while pregnant, found that vaccinated women were 62% less likely to be hospitalized than unvaccinated women and 90% less likely to need critical care, according to the study, published in JAMA. (Szabo, 12/15)

A new large cohort study in Israel suggests that adults who survive a COVID hospitalization face significantly higher long-term mortality than their uninfected peers, with elevated risk persisting for 2 years after hospitalization. The findings were published in the International Journal of Infectious Diseases. (Bergeson, 12/12)

Why some people experience long-lasting physical and mental effects from covid-19 could be linked to chronic inflammation, according to new research that experts say could help develop new treatments for the confounding condition that continues to afflict millions. Some early research on the condition has suggested that long covid’s symptoms linger because the virus persists in people’s bodies. But the new study published Friday in Nature Immunology found that people with long covid had activated immune defenses and heightened inflammatory responses for more than six months after initial infection compared with those who fully recovered. (Chiu, 12/15)

On measles and bird flu —

Officials responding to a South Carolina measles outbreak are following an increasingly familiar script in their advice to families: You should vaccinate your kids, but it's your choice. (Bettelheim, 12/16)

As the United States faces its largest measles outbreak in three decades, one of the nation’s most storied public health voices has largely fallen silent on social media. A new exploratory analysis suggests that the Centers for Disease Control and Prevention (CDC) dramatically scaled back its social media posts during the first seven months of 2025, creating what researchers call a “health communication void.” That empty space was quickly filled by news media and, in some cases, less-credible voices. (Bergeson, 12/15)

Yesterday the US Department of Agriculture’s Animal and Plant Health Inspection Service (APHIS) announced the first known case of highly pathogenic avian influenza (HPAI) in a dairy cattle herd in Wisconsin, noting that the detection does not does pose a risk to consumer health or affect the safety of the commercial milk supply. (Soucheray, 12/15)

U.S. health officials have expanded approval of a much-debated drug aimed at boosting female libido, saying the once-a-day pill can now be taken by postmenopausal women up to 65 years old. The announcement Monday from the Food and Drug Administration broadens the drug’s use to older women who have gone through menopause. The pill, Addyi, was first approved 10 years ago for premenopausal women who report emotional stress due to low sex drive. (Perrone, 12/15)

An influential anti-abortion group is rallying its supporters around the country to flood EPA with requests to add mifepristone — a drug used in more than two-thirds of all abortions — to a list of drinking water contaminants tracked by public utilities. The strategy by Students for Life of America to target EPA’s rule-making process, which grew out of a recent meeting with EPA staff, is the latest move in a yearslong crusade by abortion opponents to use environmental laws to restrict abortion. (Ollstein and Wittenberg, 12/15)

The US Food and Drug Administration sent warning letters to Target, Walmart, Kroger and Albertsons after some of the stores failed to remove recalled baby formula linked to a large infant botulism outbreak. The FDA said it communicated with the retailers about the recall repeatedly, even sending several emails requesting plans of action to comply with the recall, but none of the companies responded to the request. (Christensen, 12/15)

Sanofi agreed to pay US biotech Dren Bio as much as $1.8 billion, including $100 million upfront, as the French company expands a push to develop medicines for immune-system diseases. The two companies will use closely held Dren Bio’s platform to discover new drug candidates which Sanofi will then develop and commercialize, according to a statement Monday. The terms are largely made up of conditional payments to Dren Bio dependent on the experimental medicines reaching certain milestones. (Furlong, 12/15)

Paul Friday remembers when his hand started flopping in the cold weather – the first sign nerve cells in his brain were dying. He was eventually diagnosed with Parkinson’s, a brain disease that gets worse over time. His limbs got stiffer. He struggled to walk. He couldn’t keep living on his family farm. Shortly afterward, Friday came to believe that decades of spraying a pesticide called paraquat at his peach orchard in southwestern Michigan may be the culprit. (White, 12/15)

Two pediatricians say they were fired from University Hospitals after raising concerns about patient safety. Dr. Lauren Beene and Dr. Valerie Fouts-Fowler filed a lawsuit Monday in Cuyahoga County Common Pleas Court against the hospital for claims that include wrongful termination and defamation. (Gambino, 12/15)

More about health care workers —

In this remote corner of western North Carolina, some of the people whom paramedics Evan Carroll and Nicole McKinney serve don’t have cellphone service, and bridges that once took the two to isolated homes deep in the mountains were washed away by Hurricane Helene. And instead of simply responding to emergencies, Carroll and McKinney make old-fashioned medical house calls for nonurgent care. They help elderly patients monitor their high blood pressure and other chronic conditions. They advise people on what they should be eating, even dropping off meals and produce. They set up transportation and help make sure people are following doctors’ orders. (Joyce, 12/15)

Despite spending hundreds of millions of dollars to fill vacant medical and mental health positions at prisons and state hospitals, California has little to show for it, according to a new report from the state auditor. Job vacancy rates have increased since 2019 at the three facilities examined in the audit, as has the state’s reliance on pricey temporary workers. Atascadero State Hospital, Porterville Developmental Center and Salinas Valley State Prison had health-related vacancy rates topping 30% during fiscal year 2023-24. At Salinas Valley State Prison more than 50% of health positions were unfilled. (Hwang, 12/15)

Loyola University Maryland has received a $10 million commitment from Ellen and H. Edward Hanway, a gift that will help expand science and nursing programs and strengthen risk-management education, the Baltimore-based Jesuit institution announced on Monday. (Carlton, 12/15)

Dr. Nicholas Panetta performs the nation's first fully robotic lymphovenous bypass with NanoWrist Dissection Instruments on Dec. 5, 2025. The device uses smaller components and “enhanced controls.” (Connor, 12/15)

In other health care industry updates —

After finding abnormalities on low-dose CT lung cancer screening, many patients don't get the recommended level of follow-up care, a Medicare-linked registry analysis showed. Only 59.7% of such patients received guideline-concordant follow-up care, while 32.3% had less intensive and 7.9% had more intensive follow-up than recommended, reported Paul F. Pinsky, PhD, of the National Cancer Institute in Bethesda, Maryland, and colleagues in the Annals of Internal Medicine. (Phend, 12/15)

Executives at Humana had great news. The insurance giant’s senior-focused primary care clinics were generating extraordinary medical benefits for older Americans, keeping them out of hospitals and away from emergency rooms, they told investors in the fall of 2022. (Ross and Bannow, 12/16)

UnitedHealth Group spent 2025 striving to polish its reputation. The healthcare conglomerate’s share price has declined more than 35% since the start of the year after cuts to its earnings guidance, a sudden replacement of top executives and disclosures of federal probes spooked investors. Once known by financial analysts as the bellwether for the healthcare sector, UnitedHealth Group’s new leaders have described 2026 as a comeback year. (Tepper, 12/15)

Tens of thousands of SSM Health patients in the St. Louis area could lose access to in-network health providers if the Creve Coeur-based health system and UnitedHealthcare don’t reach a deal. Time is running out for the two health companies. Their existing agreement expires at the end of the year, on Dec. 31. SSM Health representatives estimate failure to reach an agreement could affect about 100,000 patients in the area. (Fentem, 12/16)

Home health operators plan to push other providers harder next year for value-based contracts that can offer enhanced reimbursements in exchange for post-acute access and improved patient outcomes. Bayada Home Health Care, Enhabit Home Health and Hospice, and Compassus say value-based care contracts with health systems and accountable care organizations could help them blunt the impact of a $220 million Medicare rate cut starting Jan. 1. (Eastabrook, 12/15)

The health care reform debate has become — already was — a game of hot potato among individuals, insurers and the government over who pays. Last week, two competing plans failed to pass in the Senate: Democrats want to extend Obamacare subsidies for three years; Republicans want to directly fund health savings accounts. (Peter R. Orszag, 12/16)

On December 14, 1999, a previously healthy infant was admitted to a Michigan hospital with diarrhea and jaundice. Within hours, doctors diagnosed acute liver failure caused by hepatitis B. She died three days later. Her mother had tested positive for hepatitis B at her first prenatal visit. She attended 10 appointments. But somewhere between that positive test and the delivery room, the information vanished. (Jake Scott, 12/15)

Federal agencies are preparing new guidance on recovery housing, transitional housing and long-term recovery supports. The shift comes at a time when communities face growing pressure from rising addiction, repeat overdoses, and a widening gap between treatment and stable housing. (Jim O'Connor, 12/15)

The Trump administration’s plans to restructure the National Institutes of Health and cut its annual budget by about $18 billion, along with this year’s layoffs, terminated grants, and disputes with major universities, have left many researchers concerned that the NIH — our publicly-funded biomedical research engine that has underpinned decades of lifesaving medical breakthroughs — has been, as STAT has put it, “shattered.” (Christopher M. Worsham and Anupam B. Jena, 12/16)

Around the world, nations with robust research and development infrastructure race to create therapeutics that meet the needs of their residents. Simply put, they dictate research priorities based on need. During the Covid pandemic, the United States was one of the first countries to gain access to vaccines to protect its citizens. (Michael Kinch and Kevin Gardner, 12/16)