A War on Drugs That Bombs Boats, Pardons ‘Narco-State’ President, and Prosecutes Doctors
/By Dr. Lynn Webster
On September 1, 2025, a U.S. warplane blew apart a small speedboat in the Caribbean, killing all eleven people on board. President Trump released the video like a trailer for a new season of a drug war TV series, boasting that the vessel was loaded with narcotics and crewed by Venezuelan “narco-terrorists.”
The strike was the opening salvo in a new campaign of air attacks on suspected drug boats in the Caribbean and eastern Pacific — Operation Southern Spear — that has killed at least 87, all on the strength of the administration’s unproven claims about who was on board and what cargo they were carrying.
On December 1, the same administration quietly did something very different. It issued a “full and complete pardon” to former Honduran president Juan Orlando Hernández, who was convicted in a U.S. federal court of helping move more than 400 tons of cocaine into the United States and running Honduras as what prosecutors called a “narco-state.”
Hernández was serving a 45-year sentence when the pardon came through. The White House justified the move by claiming the trial was “politicized” under the prior administration and that Hernández was the victim of overzealous prosecutors relying on compromised witnesses.
So, in the space of a few months, we have a government that claims the authority to kill alleged drug traffickers on the high seas without a trial, while freeing a former head of state that U.S. courts found to be deeply enmeshed in the cocaine trade.
At the same time, ordinary physicians inside the United States continue to be charged as “drug dealers in white coats” for prescribing opioid analgesics to patients in pain—often amid clinical uncertainty and shifting standards of care.
Drug Control by Spectacle
Together, the boat killings, the Hernández pardon, and the prosecution of well-intended physicians reveal something fundamental about the modern American war on drugs: It is less a coherent public-health strategy than a flexible political script.
Consider Hernández. For years, he was treated as a reliable U.S. ally, an eager partner in migration control and anti-drug cooperation. Only after he left office did the Justice Department present evidence that his government functioned as a protection racket for traffickers, with bribes flowing in and cocaine flowing north.
A New York jury convicted him; a federal judge imposed a 45-year sentence; and families ravaged by the cocaine trade were told this was a landmark in the fight against high-level corruption.
Yet, with the stroke of a pen, that message has been reversed. The pardon has been widely read in Honduras as an intervention on behalf of Hernández’s political allies, and it signals that even the most spectacular narcotics conviction is negotiable if the defendant is useful to Washington.
Now, set that alongside the first boat killing and the broader air campaign that followed. Under Operation Southern Spear, U.S. forces have been authorized to strike suspected drug-running vessels in international waters, killing dozens of people so far in the Caribbean and Eastern Pacific.
Human-rights experts call this an extrajudicial killing regime. They cite the fact that there has been little transparency and no meaningful process to distinguish a trafficker from, say, an unlucky fisherman who happened to be in the wrong place at the wrong time.
This is drug control by spectacle. It projects toughness and reassures a domestic audience that someone is paying the price for drug trafficking. But it does little to reduce supply, and it risks deepening resentment in countries that already bear the brunt of the U.S.’s drug policy.
Physicians Targeted
Meanwhile, inside the United States, the same punitive mindset has migrated into medicine. Under the Controlled Substances Act, doctors commit a crime if they “knowingly or intentionally” distribute or dispense controlled substances in an unauthorized way.
In our amicus brief in Ruan v. United States, my co-authors and I explained how prosecutors have increasingly treated alleged deviations from the “standard of care” as proof that a prescription lacked a “legitimate medical purpose in the usual course of professional practice.” This effectively turned malpractice or medical guideline disputes into drug-trafficking charges, and eroded the requirement that the government prove a guilty mind.
In the Ruan ruling, the Supreme Court unanimously held that the government must show that a prescriber knew their conduct was improper and illegal.
Yet for many clinicians, the message from years of aggressive prosecutions is that prescribing opioids to patients with complex pain conditions can be a fast track to a felony indictment. Physicians have watched colleagues led from their offices in handcuffs, their careers and reputations destroyed, sometimes on the basis of retrospective judgments about “red flags” rather than evidence of deliberate criminality.
Put crudely, our system has developed three very different responses to people labeled “drug traffickers.”
If you are a poor person on a boat in the Caribbean, you may be killed without a trial.
If you are a former president whose government helped move hundreds of tons of cocaine, you may be pardoned.
If you are a physician treating complex pain patients in a fragmented, under-resourced health system, you may be prosecuted as a drug dealer if your prescribing patterns later look suspicious on a spreadsheet.
That is not a rational drug policy. It is a hierarchy of whose lives are expendable, whose conduct is negotiable, and whose mistakes are treated as crimes.
None of this is to deny that real traffickers wield violence and that some clinicians have abused their prescribing privileges. But when we glorify lethal force at sea, quietly forgive a leader of what U.S. prosecutors themselves called a narco-state, and simultaneously treat legitimate clinical judgment as suspect, we are no longer talking about a war on drugs.
We are talking about a war on certain kinds of people: the poor, the foreign, the sick, and medical professionals all serve as convenient scapegoats.
If we are serious about reducing overdose deaths and drug-related harm, we need to abandon the theatrics. That means three things.
First, we must subject military operations to rigorous legal and human-rights scrutiny.
Second, we must acknowledge that pardoning a convicted narco-president while bombing alleged couriers does not “send a message” of resolve. It sends a message of incoherence — and of a system more invested in performance than in justice or saving lives.
Third, once and for all, we must end the use of criminal law to second-guess good-faith medical practice.
Lynn Webster is a physician specializing in pain and addiction medicine, a former president of the American Academy of Pain Medicine, Senior Fellow at the Center for U.S. Policy, and author of “The Painful Truth” and the forthcoming book “Deconstructing Toxic Narratives – Data, Disparities, and a New Path Forward in the Opioid Crisis.” He has written extensively on drug policy, the opioid crisis, and the criminalization of medicine.
