Trump Wants YOUR Medical Data for His Drug War
A proposed surveillance system is supposed to target fentanyl, but there are fears it could be used to monitor abortion, pregnancy, gender transition, or any behavior the government wants to go after.
The Trump administration’s new drug strategy does more than escalate the war on fentanyl. It sketches the architecture for a national surveillance system built from some of Americans’ most personal data: prescriptions, toxicology results, wastewater, electronic health records, license plate scans, and law enforcement intelligence.
The plans are laid out in the 2026 National Drug Control Strategy, a 195-page blueprint released in early May. Drug Czar Sara Carter announced it on Sean Hannity’s Fox show, calling it “a battle cry.” The document promises to “fully resource and empower” Homeland Security Task Forces, “leverage advanced technology and Artificial Intelligence,” and “modernize and integrate public safety and public health data collection,” applying “advanced data science methods” to “toxicology results, wastewater analysis, electronic health records, and law enforcement seizures.”
The strategy describes a surveillance architecture but never addresses how it may or may not be used. Nowhere does the strategy mention HIPAA. Nowhere does it say how patient privacy would be protected. Nowhere does it explain what limits would prevent a system built for fentanyl from being used to monitor abortion, pregnancy, gender transition, methadone treatment, protest activity, or any other behavior a future administration decides to target.
To law enforcement veterans, the appeal of a system that fuses health data, law enforcement intelligence, and modern analytics into a single system is obvious. Derek Maltz, a former acting DEA administrator who spent a decade running the agency’s Special Operations Division, has spent years arguing that cartels, Chinese chemical brokers, money laundering networks, and synthetic drug suppliers have outpaced a fragmented federal response.
“If you wanna connect the dots, you have to collect the dots,” Maltz told me.
Maltz talks about families whose children died from fentanyl, the collages of dead kids he takes to public events, and the parents who told him they never got the warning that might have saved their child. He describes his work as “not a red or a blue issue,” but “red, white, and blue.” The threat is real: Chinese chemical networks linked to Mexican cartels feed a synthetic-drug supply that kills tens of thousands of Americans a year. Maltz argues that agencies need integrated data and modern tools to keep pace with networks that already operate across borders, banks, chemicals, and encrypted platforms.
Even so, he conceded the limits of enforcement. “We are not going to seize our way out of this problem,” he said. “We are not going to arrest our way out of this problem.”
That is what makes the strategy’s surveillance ambitions so consequential. Fentanyl is deadly, and law enforcement does need better tools. The harder question is what happens when public health infrastructure becomes law enforcement infrastructure, and the government builds a machine with no clear oversight.
Much of the machinery already exists. Every state runs a prescription drug database. Police use national license plate reader networks. Wastewater surveillance expanded during COVID. Risk scores sit atop prescription records, and health data is already used in criminal cases.
The 2026 strategy doesn’t invent these systems from scratch. It connects them, which is the more consequential move.
A Prescription Database With No Privacy Law
Every time a doctor prescribes a controlled substance – painkillers, stimulants, anti-anxiety medication, certain hormones – that prescription goes into a state-run database called a Prescription Drug Monitoring Program (PDMP). Every state has one. These databases are not protected by HIPAA. Federal drug agents can access any state’s database by filing a subpoena that requires no judicial review.
“This is a wild, wild west,” said Jennifer Oliva, a law professor at Indiana University who has spent a decade studying prescription drug databases.
The federal government helped build these systems through grants from the Department of Justice. The DEA could not collect prescriber-level data on its own, so it funded states to build the databases. The opioid crisis made that politically easy. But the databases were never limited to opioids.
“There’s no reason to think that the same mechanisms in place to track and respond to potential opioid misuse can’t be turned to other drugs,” said Corey Davis, a senior attorney at the Network for Public Health Law. And there is “decent evidence that PDMPs do move people from prescription opioid misuse to misuse of street opioids, which is a net negative.” The system that was supposed to solve the opioid crisis made it worse. The same architecture is now being expanded.
States can also expand prescription-monitoring databases beyond opioids through controlled-substance scheduling, “drugs of concern” categories, or similar reporting rules. Others formally reschedule drugs under state law. Louisiana went further in 2024, becoming the first state to classify mifepristone and misoprostol as Schedule IV controlled dangerous substances, placing abortion medications inside the state’s controlled-substances monitoring regimen. Texas and Indiana lawmakers have introduced similar reclassification proposals, and Idaho has reportedly been considering similar tracking measures.
Testosterone is already federally controlled as a Schedule III anabolic steroid and has been tracked through controlled-substance reporting since anabolic steroids were added to the Controlled Substances Act in 1990. You cannot tell, from a database entry, whether testosterone is prescribed for low hormone levels or for gender transition. You cannot tell whether mifepristone is prescribed for an abortion or a miscarriage.
Craig Konnoth, a law professor at the University of Virginia, called this “a clear example of targeting a vulnerable minority.” Asked whether there is legal recourse, he said: “Unfortunately, in my opinion, no.”
AI on Medical Records
A company called Bamboo Health runs a platform called NarxCare on top of these prescription databases. It assigns patients risk scores based on factors such as how they pay, whether they have insurance, and how far they travel to the pharmacy. No state requires doctors to tell patients the system exists. Patients cannot see their scores.
The 2026 drug strategy proposes going further: “applying predictive analytics to electronic health records to identify patients at high risk of overdose.”
That may sound clinical. But Charlotte Tschider, a health AI scholar at Loyola Chicago, said the “current regulatory framework does not distinguish between the use of AI for helping patients and enforcement.” Nothing in the law stops a system built to identify overdose risk from being repurposed to flag who is getting an abortion pill or hormone therapy.
The records that AI would analyze are not the clean clinical documents most people imagine. They are billing tools. Dr. Mishka Terplan, an OB/GYN and addiction medicine specialist, gave an example: a patient has one positive drug test at her first prenatal visit and nothing after. The billing code “drug abuse complicating pregnancy” gets attached to her record anyway. “Complicating” just means it happened at the same time, not that drugs caused a problem.
But in court, judges may read it as proof.
“The chart says drug abuse complicating pregnancy in the third trimester, therefore you must be lying,” Terplan said. “And the judge agrees.”
The strategy proposes AI analytics applied to these records.
Terplan said his patients are “legitimately reluctant to disclose and may sometimes, not always, forego care or delay care.” What he tells them now: “I can’t ensure protection of that information any longer.”
The danger is not hypothetical. Medical information already moves from healthcare into the criminal legal system. According to Pregnancy Justice, more than 64% of pregnancy criminalization cases involve information flowing from healthcare settings into the legal system.
In late December 2025, Alexia Moore went to a Georgia emergency room after a medical crisis. She had obtained abortion pills from an online provider. Hospital staff contacted the police. In March, she was charged with murder, based entirely on medical records, toxicology results, and statements taken at her bedside. No surveillance technology was involved.
Karen Thompson, Pregnancy Justice’s legal director, said: “The point of this is to terrify people. The point of this has no scientific function.”
Now add to that existing pipeline more data, more automation, more scoring, and more law enforcement integration.
From COVID to Drug Intelligence
During the COVID pandemic, public health agencies built the National Wastewater Surveillance System to test sewage for the virus. That funding is now drying up. The drug strategy proposes to fill the gap with law enforcement money, to “implement wastewater testing for the first time at a national scale.” On ‘Hannity,’ Carter confirmed: “We’re doing wastewater testing right now across the nation.”
Mariana Matus, CEO of Biobot Analytics, the largest commercial wastewater testing company, confirmed that “Biobot uses the same wastewater collection infrastructure for both pathogen and drug trend surveillance.”
The technology can detect HIV prevention drugs, testosterone, psychiatric medications, and abortion pills. Matus confirmed her company received inquiries about testing for abortion-related drugs from “local government agents.” She would not say which ones. “We have no plans to develop abortifacient testing,” she said.
But when asked about connections between Biobot’s lead venture funder – Valor Equity Partners, run by Antonio Gracias, a major Trump donor and former DOGE official – and Biobot’s January 2026 Office of National Drug Control Policy wastewater intelligence contract, she did not answer. Instead, she volunteered that she “would welcome the opportunity to educate” law enforcement on integrating wastewater intelligence.
Rolf Halden, a scientist at Arizona State University who built the first U.S. citywide wastewater drug monitoring program, independently confirmed that “almost any medication or its metabolites can be monitored in wastewater.” His lab also received inquiries about testing for abortion drugs.
What protects individuals from identification, he said, “are not regulatory barriers but the high cost at this point in time.”
The CDC’s National Wastewater Surveillance System, built during the pandemic, runs on Palantir’s Foundry platform under a $443 million contract. The CDC has said it will have no funding to sustain the program beyond September 30, 2026. Meanwhile, there are bills in several states that propose requiring wastewater testing for abortion-related drugs.
Natalie Ram and Jessica Roberts, law professors at the University of Maryland and Emory, warned that wastewater monitoring for mifepristone, “if successful, would create a roadmap for surveilling, suppressing, and sanctioning other politically contested medical care.”
Prescription databases show what people are prescribed. Electronic health records show what clinicians document and bill. Wastewater can show what communities consume or excrete. License plate readers show where people go.
The strategy also encompasses six overlapping federal license plate reader networks that Congress never authorized. What stops them from tracking someone driving to an abortion clinic or a methadone program?
“Under the current way that law enforcement uses these systems, absolutely nothing stops that kind of abuse,” said Nathan Wessler, an ACLU lawyer who has argued surveillance cases at the Supreme Court.
An Electronic Frontier Foundation investigation documented deputies in Texas using a nationwide plate reader network to search for a woman who had a self-managed abortion. Both searches were logged as “had an abortion, search for female.”
Each of these surveillance systems gets evaluated on its own, if at all. But no one is assessing what happens when they all feed into the same task forces.
Barry Friedman, a law professor at NYU, was direct: “No oversight. None.”
The drug strategy’s surveillance architecture has no special court, no sunset clause, no congressional debate – none of the safeguards that even counterterrorism surveillance has under the Foreign Intelligence Surveillance Act.
And the distinction between drug enforcement and counterterrorism may no longer hold.
Palantir Inside the Government
The company positioned to run the data architecture where those missions converge is already inside the federal health system.
HHS has an agreement worth up to $90 million, making Palantir’s platform available across the department. The department’s later-installed Chief Information Officer, Clark Minor, previously spent more than a decade at Palantir and oversees health data infrastructure across HHS.
Minor’s financial disclosure shows he held between $1 million and $5 million in Palantir stock for more than five months after taking office before selling. President Trump made Palantir stock purchases totaling six figures, disclosed in a transaction report signed May 8, 2026, while his administration has awarded the company more than $1 billion in federal contracts.
The concern is not that one company holds federal contracts. It is that the government is expanding integrated data infrastructure while failing to set boundaries around medical privacy, law enforcement access, and political repurposing.
What’s Off-Limits?
The administration’s 2026 Counterterrorism Strategy, also released in May, classifies fentanyl and its precursor chemicals as “Weapons of Mass Destruction,” merging drug enforcement with counterterrorism and opening access to the broader surveillance authorities that come with it.
“There’s a tremendous danger that you have the executive branch throwing together a whole bunch of stuff in an attempt to look tough,” Wessler said. “And it will be years potentially before judges are able to get involved.”
Maltz sees integrated data as a matter of public safety. Law enforcement and the intelligence community, he argues, have long needed systems that pull together data collected under court order, so agencies can map criminal networks rather than get buried in scattered records. “The data sets that these agencies are receiving from the providers pursuant to court orders and search warrants and things like that, it’s a tidal wave of data,” he said. “It’s impossible to go through it without having robust technology tools.”
But health data is not just another intelligence stream. It is generated when people seek care, fill prescriptions, get screened in pregnancy, use medication, receive addiction treatment, drive to clinics, or live in communities whose sewage is tested. Once those data streams are fused with law enforcement and counterterrorism tools, the question is not whether the system can find people. It is whether there is anything it is forbidden to find.
To some drug enforcement insiders, the answer is better oversight, not less technology. Maltz argues that the United States is falling behind sophisticated criminal networks and that agencies need modern tools to save lives. But public health and privacy experts see a surveillance architecture being assembled with no rules governing what it can do, and no limit on what it could eventually target.
Oliva saw a system capable of identifying and tracking virtually anyone. “You can get anybody with all of them for sure,” she said, “no matter how off the grid they think they are.”
Wessler called it “a completely unprecedented look at somebody’s medical history, their movements, their associations.”
The administration has already offered clues about who else could be targeted. The same counterterrorism strategy that classifies fentanyl as a WMD also identifies “violent secular political groups whose ideology is anti-American, radically pro-transgender, and anarchist” as a priority target, alongside cartels and Islamist terrorists. It promises to use “all the tools constitutionally available to us to map them at home, identify their membership,” and to “cripple them operationally before they can maim or kill the innocent.”
The drug strategy builds the tools: prescription databases that track testosterone and abortion pills, wastewater that can detect hormones, AI on medical records, and license plate readers. The counterterrorism strategy identifies who they’re targeting and authorizes pre-emptive action.
Oliva offered the clearest warning. “Just pick something that they’ve decided, that MAHA [‘Make America Healthy Again’] has decided is bad tomorrow, despite all the scientific evidence, boom.” The HPV vaccine and mRNA vaccines. Tylenol. Hormones. Stem cell therapies. “It never ends. It just continues.”
Dr. Céline Gounder a physician, epidemiologist, and medical journalist. Read her newsletter UNDERLYING CONDITIONS here.
The views expressed in this article are the author’s own and do not necessarily reflect those of Zeteo.
Check out more from Zeteo:
Everyday, the surveillance state becomes an integral part of a police state, upon which Trump’s authoritarian state would rely and upon which the Christian Nationalist state would rely.
considering that MY medical data has absolutely NOTHING to do with running the country, how about YOU let us know EVERYTHING about your medical data because quite frankly, you don't sound so good trump!