A new report from Politico found that Kellyanne Conway has debilitated the federal drug policy office and silenced its experts as she and her own political staff made up of officials without specific drug policy expertise guide the formation of a federal opioid strategy.

This report, based in part on interviews with people familiar with the office and Conway’s initiative, found that Rich Baum, the acting director of the Office of National Drug Control Policy, which has for decades guided government policy on drug abuse, was not invited to Conway’s opioid cabinet meetings and that two political appointees from his office attended in his stead. These meetings also included officials from the Health and Human Services agency and Defense Department, an indicator of the federal government’s swing away from addiction treatment and toward an emphasis on law enforcement and border control in their efforts to manage the crisis.

According to Politico, lawmakers from states hit hard by the epidemic and who have worked closely with the drug czar office in the past have not heard from Conway. Those defending Conway’s growing role in setting the opioid policy agenda in the Politico article argued her high rank in the administration could make for a more powerful champion. Others worried about the absence of expert voices in the discussion.

Conway was reported to have been assigned the task of “opioid czar” early in December, though her exact role and powers were unclear. Conway, a political figure with a background in polling, has no expertise related to addiction.

The drug czar office has floundered at the leadership level since Trump’s inauguration, as the president hasn’t named a permanent director. According to Politico, its leadership team consists of three political appointees, as opposed to nine members a year ago. A 24-year-old recent college graduate was appointed to a top position for a few months because of “staff turnover and vacancies” as well as a misleading resume, according to the Washington Post. In October, Pennsylvania Rep. Tom Marino, Trump’s nominee to lead the office, withdrew from consideration after an investigation by the Post and 60 Minutes found he championed a law that effectively killed the Drug Enforcement Agency’s ability to shut down suspicious drug shipments.

Despite Trump naming the opioid crisis as a priority during his State of the Union address—and despite his declaration of a nationwide Public Health Emergency in October—the Trump administration has shown little in the way of progress on developing a consistent opioid policy. During his State of the Union speech, Trump called for greater border security, painting the opioid crisis as an evil brought in from the south. “Our plan closes the terrible loopholes exploited by criminals and terrorists to enter our country,” he said. “These reforms will also support our response to the terrible crisis of opioid and drug addiction.”

In reality, the opioid crisis doesn’t just stem from street drugs like heroin and fentanyl but also from legal but addictive painkillers. And according to the final report by Chris Christie’s presidential commission on the opioid crisis, the epidemic has resulted largely from “excessive prescribing of opioids since 1999.” The vast majority of heroin users reported using prescription opioids first, according to PolitiFact. While heroin and fentanyl are smuggled from Mexico, the drugs are most commonly smuggled in vehicles legally entering the U.S., and the opioid commission was more worried about shipments from China than smuggling from Mexico when it came to fentanyl.

The other point of attack for the Trump administration involves public attitudes. During his speech announcing the public health emergency, Trump advocated spending more on a “just say no” campaign—a policy that has been shown to be largely ineffective when implemented in the past.

The Christie presidential commission made recommendations about access to treatment and education for doctors, but the White House has not yet acted on most of them.

Trump is also expected to propose devastating cuts to the drug czar office’s budget this month. A bipartisan group of senators has challenged the proposal, urging the White House in a letter to reconsider.

According to the Centers for Disease Control and Prevention, more than 42,000 people died in 2016 from opioid use.