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While American foreign policy has for years fixated on the conflict in Syria and the Middle East, just across the border in Mexico and throughout Central America tens of thousands of people lost their lives last year because of the conflict between drug cartels competing to deliver illicit drugs into the United States.

According to a recent report from the International Institute for Strategic Studies, whereas approximately 50,000 lives were lost in Syria last year, approximately 39,000 were killed in Mexico, Honduras, Guatemala and El Salvador, much of which is attributable to drug-war violence.

Mexico’s homicide total of 23,000 for 2016 is second only to Syria’s, and is only the latest development in a conflict which stretches back to 2006, when President Felipe Calderon deployed the military to combat drug cartels.

Although the exact number of people killed because of the drug war in Mexico is unlikely to ever be known, a recent report from the Congressional Research Service cited estimates from 80,000 to more than 100,000 in that country alone.

The cause of this violence is obvious, and it is a direct, predictable consequence of our failed policy of drug prohibition. In the near-half century since President Richard Nixon declared a “war on drugs,” hundreds of thousands of Latin Americans have been killed in conflicts fueled by a lucrative illicit drug trade made possible by our prohibition of drugs.

This is an insight a certain New York developer possessed 27 years ago. “We’re losing badly the war on drugs,” Donald Trump said in 1990. “You have to legalize drugs to win that war. You have to take the profit away from these drug czars.”

While Trump may have since lost this insight, the fact remains that the war on drugs does more harm than drugs themselves.

Last year, Colombian President Juan Manuel Santos used his Nobel Peace Prize acceptance speech to call for a “rethink” of the drug war, which contributed to decades of conflict in Colombia that killed hundreds of thousands.

Rather than squander more lives and resources fighting a War on Drugs that cannot be won — including in our inner cities — the United States must recognize the futility and harm of its drug policies.

Having coined Bush Derangement Syndrome more than a decade ago, I feel authorized to weigh in on its most recent offshoot. What distinguishes Trump Derangement Syndrome is not just general hysteria about the subject, but additionally the inability to distinguish between legitimate policy differences on the one hand and signs of psychic pathology on the other.

Take Trump’s climate-change decision. The hyperbole that met his withdrawal from the Paris agreement — a traitorous act of war against the American people, America just resigned as leader of the free world, etc. — was astonishing, though hardly unusual, this being Trump.

What the critics don’t seem to recognize is that the Paris agreement itself was a huge failure. It contained no uniform commitments and no enforcement provisions. Sure, the whole world signed. But onto what? A voluntary set of vaporous promises. China pledged to “achieve the peaking of CO2 emissions around 2030.” Meaning that they rise for another 13 years.

The rationale, I suppose, is that developing countries like India and China should be given a pass because the West had a two-century head start on industrialization.

I don’t think the West needs to apologize — or pay — for having invented the steam engine. In fact, I’ve long favored a real climate-change pact, strong and enforceable, that would impose relatively uniform demands on China, India, the U.S., the EU and any others willing to join.

Paris was nothing but hot air. Withdrawing was a perfectly plausible policy choice (the other being remaining but trying to reduce our CO2-cutting commitments). The subsequent attacks on Trump were all the more unhinged because the president’s other behavior over the last several weeks provided ample opportunity for shock and dismay.

It’s the tweets, of course. Trump sees them as a direct, “unfiltered” conduit to the public. What he doesn’t quite understand is that for him — indeed, for anyone — they are a direct conduit from the unfiltered id. They erase whatever membrane normally exists between one’s internal disturbances and their external manifestations.

For most people, who cares? For the president of the United States, there are consequences. When the president’s id speaks, the world listens.

Consider his tweets mocking the mayor of London after the most recent terror attack. They were appalling. This is a time when a president expresses sympathy and solidarity — and stops there. Trump can’t stop, ever. He used the atrocity to renew an old feud with a minor official of another country. Petty in the extreme.

As was his using London to support his misbegotten travel ban, to attack his own Justice Department for having “watered down” the original executive order (ignoring the fact that Trump himself signed it) and to undermine the case for it just as it goes to the Supreme Court.

As when he boasted by tweet that the administration was already doing “extreme vetting.” But that explodes the whole rationale for the travel ban — that a 90-day moratorium on entry was needed while new vetting procedures were developed. If the vetting is already in place, the ban has no purpose. The rationale evaporates.

And if that wasn’t mischief enough, he then credited his own interventions in Saudi Arabia for the sudden squeeze that the Saudis, the UAE, Egypt and other Sunni-run states are putting on Qatar for its long-running dirty game of supporting and arming terrorists (such as the Muslim Brotherhood and Hamas) and playing footsie with Iran.

It’s good to see our Sunni allies confront Qatar and try to bring it into line. But why make it personal — other than to feed the presidential id? Gratuitously injecting the U.S. into the crisis taints the endeavor by making it seem an American rather than an Arab initiative and turns our allies into instruments of American designs rather than defenders of their own region from a double agent in their midst.

And this is just four days’ worth of tweets, all vainglorious and self-injurious. Where does it end?

The economist Herb Stein once quipped that “if something cannot go on forever, it will stop.” This really can’t go on, can it? But it’s hard to see what, short of a smoking gun produced by the Russia inquiry, actually does stop him.

Trump was elected to do politically incorrect — and needed — things like withdrawing from Paris. He was not elected to do crazy things, starting with his tweets. If he cannot distinguish between the two, Trump Derangement Syndrome will only become epidemic.

Charles Krauthammer is a columnist for The Washington Post.

Letters@charleskrauthammer.com

Philippine President Rodrigo Duterte is not a nice man. His war on drugs has taken the lives of thousands upon thousands in extrajudicial killings.

He jokes publicly about rape — telling troops in Mindanao, where he recently imposed martial law, that he’d go to the mat for them if they employed serial rape in the course of enforcing the crackdown.

President Donald Trump has received a barrage of criticism for inviting Duterte to a personal meeting at the White House. But as the United States and the wider West failed to stop the spread of the Islamic State beyond its Mideast base, the terrorists zeroed in on the Philippine islands — specifically Mindanao — teeing up a superficially difficult choice for America. If Duterte is bad, the Islamic State is worse.

In part, Duterte himself is to blame for the misfortune. Mindanao has been home to separatists and splinter groups for nearly a half-century, and a headquarters for Islamists since the 1990s.

A casual observer could be forgiven for expecting that, in the wake of failed peace talks between the government and the would-be rebels, the latest round of jihad-inflected violence would remain a fundamentally local problem. But Duterte needed to know better.

This time, insurgents aligned with the Islamic State brought to Mindanao an international stature and theological fanaticism capable of fueling a much bigger problem than Duterte anticipated.

Now, his troops are battling not only a cadre of hardened jihadis, but a movement wired in with the global Islamist superstructure. And as important as a willingness to use force may be in excising Islamist tumors, it is hard to be sure that Duterte alone can beat the militants without breeding even deeper resentment and radicalization.

A warning this week from Indonesia’s defense minister, that as many as 1,200 foreign IS fighters have set up shop in the Philippines, came as an embarrassing public surprise to Duterte’s military. Adding to the confusion, a recent botched casino assault claimed by the Islamic State has been dismissed by police as an attempted robbery.

Amid such uncertainty and fear, militants grow bold and flourish.

There is some good news. Starting later this month, Indonesia will join the Philippines, along with neighboring Malaysia, in routine joint naval patrols around Mindanao and in the Sulu Straits. Australian Prime Minister Malcolm Turnbull, meanwhile, pledged his country’s assistance should Duterte request it.

But the role of the United States is yet to be set in stone. For the Trump administration, Southeast Asia is a problem spot in its own right. China’s aggressive moves to all but capture the South China Sea have put it on the outs with the region’s other states, but Washington is hard pressed to harm Sino-American relations while working overtime to activate Chinese leverage against North Korea.

Still, the situation in Mindanao offers the White House an opportunity to take a leadership role for a legitimate reason that won’t bleed over into other issue areas already bedeviling policymakers.

Nevertheless, it’s impossible to make right what went wrong with anti-Islamist strategy under Obama if Duterte himself is kept at arm’s length. The hard lesson of globalization today is that, while violence threatening all kinds of people is growing worldwide, cultural differences around basic questions of justice and morality are, if anything, sharpening.

Confronting shared threats despite such uncomfortable diversity won’t always feel good. But it will be necessary.