Trends in Opioid Availability and Abuse DEA Philadelphia Field Division April 2018

Transcription

1 Trends in Opioid Availability and Abuse DEA Philadelphia Field Division April 2018

2 Mission DEA has two distinct authorities: Enforcement Attack supply: To prevent drug abuse, drug-related deaths, and drug-related crime by attacking the supply of illicit narcotics Reduce demand: Reduce demand through education and nontraditional law enforcement partnerships Regulatory Regulation of all facets of production, distribution, and prescribing of controlled substances

3 Opioid Threats What you already know: Pennsylvania is in the midst of a drug abuse and overdose epidemic Prescription opioid abuse has fueled heroin abuse Abuse of prescription opioids, heroin, and fentanyl has led to the overdose deaths of more than 15,000 Pennsylvanians in the last four years Pennsylvania is amongst the states with the highest rates of overdose

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5 Philadelphia Overdose deaths in 2017 rose ~35% from % increase between 2014 and % involved an opioid in 2017 ~70% involved fentanyl in

6 Oxycodone and Hydrocodone Pills Dispensed in PA z Prescription Opioid Availability 275 million 259 million 170 million 146 million

7 z

8 Prescription Opioids Oxycodone, primarily 30mg and 10mg, are most frequently sought for non-medical use Initially sourced from friends, relatives, etc. Obtained via complicit doctors, fraudulent prescriptions, street purchases Purchased for approx. $1 per milligram on street

9 Rx Opioids Progress Decreased availability of prescription opioids PDMP, new prescribing regulations DEA oversight of registrants Prevention Initiatives Decreased number of new Rx opioid abusers (NDTA, 2017)

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11 20.0% 18.0% 16.0% 14.0% z Pennsylvania Overdose Deaths with Presence of Oxycodone 17.9% 18.6% 14.6% 12.0% 10.0% 8.0% 8.3% 6.0% 4.0% 2.0% 0.0%

12 Heroin Abundance of Heroin Change in Production/Source Late 2000 s decrease in cocaine movement by MX TCOs in order to increase heroin trafficking and profit Early 2010 s - Change in heroin production from SA to MX Need to recoup lost revenue from marijuana sales Response to demand in U.S.

13 Metric Tons Heroin Production in Mexico Potential Pure Heroin Production in Mexico,

14 Types of Drugs Seized in PA Heroin Trends in Drug Seizures Over Time

15 DEA Heroin Seizures (NY, NJ, PA) Heroin 536 Kilos 414 Kilos 395 Kilos

16 Heroin White Heroin Impact on purity and potential for adulteration Impact on Pennsylvania Established heroin user base Demand for highly pure product Highest purity heroin in the country for 20 years Wholesale purities >90% Retail purities from 50-90%

17 Heroin Purity by City Heroin

18 60.0% 50.0% z Oxycodone and Heroin Presence in Pennsylvania Overdose Deaths 51.8% 54.6% 45.0% 40.0% 38.0% 30.0% 20.0% 17.9% 18.6% 14.6% 10.0% 8.3% 0.0% Oxycodone Heroin

19 If things weren t complicated enough.

20 Fentanyl Fentanyl Introduced into illicit U.S. drug supply in (after previous surge in ) 30-50x more potent than heroin; x more potent than morphine Primary sources of supply Mexico and China

21 Fentanyl Two primary production areas: China supplies precursor chemicals and finished product Mexico manufacturing fentanyl in clandestine labs

22 Poppy field in Mexico Clandestine Drug Lab in Mexico Entirely synthetic process. No plant materials, farmers, weather, etc. Why switch from heroin production to fentanyl production?

23 It s all about the Money Drug Heroin Cost per 1 KG to DTO $5,000-7,000 (Purchased from Mexico) ~ Number of KGs Produced from Original Drug Procurement Wholesale Price per KG in Philadelphia Revenue to DTO from 1 KG 1 KG $65,000 $65,000 Fentanyl $3,300-5, KGs $65,000 $1,040,000 to 1,560,000

24 Fentanyl in 2010 How quickly can things change?

25 Fentanyl in 2017

26 Fentanyl Who brings it, how does it get here, how is it packaged, how is it sold? Mexican TCOs traditional routes and methods Mixed at street/mill level, not wholesale Wholesale heroin and fentanyl seizure (packaged/marked separately). Tied to CJNG.

27 Fentanyl in PA in 2010

28 Fentanyl in PA in 2017

29 Fentanyl Fentanyl purities Nationwide purity of MX produced fentanyl averages 7% 7% pure fentanyl is the equivalent of 300% pure heroin 10% pure fentanyl found locally Increase in openly acknowledged sales of fentanyl

30 DEA Fentanyl Seizures (NY, NJ, PA) Fentanyl 200 Kilos 67 Kilos 58 Kilos

31 90.0% 80.0% Oxycodone, Heroin, and Fentanyl Presence in Pennsylvania Overdose Deaths 79.0% 70.0% 60.0% 50.0% 51.6% 40.0% 30.0% 30.6% 20.0% 14.0% 10.0% 0.0% Oxycodone Heroin Fentanyl/Acetyl Fentanyl

32 Heroin and Fentanyl Is fentanyl replacing heroin?

33 Philadelphia Fentanyl Overdose Deaths without Heroin z Fentanyl

34 Fentanyl Other Drugs Found with Fentanyl in Drug Seizures (PA) What else is fentanyl mixed with? Is cocaine/fentanyl mixing an increasing trend?

35 Fentanyl Related Substances What are they? Who brings it, how does it get here, how is it packaged, how is it sold? Chinese chemical companies Darkweb and Clearnet purchases Routed through other countries for anonymity Regional re-distributors filling darkweb orders Attempts to circumvent scheduling/enforcement

36 Fentanyl Related Substances Chinese fentanyl labs Why are they producing? Legal until 2016 Control of cathinones Abundance of chemists Darkweb/Clearnet purchasing More than 40 fentanyl related substances found by forensic laboratories

37 z 3-methylfentanyl 3-methylthiofentanyl 4-methoxy-butyryl fentanyl Acetyl norfentanyl Acetyl-alpha-methylfentanyl Acetylfentanyl Acryl-alpha-methylfentanyl Acrylfentanyl Alfentanil Alpha-methylfentanyl Alpha-methylthiofentanyl Benzodioxole fentanyl Benzoylbenzyl fentanyl Fentanyl Related Substances Benzylfentanyl Furanyl fentanyl Isobutyryl fentanyl Beta-hydroxy-3-methylfentanyl Lofentanil Beta-hydroxyfentanyl Methoxyacetyl fentanyl N-isobutanoyl 4-fluoro fentanyl Beta-hydroxythiofentanyl Ortho-fluorofentanyl Butanoyl 4-fluoro fentanyl P-fluorobutyryl fentanyl P-fluorofentanyl Butyryl fentanyl P-fluoroisobutyryl fentanyl Carfentanil Phenyl fentanyl Crotonyl fentanyl Remifentanil Sufentanil Cyclopentyl fentanyl Tetrahydrofuran fentanyl Cyclopropyl fentanyl Thenylfentanyl Thiofentanyl Fluorobutyryl fentanyl Thiofuranyl fentanyl Fluorofentanyl Fluoroisobutyryl fentanyl

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39 It s all about the Money Approximately 500,000 counterfeit pills can be manufactured from one kilogram of fentanyl (2mgs per pill) Retail prices between $10 and $20 per pill Potential revenue $5 million on one kilogram

40 Fentanyl Related Substances in PA, 2010

41 Fentanyl Related Substances in PA, 2017

42 Fentanyl What is being done to address fentanyl production? Worldwide scheduling of 4-ANPP (fentanyl precursor) Fentanyl lab identification and seizures in Mexico Darkweb law enforcement operations Requires law enforcement response to evolve quickly with availability and source changes

43 Efforts Law Enforcement Efforts Increased scrutiny of DEA registrants, including manufacturers Drug Take Back Initiative Identification and investigation of overseas heroin/fentanyl suppliers Identification and targeting of regional re-suppliers of fentanyl/fentanyl related substances Identification and dismantlement of Mexican fentanyl labs Control of precursor chemicals Coordination with foreign counterparts in dismantling darkweb marketplaces Scheduling of all fentanyl-related substances in late 2017

44 Questions?

45 Laura Hendrick Field Intelligence Manager DEA Philadelphia Field Division