The threat posed by heroin in the United States is serious and has increased since 2007. Heroin is available in larger quantities, used by a larger number of people, and is causing an increasing number of overdose deaths. In 2014, 10,574 Americans died from heroin-related overdoses, more than triple the number in 2010. (See Chart 1.) Increased demand for, and use of, heroin is being driven by both increasing availability of heroin in the U.S. market and by some controlled prescription drug (CPD) abusers using heroin. CPD abusers who begin using heroin do so chiefly because of price differences.
In April 2016, the Drug Enforcement Administration’s (DEA) Philadelphia Field Division (PFD) Intelligence Program conducted an analysis of drug availability and abuse for the State of Delaware. Delaware is home to 935,000 people in three counties: New Castle (including the city of Wilmington), Kent, and Sussex.1 The primary drug threats to Delaware are heroin and diverted prescription opioids, as measured through information regarding drug availability, seizures, treatment admissions, and drug-related overdose deaths. In 2014, Wilmington ranked third on the Federal Bureau of Investigation’s annual list of the most violent cities of comparable size, and it ranked fifth in violent crime when compared to all cities with populations greater than 50,000.2 As a result, Wilmington was included in the Department of Justice’s Violence Reduction Network in 2014. In 2015, the Office of National Drug Control Policy designated New Castle County as part of the Philadelphia/Camden High Intensity Drug Trafficking Area (HIDTA).
The Drug Enforcement Administration (DEA) Philadelphia Field Division (PFD) Intelligence Program conducted a broad analysis of the impact of illicit drug and diverted pharmaceutical misuse in Pennsylvania, as examined through drug-related overdose death data. According to a 2015 report, Pennsylvania ranked ninth in the country in drug overdose deaths (18.9 per 100,000 people); drug overdoses were reported as the leading cause of injury.
The 2015 National Drug Threat Assessment (NDTA) is a comprehensive assessment of the threat posed to the United States by the trafficking and use of illicit drugs. The drug section of this report is arranged in ranking order based on the level of threat each drug presents. The threat level for each drug is determined by strategic analysis of the domestic drug situation during 2014, based on law enforcement, intelligence, and public health data available for the period. For instance, each day in the United States, over 120 people die as a result of a drug overdose. In particular, the number of deaths attributable to controlled prescription drugs (CPDs) has outpaced those for cocaine and heroin combined. Additionally, some opioid CPD abusers are initiating heroin use, which contributes to the increased demand for and use of heroin. For these reasons, CPDs and heroin are ranked as the most significant drug threats to the United States. Fentanyl and its analogs are responsible for more than 700 deaths across the United States between late 2013 and late 2014. While fentanyl is often abused in the same manner as heroin, it is much more potent. Methamphetamine distribution and abuse significantly contribute to violent and property crime rates in the United States. Further, cocaine distributors and users seek out methamphetamine as an alternative as cocaine availability levels decline. While marijuana is the most widely available and commonly used illicit drug and remains illegal under federal law, many states have passed legislation approving the cultivation, possession, and use of the drug within their respective states. Marijuana concentrates, with potency levels far exceeding those of leaf marijuana, pose an issue of growing concern. Finally, the threat posed by synthetic designer drugs continues to impact many segments of the American population, particularly youth. A full discussion for each of these drugs cannot be undertaken without first examining the criminal groups that supply these substances to distributors and users in the United States.
Mexican transnational criminal organizations (TCOs) pose the greatest criminal drug threat to the United States; no other group is currently positioned to challenge them. These Mexican poly-drug organizations traffic heroin, methamphetamine, cocaine, and marijuana throughout the United States, using established transportation routes and distribution networks. They control drug trafficking across the Southwest Border and are moving to expand their share, particularly in the heroin and methamphetamine markets.
The threat posed by heroin in the United States is serious and has increased since 2007. Heroin is available in larger quantities, used by a larger number of people, and is causing an increasing number of overdose deaths. In 2013, 8,620 Americans died from heroin-related overdoses, nearly triple the number in 2010. (See Chart 1.) Increased demand for, and use of, heroin is being driven by both increasing availability of heroin in the U.S. market and by some controlled prescription drug (CPD) abusers using heroin. CPD abusers who begin using heroin do so chiefly because of price differences, but also because of availability, and the reformulation of OxyContin®, a commonly abused prescription opioid.
The threat from CPD abuse is persistent and deaths involving CPDs outnumber those involving heroin and cocaine combined. The economic cost of nonmedical use of prescription opioids alone in the United States totals more than $53 billion annually. Transnational Criminal Organizations (TCOs), street gangs, and other criminal groups, seeing the enormous profit potential in CPD diversion, have become increasingly involved in transporting and distributing CPDs. The number of drug overdose deaths, particularly from CPDs, has grown exponentially in the past decade and has surpassed motor vehicle crashes as the leading cause of injury death in the United States. Rogue pain management clinics (commonly referred to as pill mills) also contribute to the extensive availability of illicit pharmaceuticals in the United States. To combat pill mills and stem the flow of illicit substances, many states are establishing new pill mill legislation and prescription drug monitoring programs (PDMPs).
The 2013 National Drug Threat Assessment (NDTA) Summary addresses emerging developments related to the trafficking and use of primary illicit substances of abuse and the nonmedical use of controlled prescription drugs (CPDs). In the preparation of this report, DEA intelligence analysts considered quantitative data from various sources (seizures, investigations, arrests, drug purity or potency, and drug prices; law enforcement surveys; laboratory analyses; and interagency production and cultivation estimates) and qualitative information (subjective views of individual agencies on drug availability, information on smuggling and transportation trends, and indicators of changes in smuggling and transportation methods).