By Claire Duddy, William Downs

What are controlled drugs? Controlled drugs are substances that are considered harmful to human health and subject to legal controls. In the UK, these drugs are categorised as Class A, Class B or Class C according to their potential harm. Class A drugs like heroin and cocaine are considered the most harmful. They are subject to the strictest legal controls and penalties for misuse. Controlled drugs legislation The Misuse of Drugs Act 1971 regulates the production, supply and possession of controlled drugs in the UK. The act is complemented by the Misuse of Drugs Regulations 2001, which set out exceptions that allow the lawful possession and use of certain controlled drugs for medical, dental and veterinary use. The regulations categorise drugs into five schedules, according to their medical usefulness and the potential harms of misuse. Schedule 1 drugs are considered to have no legitimate current medical use and are the most tightly controlled. Classification and scheduling decisions The Advisory Council on the Misuse of Drugs (ACMD) is an independent expert advisory body that advises the government on the classification and scheduling of drugs. The Home Secretary can make changes to the classification of a drug after consultation with the ACMD. However, the government is not required to take their advice. The Library Insight Nitrous Oxide becomes a Class C drug describes how nitrous oxide was classified as a Class C substance, despite ACMD advice that it should become a controlled drug. Drug offences and enforcement It is an offence to import, produce, supply or possess a controlled drug, except in circumstances specified in law. The maximum sentences available are specified in schedule 4 of the Misuse of Drugs Act 1971. In England and Wales, sentencing guidelines set out the appropriate sentence for convicted offenders. The drugs market is dominated by serious and organised crime groups, with several UK enforcement agencies involved in seeking to tackle the production, supply and importation of drugs. The National Crime Agency and Regional Organised Crime Units work with regional police forces and the British Transport Police, to tackle drug supply operating across police force boundaries, including county lines. The National Crime Agency also leads on cooperation with international agencies oversees to tackle international supply lines. Border Force is the lead agency for seeking to intercept drug shipments from crossing UK borders. Responding to drug possession The possession of any controlled drug is an offence under section 5 of the Misuse of Drugs Act 1971, carrying a penalty of up to 7 years’ imprisonment. However, in many cases people found in possession of small quantities of drugs for personal use will not be prosecuted. The police have a large degree of discretion when deciding to arrest and prosecute an individual for drug possession or whether instead to issue an out of court resolution. In some areas of England and Wales, drug diversion programmes are being trialled to refer people into drug treatment services as an alternative to criminal justice sanctions entirely. There has also been debate about whether the government should go further in embracing a health-led approach to people who use drugs. For example, the Home Affairs Committee in 2023 called for responsibility for misuse of drugs to be jointly owned by the Home Office and Department of Health and Social Care, and for a wider use of drug diversion schemes and harm reduction measures. Changes to controlled drugs legislation There have been multiple calls for reform of controlled drugs legislation in the UK, including calls to change how drugs are classified and scheduled under the legislation. In December 2024, the Controlled Drugs (Procedure for Specification) Bill, a Private Member’s Bill sponsored by Alex McIntyre MP, is due to have its second reading in the House of Commons. This bill proposes changes to the processes used to change drug classifications. It aims to allow the government to make changes more quickly and allow corresponding changes to the classification of drugs (under the Misuse of Drugs Act) and scheduling of drugs (under the Misuse of Drugs Regulations) to be made at the same time.

Research Briefing, London: House of Commons Library, 2024. 36p.

Shocking videos surfaced in late August of gun-wielding Venezuelan migrants storming an apartment building in the suburban city of Aurora, Colorado. One of the migrants, a 20-year-old, confessed that he is part of a Venezuelan gang called Tren de Aragua (TdA, or “Train from Aragua”). The Aurora police department is now beefing up its budget to confront the increased crime spilling over from the sanctuary city next door in Denver.Aurora was just the beginning. In the past 11 months, there have been increasing reports of TdA activity in no fewer than 30 major cities across America. At least 100 federal investigations involving the TdA are underway, catching most of the U.S. law enforcement community by surprise. Shooting two New York City

police officers, building sex trafficking rings in Louisiana, and murdering the Georgia nursing student Laken Riley and 12-year-old Jocelyn Nungaray in Houston are just some of the high- profile violent crimes carried out by the TdA. Moreover, given that the Venezuelan government does not cooperate or provide any data on suspected criminals coming from their country into the United States, some law enforcement officers have dubbed the TdA as “ghost criminals” with little to identify them other than confessions and/ or tattoos. The Tren de Aragua has been around for more than a decade, first as a Venezuelan prison gang, then as a transnational criminal organization (TCO) spreading throughout Latin America, and now as a major street gang terrorizing cities in at least 20 states throughout America—and growing. Many comparisons have been drawn between the TdA and the transnational Salvadoran gang, La Mara Salvatrucha 13 (MS-13). The TdA, however, is expanding much more quickly, likely due to its unique origin and state sponsorship in Venezuela. Unlike MS-13, which was born in Los Angeles in the 1980s, the TdA is foreign-born and was virtually nonexistent in America until 2021, distinct from other major TCOs such as MS-13 or the Mexican cartels. The TdA’s rapid expansion in the United States is a direct consequence of the Biden–Harris Administration’s failed immigration policies and lack of border enforcement.

KEY TAKEAWAYS The TdA’s goal is to establish territorial control and impose a criminal economy that connects illicit networks to penitentiaries in or near those neighborhoods. The new Trump Administration should work with Latin American partners to dismantle the TdA throughout the Western Hemisphere.

BACKGROUNDER No. 3876 | December 5, 2024

Washington DC: The Heritage Foundation, the Douglas ans Sarah Alison Center for National Security, 2024. 18p.

By Godwin Omokhagbo Emmanuel, Folahanmi Tomiwa Akinsolu , Olunike Rebecca Abodunrin,

Oliver Chukwujekwu Ezechi

ntroduction

Substance use is a growing public health concern in West Africa, contributing to significant morbidity, mortality, and socioeconomic challenges. Despite the increasing prevalence, comprehensive data on the patterns and factors influencing substance use in the region remain limited. This systematic review and meta-analysis aim to synthesize existing research on the prevalence and patterns of substance use in West Africa, providing critical insights for developing targeted interventions and policies.

Methodology

This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA] guidelines. A systematic search was performed across four major databases [PubMed, Web of Science, CINAHL, and Scopus] from January 2000 to June 2024. A total of 22 studies involving 43,145 participants met the inclusion criteria. Multiple reviewers performed data extraction and quality assessment independently, and a random-effects meta-analysis was used to estimate the pooled prevalence of various substances. Sensitivity analysis was conducted using a leave-one-out approach to evaluate the influence of individual studies on the overall prevalence.

Results

The meta-analysis revealed the pooled prevalence rates of alcohol [44%], cannabis [6%], tramadol [30%], codeine [11%], and kolanut [39%]. The analysis identified high heterogeneity across studies [I2 = 98– 99%], reflecting diverse substance use patterns and influencing factors, including peer influence, availability of substances, socioeconomic conditions, and demographic characteristics. Sensitivity analysis indicated that no single study significantly impacted the overall prevalence estimates, confirming the robustness of the findings.

Conclusion

Substance use in West Africa is widespread and influenced by complex factors. The high prevalence of alcohol and tramadol use highlights the urgent need for targeted public health interventions, including stricter regulatory frameworks, community-based prevention programs, and comprehensive public education campaigns. This study provides a critical foundation for developing effective strategies to mitigate the escalating substance use crisis in the region.

PLOS Glob Public Health 4(12): e0004019. https://doi.org/10.1371/journal. pgph.0004019

By Tadesse Simie Metekia and Matt Herbert

Summary Due to their difficult political paths – Ethiopia’s stalled transition and Tunisia’s reversal – these two nations demonstrate the effects of failing transitions and democratic backsliding on rising transnational organised crime. Reversing the current trend of organised crime depends heavily on restoring stability and rule-of-law-based democracies, which could be achieved through a revived political process that embraces dialogue and transitional justice to mitigate the challenges and enable governance structures to tackle the complexities of organised crime. Key points The surge in transnational organised crime in Ethiopia and Tunisia can be seen as a consequence of their unrealised political transitions due to: • ensuing economic upheaval that has been the major driver of transnational organised crimes in both countries • porous borders and ungoverned spaces that allow criminal networks to grow • attention to pressing security challenges, such as conflicts and terrorism, that create space for criminal networks to strengthen and operate with impunity

ENACT Africa, 2024. 48p.

By Matthew F. Garnett and Arialdi M. Miniño

Drug overdoses are one of the leading causes of injury death in adults and have risen over the past several decades in the United States (1–3). Overdoses involving synthetic opioids (fentanyl, for example) and stimulants (cocaine and methamphetamine, for example) have also risen in the past few years (1). This report presents rates of drug overdose deaths from the National Vital Statistics System over a 20-year period by demographic group and by the type of drugs involved, specifically, opioids and stimulants, with a focus on changes from 2022 to 2023. Key findings Data from the National Vital Statistics System ● The age-adjusted rate of drug overdose deaths increased from 8.9deaths per 100,000 standard population in 2003 to 32.6 in 2022; however, the rate decreased to 31.3 in 2023. ● Rates decreased between 2022 and 2023 for people ages 15–54 and increased for adults age 55 and older. ● From 2022 to 2023, rates decreased for White non-Hispanic people, while rates for other race and Hispanic-origin groups generally stayed the same or increased. ● Between 2022 and 2023, rates declined for deaths involving synthetic opioids other than methadone, heroin, and natural and semisynthetic opioids, while the rate for methadone remained the same. ● From 2022 to 2023, rates increased for deaths involving cocaine by 4.9% (from 8.2 to 8.6) and psychostimulants with abuse potential by 1.9% (10.4 to 10.6)

NCHS Data Brief No. 522, December 2024. 12p.
Hyattsville, MD: National Center for Health Statistics. 2024. DOI: https://dx.doi.org/10.15620/cdc/170565.

By Joseph Friedman, jofriedman@health.uDaniel Ciccarone

Synthetic illicit drugs, such as nitazenes and fentanyls, are becoming commonplace in countries around the world, including in Europe, Australia, and Latin America, which raises concern for overdose crises like those seen in North America. An important dimension of the risk represented by synthetic drugs is the fact that they are increasingly packaged in counterfeit pill form. These pills—often indistinguishable from authentic pharmaceuticals—have substantially widened the scope of populations susceptible to synthetic drug overdose in North America (eg, among adolescents experimenting with pills or tourists from the USA seeking psychoactive medications from pharmacies in Mexico). The non-medical use of diverted prescription medications is relatively more common, and less stigmatised, than the use of powder drugs. Many consumers of counterfeit pills are unaware that they contain synthetic illicit drugs, believe them to be authentic pharmaceuticals, and would be unlikely to consume those drugs knowingly or if in powder form. Given these issues, we recommend the expansion of educational and awareness campaigns, pill testing programmes to help consumers shift demand to safer products, increased monitoring in routine clinical scenarios and overdose death toxicology, and expanding medically managed safer alternatives to counterfeit pill use.\

The Lancet Public Health, Volume 10, Issue 1, e58 - e62 2025.

By Ella Cockbain, Patricio Estévez-Soto, and Felia Allum

Organised crime – and the people, processes and structures involved – do not exist in a geographical vacuum. They have an inherent spatiality: shaped by and shaping the places they occupy in physical, virtual and hybrid spaces. Although the ‘social embeddedness’ of organised crime is relatively well-recognised, its spatiality – or ‘spatial embeddedness’ – has been neglected. This article contextualises and introduces our special issue on the new geographies of organised crime. We put forward a central argument that geographical lenses can advance and enrich understanding of organised crime, briefly review relevant literature and explain some of the foundational concepts in geographical thinking. We discuss the rationale for this special issue and highlight its papers’ main contributions. Since the geographies of the illicit are full of complexities, heterogeneities and subjectivities, we do not propose any singular approach, but rather see a plurality of possibilities for better incorporating geography into organised crime scholarship. Accordingly, the papers are theoretically and methodologically diverse, as well as covering varied topics and locations

Criminology & Criminal Justice, 25(1). 2025, 3-20 pages

By The Transnational Alliance to Combat Illicit Trade (TRACIT)

The report, Confronting the Threat of Illicit Trade: Spotlight on the Dominican Republic, assesses the nature and extent of illicit trade in the Dominican Republic. It examines the impact of illicit trade on the economy and society, analyzes the government's ongoing efforts to address the issue, and presents practical recommendations for effective solutions. This report aims to empower stakeholders in their fight against illicit trade, ultimately contributing to a more secure and prosperous Dominican Republic

New York: Transnational Alliance to Combat Illicit Trade (TRACIT), 2024. 12p.

By The World Trade Organization

International trade in food has helped to reduce global poverty and hunger. However, illicit trade in food and food fraud undermine the global food system and endanger public health. This publication looks into the challenges of combating illicit practices, such as smuggling and counterfeiting, and the role the WTO could play

The publication draws on the expertise of the WTO Secretariat, the Food and Agriculture Organization of the United Nations, the International Seed Federation, SSAFE — a non-profit organization for food safety, the Transnational Alliance to Combat Illicit Trade and the United Nations Interregional Crime and Justice Research Institute.

Contributors examine the topic from their particular area of expertise, discussing how best to address illegal food trade and how the WTO agreements could contribute to tackling illegal practices.

  International trade has helped to reduce global hunger, but food fraud is a growing problem Access to healthy, affordable food is a prerequisite for improving the lives of the poorest. International trade has helped to reduce both global poverty and hunger. However, the resulting complexity of food supply chains makes combating illicit trade in food and food fraud much harder. Increased interconnectivity of supply chains and greater distances between where food is grown and where it is consumed provide more opportunities for illegal activities. Illicit trade in food and food fraud inflict considerable damage to international trade and public health The illicit trade in food and food fraud includes the buying and selling of products to be eaten, drunk or grown that are not what they are claimed to be, that fail to comply with health and other regulations (e.g. on quality) and that are smuggled or otherwise produced or traded outside the legitimate market framework. Illicit trade in food and food fraud inflict considerable damage to international trade and public health. Illicit trade in food undermines international trade by distorting markets, eroding consumer confidence and triggering the imposition of trade barriers due to safety concerns. Simultaneously, it poses significant public health risks through the distribution of counterfeit or substandard products, contributing to the spread of diseases and creating challenges for regulatory enforcement on a global scale. The consumption of contaminated, counterfeited or adulterated food products can result in malnutrition and even death. Illicit trade in food undermines global food security and agri-food value chains Illicit trade in food disrupts legitimate supply chains and limits access to foods by reducing availability and increasing prices. It undermines fair markets and reduces income for legitimate producers, with the most vulnerable communities affected the greatest. The impact of illicit trade in seeds and seed fraud can be significant for farmers, the agri-food value chain and hence global food security. Illegal seed practices also discourage innovation. The integrity of the seed sector can be strengthened through the protection of intellectual property rights and enhancing enforcement to ensure that farmers have access to reliable, high-quality seeds. The WTO rulebook brings a legal framework to international trade in food, helping to combat illicit trade The WTO agreements can be used in the fight against illicit trade in food and food fraud, in particular the Agreement on the Application of Sanitary and Phytosanitary Measures and the Agreement on Technical Barriers to Trade. The WTO rulebook brings a legal framework to the international trade in food, helping to combat illicit trade. The WTO has a unique role in promoting open and legal trade. WTO rules enable members to exercise control over their borders and enforce their trade laws, leaving less room for illegal trade.  

Geneva, SWIT: World Trade Organization 2024. 92p.

By Russell G. Smith

This report estimates the cost of serious and organised crime in Australia in 2022–23 to be between $30.4b and $68.7b. This is the fourth in a series of reports undertaken for the Australian Criminal Intelligence Commission estimating the cost of serious and organised crime. It updates and improves on the methodology used in the previous report, which estimated the cost of serious and organised crime in 2020–21 to be between $24.8b and $60.1b. As with the previous research, this report considers the direct and consequential costs of serious and organised crime in Australia, as well as the costs to government entities, businesses and individuals associated with preventing and responding to serious and organised crime. The current estimate includes the cost of some additional crime types, not previously included, but even accounting for these additions it is clear that serious and organised crime continues to impose a substantial burden on the Australian economy.

Statistical Report no. 50. 

Canberra: Australian Institute of Criminology. 2024. 87p.

By Donald J. Trump

Section 1. Purpose. This order creates a process by which certain international cartels (the Cartels) and other organizations will be designated as Foreign Terrorist Organizations, consistent with section 219 of the INA (8 U.S.C. 1189), or Specially Designated Global Terrorists, consistent with IEEPA (50 U.S.C. 1702) and Executive Order 13224 of September 23, 2001 (Blocking Property and Prohibiting Transactions With Persons Who Commit, Threaten to Commit, or Support Terrorism), as amended.

(a) International cartels constitute a national-security threat beyond that posed by traditional organized crime, with activities encompassing:

(i) convergence between themselves and a range of extra-hemispheric actors, from designated foreign-terror organizations to antagonistic foreign governments;

(ii) complex adaptive systems, characteristic of entities engaged in insurgency and asymmetric warfare; and

(iii) infiltration into foreign governments across the Western Hemisphere.

U.S. White House. Washington D.C. Jan. 2025. 14p.

By Erica Marat and Gulzat Botoeva

Summary This research brief examines the links between illegal drug trafficking, violence, and corruption in Central Asia. We argue that drug trafficking is highly organised with major criminal and state actors participating in the illicit activity. Criminal violence is spread across the region, especially in urban areas, but the Central Asian states are capable of intercepting and preventing illicit activities. By analysing big data on violence, drug interdictions, and patterns of corruption in the region between 2015 and 2022, we explain the relationship between drug trafficking and key actors from the criminal underworld and state agencies in Central Asia. We also rely on expert interviews explaining states’ involvement in the drugs economy. Our analysis of violence and policing dynamics in the region shows how patterns of organised crime change depending on state effectiveness and the presence of competition between traffickers. Each country exhibits a unique relationship between state actors and criminal syndicates in both interdicting and facilitating drug trafficking. Our research comes at a time of an anticipated increase in drug trafficking from Taliban-controlled Afghanistan, and of growing economic uncertainty in the wider region due to Western sanctions against Russia. In the policy realm, our research findings can help develop anti-trafficking strategies in the Central Asian region and improve our understanding of how drug trafficking can be curbed more effectively by identifying the main actors involved in this highly organised criminal process

Birmingham, UK: University of Birmingham., 2022. 48p.

By Mark Galeotti

In May 2022, Lithuanian police raided two underground factories where counterfeit cigarettes worth some €73 million were being produced.2 This happens all the time, and even the involvement of a Russian-linked organized crime group was hardly unusual. However, as the investigation extended to Belgium (where the goods would be transhipped to Britain), it became clear that behind the gangsters lay Russian intelligence officers, who were using the business – or at least part of its profits – to raise operational funds for their activities in Europe. With Putin regarding himself as ‘at war’ with the West, at a time when Europol chief Catherine de Bolle is warning that organized crime is on the rise across Europe,3 and Thomas Haldenwang, head of Germany’s counter-intelligence agency, is assessing ‘the risk of [Russian] state-controlled acts of sabotage to be significantly increased’,4 it is perhaps unsurprising that gangsters and spies would find themselves brought together in his campaign. It has, after all, become commonplace since the full-scale invasion of Ukraine in February 2022 to characterize the relationship between Russia and the West as some shade of war: economic, political, but typically more than just cold. Indeed, even as he insists that his invasion is not a war, just a ‘special military operation’ (SVO) – actually calling it a ‘war’ can conceivably get Russians a 15-year prison sentence5 – Putin freely uses the term when describing his country’s engagement with the West. However, it is less clearly understood just how significant and long held this view of his may be. In this context, it does seem in hindsight that Putin has considered himself as de facto at war with the West – or, more precisely, that the West has been warring against him – since at least around 2012. After stepping back from the presidency to the position of prime minister in order to observe the letter, if not the spirit, of term limits, all the while clearly still running the country, when Putin announced he would be returning to the Kremlin, this was for many the last straw. Demonstrations that became known as the Bolotnaya Protests were mastered and dispersed, but Putin seems to have been unable or unwilling to accept that they were a genuine, organic expression of dismay. Instead, he chose to see them as spurred by the US Department of State, after then-Secretary of State Hillary Clinton ‘gave the signal’ to opposition leaders.6 There had been a growing school of thought within Russian security circles that the West was using ‘political technologies’ to topple hostile governments, and support for civil society, democratization and the rule of law were seen as part of this campaign. As a former Kremlin insider put it, Putin was scared, then angry. As far as he was concerned, this was it, this was a sign that the West – the Americans – were coming for him. So he was determined to fight back, and that didn’t just mean defending himself, the repressions and arrests, it meant going on the attack. He was clear, he made it clear to us all: if the West was coming to mess with him, we would mess them up worse, by whatever means necessary.

Russia’s transition from a “conscription state” to a full “mobilization state”, after the 2022 invasion of Ukraine, has intensified the involvement of criminal groups in operations tied to sanctions-busting, cyber warfare, and intelligence. Organized crime networks provide Russia with access to restricted goods, such as advanced electronics for its military, and facilitate money laundering and illegal financial flows. Notably, Russian intelligence services have relied on criminal syndicates to supplement their espionage activities, including sabotage, cyberattacks, and assassinations.

The report also highlights Russia’s weaponization of migration, using smuggling networks to create political instability across Europe. Meanwhile, Putin’s regime has blurred the lines between state and criminal actors, using them as tools to evade international sanctions and expand Russian influence globally.

“Gangsters at War” reveals how Russian-based organized crime operates as a tool of Kremlin foreign policy, focusing not just on profits but on weakening geopolitical rivals. From sanctions evasion to destabilizing societies, criminal networks have become a key element in Russia’s geopolitical arsenal. The report calls for increased vigilance, international cooperation, and stronger countermeasures to address this growing threat to global stability

Geneva: Global Initiative Against Transnational Organized Crime.2024. 62p.

By the U.S. Department of Justice, Drug Enforcement Administration,

Education plays a critical role in preventing substance use and misuse. Drugs of Abuse, A DEA Resource Guide, is designed to be a reliable resource on the most commonly used and misused drugs in the United States. This comprehensive guide provides important information about the harms and consequences of drug use by describing a drug’s effects on the body and mind, overdose potential, origin, legal status, and other key facts.

Washington, DC: DEA, 2024. 117p.

By Earth League International; John Jay College of Criminal Justice; State University of New York - Farmingdale

In the early twentieth century, the Totoaba fishery was the most important fishery in the Gulf of California. At its peak, in 1942, over two thousand tons of fish maw were exported to China and the Chinese communities in California. Realizing the danger the fish faced, in 1975, the Mexican government banned the fishing of the species (Martínez & Martínez, 2018). Nonetheless, this critically endangered fish remains heavily overfished today, with organized criminal networks across the country playing a pivotal role in trafficking the species (Alvarado Martinez, 2014). The swim bladder is a highly prized commodity in China, as it is believed that the bladder can be used to treat a variety of medical conditions, including infertility, circulatory issues, kidney problems, and arthritis (Yagoub, 2016). Because of this, a single bladder can fetch for significantly high prices, and one gram of totoaba fish bladder can be more expensive than one gram of cocaine (Martínez & Alonso, 2021). Totoaba swim bladders are also referred to as “money maw” (Amepou et al, 2024), as individuals buy the bladder when prices drop in hopes that fish maw prices will rise once again and can be sold for profit. The poaching of totoaba for its swim bladder has had devastating consequences not only for the species itself and the marine life in the Sea of Cortez, but also for the vaquita porpoise, the world's most endangered marine mammal. The illegal fishing methods used to catch totoaba, particularly gillnets, also ensnare and kill vaquitas as bycatch. With only a few individuals remaining, the vaquita is on the brink of extinction. The survival of this species is directly linked to the elimination of totoaba poaching and trafficking.

Using the crime script analytical technique, and the meticulously-recorded first-hand investigative materials by Earth League International, this report analyzes the intricacies involved in trafficking totoaba swim bladder from Mexico to international destinations.

Los Angeles: Earth League International (ELI), 2024. 14p.

By Stephen F Pires and Nerea Marteache

Empirical studies on flora poaching are scarce, and the few that exist tend to focus on the study of illegal logging. The goal of this paper is to provide a deeper understanding of the issue of timber theft in protected parks, as well as to identify potential avenues for detection and prevention of this criminal behavior, using the case study of split-rail theft at Humboldt Redwoods State Park in California (USA). We utilize script analysis to offer a detailed description of the crime-commission process and the procedural requirements to carry out this type of crime. To do so, we used a mixed methods design that included incident data collection, field observations, and informal interviews with park rangers. Interventions that could potentially disrupt the chain of events, based on Situational Crime Prevention, are identified, and discussed.

Journal of Contemporary Criminal Justice 36, March 2020, 12p.

By Lauren J. Tanz; Andrea Stewart, R. Matt Gladden,; Jean Y. Ko, Lauren Owens, Julie O’Donnell

During 2023, approximately 72,000, or nearly seven in 10, drug overdose deaths in the United States were estimated to involve illegally manufactured fentanyls (IMFs). Carfentanil, a fentanyl analog 100 times more potent than fentanyl, has reemerged in the U.S. drug supply. Using CDC’s State Unintentional Drug Overdose Reporting System data, this report describes trends in overdose deaths during January 2021– June 2024, overall and with IMFs detected, by U.S. Census Bureau region, and in deaths with carfentanil detected, in 45 states and the District of Columbia (DC). Numbers of deaths with carfentanil detected by state during January 2023–June 2024 in 49 states and DC are also reported. The number of overdose deaths with IMFs detected declined from 2022 to 2023 in the Northeast (3.2% decline), Midwest (7.8%), and South (2.8%) regions; deaths in the West increased 33.9%. The percentage of deaths with IMFs detected was steady at approximately 70%–80% in the Northeast, Midwest, and South. In contrast, the percentage of deaths with IMFs detected in the West increased from 48.5% during January–March 2021 to 66.5% during April–June 2024. Overdose deaths with carfentanil detected increased approximately sevenfold, from 29 during January–June 2023 to 238 during January–June 2024; during January 2023–June 2024, overdose deaths with carfentanil detected were reported in 37 states. Overdose prevention efforts that address the widespread presence of IMFs, including carfentanil, and can rapidly adapt to other potent opioids in the drug supply might result in lasting reductions in overdose deaths across the entire United States

MMWR | December 5, 2024 | Vol. 73 | No. 48, 7p.

By Tami L. Mark; Benjamin D. Huber

IMPORTANCE: Medicaid programs have expanded coverage of substance use disorder treatment and undertaken many other initiatives to reduce drug overdoses among beneficiaries. However, to date, no information has been published that tracks overdose deaths among the Medicaid population. OBJECTIVE To determine the rate of drug overdose among Medicaid beneficiaries. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional study, US Centers for Medicare & Medicaid Services data from 2016 to 2020 that linked enrollment and demographic data from all Medicaid beneficiaries in the US with the US Centers for Disease Control and Prevention National Death Index were used to determine the rate of drug overdose death among Medicaid beneficiaries. The Medicaid population rates were compared with those of the total US population, overall and by age and sex. EXPOSURE Participation in the Medicaid program. MAIN OUTCOME Death of a drug overdose. RESULTS In 2020, the drug overdose death rate among Medicaid beneficiaries was 54.6 per 100 000, a rate that was twice as high as the drug overdose rate among all US residents (27.9 per 100 000). In 2020, Medicaid beneficiaries comprised 25.0% of the US population but 48% of all overdose deaths (44 277 of 91 783). For each age and sex group older than 15 years, overdose deaths were higher for the Medicaid population than for the US population, with the greatest difference occurring among adults ages 45 to 64 years. From 2016 to 2020, Medicaid overdose deaths increased by 54%. CONCLUSIONS AND RELEVANCE The results of this study suggest that more research is needed to understand why Medicaid beneficiaries have higher rates of drug overdoses than all US residents. Additionally, research is needed to understand how best to prevent overdoses among Medicaid beneficiaries. The federal government should s

JAMA Health Forum. 2024;5(12):e244365. doi:10.1001/jamahealthforum.2024.4365

By The U.S. Drug Enforcement Administration

The most significant drug-related threat to Illinois is posed by Mexican drug trafficking organizations (DTOs), particularly the Cartel de Sinaloa (CDS) and the Cartel de Jalisco Nueva Generación (CJNG). Mexican DTOs dominate the wholesale supply of illicit opioids (fentanyl and heroin), cocaine, methamphetamine, and Mexico grown marijuana in the state.

Washington, DC: U.S. Drug Enforcement Administration, DEA Intelligence Report; 2024. 6p.

By The U.S.Drug Enforcement Administration

The most significant drug-related threat to Indiana is posed by Mexican drug trafficking organizations (DTO), particularly the Cartel de Sinaloa (CDS) and the Cartel de Jalisco Nueva Generación (CJNG). Mexican DTOs dominate the wholesale supply of illicit opioids (both fentanyl and heroin), cocaine, methamphetamine, and Mexico-grown marijuana in the state. The opioid threat remains dire and is of grave concern.

Washington, DC: U.S. Drug Enforcement Administration, DEA Intelligence Report; 2024. 7p.