October 17 2017 Douglas C Dorley Public Information Officer Drug Enforcement Administration St Louis Division Methamphetamine widely available primary drug threat in western Division Mexican crystalized methamphetamine ID: 651653
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Missouri Opioid Summit DEA PerspectiveOctober 17, 2017
Douglas C. DorleyPublic Information OfficerDrug Enforcement AdministrationSt. Louis DivisionSlide2Slide3
Methamphetamine
widely available
primary
drug threat in western Division
Mexican crystalized methamphetamine is most prevalent formconsistent high purity range 98% - 100% HeroinIncreasing, high availability, always in demandFentanyldeadly synthetic opioidusers demand over heroin Prescription Opioidsalways available, continuous threatfuel the heroin/opioid epidemic
Regional Drug Threats Slide4
Methamphetamine greatest drug threat for majority of St
Louis Divisionduring 2000s, local meth labs predominated since 2010, potent Mexican crystal methamphetamine
has dominated demand
Mexican cartels
control U.S. drug marketSinaloa Cartel has greatest presence in SLDactual members or affiliatespervasive availabilitypurity can be 99% or 100%more than doubled in potency since 1990stypically powder form can be liquid or crystallizedgreatly contributes to Division violent crimeSlide5
extensively available in eastern Missouri
h
eroin is moving westward
primary drug threat in the St. Louis metropolitan area (SLMA)
heroin/opiate overdose deaths nearly doubled in SLMA during 2016Springfield Police Department responds to average of 25 drug overdoses per monthevidence points to heroin as primary drugbottom line: heroin is at heart of increasing drug incidents in Springfield and across DivisionHeroinSlide6
Heroin
National Institute on Drug Abuse (NIDA) confirms heroin abuse dramatic and recent rise in U.S. national heroin/fentanyl overdose deaths nearly doubled in 2016imported from Mexico
low cost and widely available
greater purity
over last decade, up from 10% to 55%competitive price with prescription drugscurrently one of biggest drug concerns in nationusers opt for heroin when prescription pillshard to obtaintoo costlySlide7
Heroin-Opioid Update 2017
preliminary findings for St. Louis County show a continued increase in heroin/opiate (includes fentanyl) related deaths during the first six months
of 2017
March
2017, new fentanyl analogue first appeared in Divisionanalogue = synthetic version of a controlled substancetetrahydrofuran fentanylidentified in Springfield Georgia Bureau of Investigation reports indicate tetra form is resistant to naloxoneSlide8
Fentanyl
most lab submissions are sent in as other drugs (heroin, cocaine, etc)
12 doses of NARCAN were needed to revive a St. Louis area overdose victim in June 2017Slide9
fentanyl purity levels
range from 0.7
% - 4.1% in DEA laboratory submissions
fentanyl increasingly replacing current heroin markets
SLMA overdose deathsfentanyl overdose deaths increased 643% in SLMA from 2014 to 2016from 47 to 349 overdose deathsfentanyl is now major factor in opioid deaths FentanylSlide10Slide11
St. Louis Area Fentanyl vs Other Opiate Deaths Slide12
Fentanyl
50 times more potent than heroin100 times more potent than morphinecarfentanil is 10,000 times more potent than morphine
t
ypically synthetic…
not pharmaceutical gradeclandestine lab produced vs. pharmaceutical producttiny amount of fentanyl to overdoseone or two salt-sized grains of fentanyl can kill an adultfentanyl mixed with heroin, cocaine or pills is new and very dangerous threat in Divisionmany fentanyl analogues compound situation all fentanyl forms are highly addictiveheroin/fentanyl = primary SLMA drug threatSlide13
FENTANYL (cont)
Mexican cartels supply fentanyl to U.S.no crop to grow vs cheap chemicalsMexican super labs have tremendous production capabilityf
entanyl = synthetic
opioid pain
medication that is manufactured in laboratories from chemicalsChina is primary manufacturer smuggled into U.S. through Mexico or Canadapotency enables smugglers to transport compact quantities for huge profitone kilogram = apprx $60,000 street valueapprx $3500 lab cost to manufacture one kilogram fentanylif 1mg of fentanyl contained in each pill = 666,666 pillsthen = $20 million street value for pillsbottom line: majority of national opioid deaths are currently fentanyl-relatedSlide14
Carfentanil
April 2017…St. Charles County Criminal Lab analyzed its first
exhibit
of
carfentanil a plastic nasal spray bottle containing carfentanil, fentanyl and the analog butyryl fentanyl Slide15
By ComparisonSlide16
Prescription Pills
U.S. consumes 80% of global opioid supply pain pills are 2nd
largest global drug class
only cancer drugs exceed pain drug demand
in 2014, Americans ingested 99% of all hydrocodone, a powerful opioid painkillerSlide17
so…what caused this drug crisis?
heroin-prescription pills cycle started current crisisillicit drug use in U.S. has historically increased
2017…25 million+ Americans abuse drugs
user demand for more and stronger drugs only continues to increase
Mexican cartels adapted to U.S. consumer demandsynthetic opioids such as fentanyl are the latest and growing drug demandconsensus: worst drug crisis in U.S. historySlide18
FACTS
majority of drug overdose deaths stems from opioids1980…6,000 drug overdose deaths in U.S.2000 to 2015…180,000 overdose deaths in U.S.t
hree times the number of Vietnam War deaths
2016…estimated 60,000 to 65,000 Americans died from drug overdose
2016…40,000 Americans died in traffic accidents2016…deadliest on roads in last 10 years2016…drug overdose leading cause of death for Americans under 50fentanyl and fentanyl analogues compound the opioid drug disasterU.S. Dept of Health and Human Services2016…580 people began daily heroin use2016…78 people died each day from opioid overdose Slide19
Springfield
Fairview Heights
Fairview Hts
SpringfieldSlide20
Springfield
Heroin has changed from infancy stages to one of imminent danger. In 2014-2015, DEA Springfield Resident Office (SRO) seized less than 20 ounces of heroin combinedIn
2016 and
to date 2017
, the SRO has initiated nine large-scale heroin investigations that resulted in 23 federal indictments and arrests, and seized more than 16 pounds of heroin Slide21
Midwest Fentanyl Seizures
Near Major Interstates
Fairview HeightsSlide22
27 kilograms seized April 2017 by SLDO
third largest fentanyl seizure in the
U.S.
Fairview Heights, Illinois
30 kilograms fentanyl seized September 2017 by FHROsecond largest fentanyl seizure in the U.S.St. Louis Slide23
May 8, 2017 - 8 pounds of fentanyl seized from the bus terminal, originating in Los Angeles and destined for New York
May 12, 2017 - 14.7 pounds of fentanyl seized from the bus terminal, originating in Indianapolis and destined for Kansas City
May 25, 2017 - 60 pounds of fentanyl seized during a traffic stop, concealed inside a speaker box in a vehicle’s trunk
Kansas CitySlide24
St. Louis, Missouri ranked 1st
Kansas City, Missouri ranked 10th
Springfield, Missouri ranked 11
th
rankings based on offenses involving force or threat of force for every 100,000 U.S. residents FBI Report of America’s Most Dangerous CitiesOctober 2016 (Uniform Crime Reporting) Slide25Slide26
DEA 360 Goals
tackle the cycle of violence and addiction in a comprehensive approach generated
from the
link between drug cartels, violent
gangs and rising problem of prescription opioid and heroin abuse in U.S. citiesstop the deadly cycle of heroin and opioid pill abuse by eliminating drug trafficking organizations and gangs that fuel violence on the streets and perpetuate cycles of addiction in our communitiespartner with the medical community and the public to raise awareness of the dangers of prescription opioid misuse and the link to heroinstrengthen community organizations best positioned to provide long-term help and support to build drug free communitiesSlide27
DEA
recognizes we cannot arrest our way out of the drug
problem – our goal is lasting success in the communities we serve
e
ducation, prevention and opportunity are key elements for a true 360 degree strategyEnforcement Operations provide an opportunity empower communities and provide a springboard for education and prevention effortsCommunity Action Support & EducationSlide28
Diversion Control
e
ngage
drug manufacturers, wholesalers, practitioners and pharmacists to increase awareness of the opioid epidemic and encourage responsible prescribing practices for
opioid painkillers in the healthcare community hosted DEA Pharmacy Diversion Awareness Conferences for pharmacists in our region Des Moines – July 2017 Omaha – June 2017 Wichita – March 2017 St. Louis – April 2014appearances at dozens of high schools, town halls, civic organizations, and various healthcare, social work and law enforcement associations and organizations across MissouriSlide29
National Take Back Initiative
DEA sponsored program that collects unused Rx & OTC meds from the public to remove this “attractive nuisance” from homes in an effort to reduce accidental poisonings by partnering with state and local law enforcement agencies to provide collection points twice annually
b
eginning Sept
2016, these twice annual collection events have removed over 331,000 lbs. of unwanted meds from Missouri homesour first collection netted just over 5,000 lbs: the last event was our 3rd highest total of nearly 37,000 lbsnationally, this program has removed over 8 million pounds of unused meds from homesDiversion ControlSlide30Slide31
QUESTIONS?