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1 This page intentionally left 019 national drug THREAT ASSESSMENTDRUG ENFORCEMENT ADMINISTRATION2019 national drug THREAT ASSESSMENTPMS 320 PMS 505 PMS 377 This product was prepared by DEA s Strategic Intelligence Section. Comments and questions may be addressed to the Office of Intelligence Programs at For media/press inquiries call (202) 307-7977. DFN-701-03--Destroy 2 years after issuance or when the DEA Intelligence Report is superseded or ENFORCEMENT ADMINISTRATIONThis page intentionally left of Dedication |2 Letter from the Acting Administrator |3 Executive Summary |4 Fentanyl and Other Synthetic Opioids |9 Heroin |21 Controlled Prescription Drugs |31 Methamphetamine |43 Cocaine |59 Marijuana |77 New Psychoactive Substances (NPS) |91 Transnational Criminal Organizations |99 OCONUS and Tribal threats |111 Illicit Finance |121 Gangs |125 Appendix A: Additional Figures |141 Appendix B: Acronym Glossary |144 TABLE OF CONTENTSUNCLASSIFIEDUNCLASSIFIED 2 019 national drug THREAT ASSESSMENTThe 2019 national drug Threat assessment (NDTA) is dedicated to the memory of DEA Supervisory Intelligence Research Specialist Kirsten Walters.

2 Kirsten directly managed the writing, editing, vetting, and release of the NDTA from 2016 through 2019 before she sadly passed away earlier this year. Kirsten s constant energy, relentless optimism, and calm demeanor in the face of stress were all key factors in the success of DEA publishing the NDTA every year. Moreover, her caring disposition, steady guidance, sense of humor, and ever-present smile made Kirsten a wonderful supervisor, colleague, mentor, leader, and friend. We miss her dearly and cannot thank her enough for all she has done to enrich both the DEA as an organization and the lives of all those who were fortunate enough to know her. LETTER OF DEDICATIONUNCLASSIFIEDUNCLASSIFIED2 019 national drug THREAT ASSESSMENT2I am proud to present the 2019 national drug Threat assessment (NDTA). Produced in partnership with local, state, tribal, and federal agencies, and integrating the most recently available reporting from law enforcement, intelligence, and public health agencies, this annual assessment provides in-depth strategic drug -related intelligence to inform counterdrug policies, establish priorities, and allocate resources.

3 The global trafficking of illicit drugs poses a grave national security threat to our citizens. DEA works closely with all of our partners around the country and the world to protect our communities from violent criminal organizations and their networks. In every corner of America and nearly 70 countries overseas, DEA personnel are on the ground working hand-in- hand with law enforcement and public health officials to combat transnational organized crime and serve communities in need. Although the final statistics are still pending, this year we re hopeful we will see the first decrease in drug overdose deaths in 30 years, with the largest decline from controlled prescription drugs. This success is the direct result of the work by DEA and its partners to reduce opioid quotas, educate the medical community and reduce prescription rates, and to safely and securely remove unwanted and unused controlled substances from circulation.

4 I want to thank all of our partners for their contributions to the NDTA, which is among the most important and valuable reports we produce. We at DEA look forward to collaborating on future initiatives that will help protect our public health and national security interests, at home and ,Uttam DhillonActing AdministratorDrug Enforcement AdministrationLETTER FROM THE ACTING ADMINISTRATORUNCLASSIFIEDUNCLASSIFIEDDRU G ENFORCEMENT ADMINISTRATION3 EXECUTIVE SUMMARYThe 2019 national drug Threat assessment (NDTA)a is a comprehensive strategic assessment of the threat posed to the United States by domestic and international drug trafficking and the abuse of both licit and illicit drugs. The report combines federal, state, local, and tribal law enforcement reporting; public health data; open source reporting; and intelligence from other government agencies to determine which substances and criminal organizations represent the greatest threat to the United States.

5 Illicit drugs, and the transnational and domestic criminal organizations that traffic them, continue to represent significant threats to public health, law enforcement, and national security in the United States. The opioid threat (controlled prescription drugs, synthetic opioids, and heroin) continues at ever-increasing epidemic levels, affecting large portions of the United States. Meanwhile, the stimulant threat (methamphetamine and cocaine) is worsening and becoming more widespread as traffickers continue to sell increasing amounts outside of each drugs traditional markets. New psychoactive substances (NPS) remain challenging and the domestic marijuana situation is evolving as state-level medical and recreational legalization continues. drug poisoning deaths are the leading cause of injury death in the United States.

6 In 2017b, drug poisoning deaths reached their a. Analyst Note: The information in this report is current as of August Analyst Note: 2017 overdose-related death statistics is the latest available official drug Threat assessment Scope and MethodologyThe 2019 NDTA is a comprehensive assessment of the threat posed to the United States by the trafficking and abuse of illicit drugs. The report provides strategic analysis of the domestic drug situation during 2018, based upon the most recent law enforcement, intelligence, and public health data available for the period. It also considers data and information from 2017 and earlier, when appropriate, to provide the most accurate assessment possible to policymakers, law enforcement authorities, and intelligence preparation of this report, a full year of data is collected for each drug category by DEA Intelligence Research Specialists.

7 DEA Intelligence Research Specialists 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 the involvement of organized criminal groups, information on smuggling and transportation trends, and indicators of changes in smuggling and transportation methods).UNCLASSIFIEDUNCLASSIFIED2 019 national drug THREAT ASSESSMENT4highest recorded level and, every year since 2011, have outnumbered deaths by firearms, motor vehicle crashes, suicide, and homicide. In 2017, approximately 192 people died every day from drug poisoning (see Appendix A: Figure A2).

8 Fentanylc and Other Synthetic Opioidsd: Fentanyl and other highly potent synthetic opioids primarily sourced from China and Mexico continue to be the most lethal category of illicit substances misused in the United States. Fentanyl continues to be sold as counterfeit prescriptions pills as traffickers wittingly or unwittingly are increasingly selling fentanyl to users both alone and as an adulterant, leading to rising fentanyl-involved deaths. Fentanyl suppliers will continue to experiment with other new synthetic opioids in an attempt to circumvent new regulations imposed by the United States and China. Heroin: Heroin-related overdose deaths remain at high levels in the United States, due to continued use and availability, while fentanyl is increasingly prevalent in highly profitable white powder heroin markets. Mexico remains the primary source of heroin available in the United States according to all available sources of intelligence, including law enforcement investigations and scientific data.

9 Further, high-levels of sustained opium poppy cultivation and heroin production in Mexico allow Mexican Transnational Criminal Organizations (TCOs) to continue to supply high-purity, low-cost Prescription Drugs (CPDs): CPDs are still responsible for the most drug -involved overdose deaths and are the second most commonly abused substances in the United States. Traffickers continue to manufacture and distribute counterfeit CPDs often-containing fentanyl and other opioids along with non-opioid illicit drugs in attempts to expand their customer base and increase profits. Overall diversion incidents continue to decline; however, CPDs lost in transit or diverted by medical professionals remains a prevalent threat across the United States. Methamphetamine: Methamphetamine remains widely available, with traffickers attempting to create new customers by expanding into new, non-traditional methamphetamine markets such as the Northeast, or other user bases with new product forms.

10 Most of the methamphetamine available in the United States is produced in Mexico and smuggled across the Southwest Border (SWB). Domestic production occurs at much lower levels than in Mexico and seizures of domestic methamphetamine laboratories have declined steadily for many years while overall supply has : Cocaine is a resurgent threat in the United States as domestic indicators such as seizures, availability, and overdose deaths remain at elevated levels. Cocaine-involved overdose c. Unless explicitly stated, the term fentanyl, when used in this report, refers to clandestinely manufactured and illegally distributed fentanyl and not to pharmaceutical or licit In this document, the phrase synthetic opioid refers to only those substances, which are classified as opioids and have no plant-based material in their production ( fentanyl, fentanyl-related substances, and other novel opioids) and therefore does not include ENFORCEMENT ADMINISTRATION5deaths continue to exceed established benchmarks, primarily due to the continued spread of fentanyl into the cocaine supply.