Part 1—Illicit Opioids and Heroin

The 2020 National Drug Threat Assessment (NDTA) is a comprehensive assessment of the threat posed to the United States by the trafficking and abuse of illicit drugs, the diversion and abuse of licit drugs, and the laundering of proceeds generated through illicit drug sales. It also addresses the role domestic groups, including organized violent gangs, serve in domestic drug trafficking. The most widely trafficked drugs are discussed in terms of their availability, consumption and overdose related deaths, production and cultivation, transportation, and distribution.
The trafficking and abuse of illicit drugs inflict tremendous harm upon individuals, families, and communities throughout the United States. The violence, intimidation, theft, and  financial crimes carried out by transnational criminal organizations (TCOs), criminal groups, and violent gangs pose a significant threat to our nation. The criminal activities of these organizations operating in the United States extend well beyond drug trafficking and have a profoundly negative impact on the safety and security of U.S. citizens. Their involvement in alien smuggling,  firearms trafficking, and public corruption, coupled with the high levels of violence that result from these criminal endeavors, poses serious homeland security threats and public safety concerns.
Mexican TCOs are the greatest drug trafficking threat to the United States; they control most of the U.S. drug market and have established varied transportation routes, have advanced communications capabilities, and hold strong afliations with criminal groups and gangs in the United States.
Illicit fentanyl—produced in foreign clandestine laboratories and trafficked into the United States in powder and pill form—is primarily responsible for fueling the ongoing opioid crisis. Fentanyl-laced counterfeit pills continue to be trafficked across the country and remain significant contributors to the rates of overdose deaths observed across the country. As inexpensive, potent fentanyl continues to push into established heroin markets, fentanyl will augment, and in some cases supplant, white powder heroin in various domestic markets.
Methamphetamine price and purity data, as well as law enforcement reporting, all indicate methamphetamine continues to be readily available throughout the United States. Seizures along with drug poisoning deaths involving methamphetamine continue to rise—purity and potency remain high while prices remain relatively low.
Availability of cocaine throughout the United States remains steady, likely based on the high levels of coca cultivation and cocaine production in the Andean Region of South America. Leading indicators of cocaine availability, including laboratory analysis of cocaine exhibits, cocaine seizure data, and price and purity of the drug, indicate that cocaine availability is steady.
Controlled Prescription Drugs (CPDs) remain a prevalent concern within the United States— availability remains constant while abuse levels decreased from the previous year. CPD diversion continues to decrease across most categories at the national level, but some states report an increase in the number of incidents. The number of opioid dosage units available on the retail market and opioid thefts and losses reached their lowest levels in nine years.
Mexico remains the most significant foreign source for marijuana in the United States; however, in U.S. markets, Mexican marijuana has largely been supplanted by domestic-produced marijuana.
The demand market for New Psychoactive Substances (NPSs) is typified by new substances constantly being created and marketed to users. Synthetic cannabinoids and synthetic cathinones are the most common classes of NPSs available and abused in the United States; however, there are many other classes of NPSs including opioidsc, phenethylamines, tryptamines, benzodiazepines, and piperazines.
The 2020 COVID-19 pandemic and the associated restrictions on daily travel, U.S. border closings, closure of nonessential businesses, and the broad shelter-in-place orders temporarily posed new challenges to criminal organizations and their movement of drugs throughout the United States during the  first half of 2020. Global drug markets reported  fluctuations in pricing, availability, transportation, and distribution of illicit drugs during the initial stages of the pandemic in the spring of 2020. Despite initial disruptions in drug smuggling, transportation, and distribution, TCOs operating throughout foreign countries and in the United States continued to test new methods and use existing techniques to continue operating during the COVID-19 pandemic.
The full report may be viewed at www.dea.gov/sites/ default/files/2021-02/DIR-008-21%202020% 20National%20Drug%20Threat%20Assessment_WEB.pdf
The report is divided into the following sections: Illicit Opioids and Heroin; Methamphetamine; Cocaine; Controlled prescription drugs; Marijuana; New psychoactive substances; Transnational criminal organizations; Drug threat in U.S. Territories and in Indian Country and Illicit finance. A summary of each  section will be published each week.
Illicit Opioids and Heroin
Nearly 70% of all drug overdose deaths in the United States in 2018 involved an opioid. Deaths involving synthetic opioids other than methadone—the category which includes fentanyl—increased by 10% according to data provided by the Centers for Disease Control and Prevention (CDC). While deaths involving heroin decreased by four percent, heroin continues to pose a serious public health and safety threat. The domestic markets for heroin, fentanyl, and other illicit synthetic opioids overlap, as these substances disproportionately affect the Great Lakes and Northeast regions of the United States. Mexican TCOs have established clandestine laboratories in Mexico for the synthesis of fentanyl, and Mexican authorities have encountered a rise in illegal fentanyl pill press and tableting operations. Likewise, Mexican TCOs are responsible for the production and trafficking across the Southwest Border (SWB) of the overwhelming majority of the heroin available in the United States.
Availability
Fentanyl continues to be readily available across the country with 17 of DEA’s 23 Field Divisions indicating that fentanyl availability was high in 2019. Nearly all DEA Field Divisions that reported high fentanyl availability in 2019 also reported the same in 2018, demonstrating fentanyl’s continued impact on the illicit drug market.
In 2019, the majority of DEA Field Divisions indicated that heroin was easily obtained at any time. DEA’s hybrid Caribbean Field Division— with domestic and foreign offices—reported that while heroin remained moderately available when compared to 2018, heroin seizures throughout the entire Division declined in 2019. DEA’s Miami and Houston Field Divisions reported that heroin was more available in their area of responsibility (AOR) than in the previous reporting period. DEA’s El Paso, New Orleans, and San Diego Field Divisions reported that heroin availability within their respective AORs remained at the same moderate level as in 2018, meaning that heroin was generally readily accessible.
Heroin availability remains high in the United States, especially in the Great Lakes, Midwest, and Northeast regions, where the largest white powder heroin markets are located. DEA Field Divisions seized 6,951 kilograms of heroin in 2019, a 30 percent increase from 2018, with the largest amounts of heroin seized in Texas, California, Arizona, and New York. California, Texas and Arizona are all major entry points for heroin sourced from Mexico and also serve as transshipment points for the onward movement of heroin to domestic markets throughout the United States. New York is regarded as the most significant heroin market and distribution hub in the United States.  
Analysis conducted on retail level heroin seizures by the STRL under the Heroin Domestic Monitor Program (HDMP) indicates that Mexico- sourced heroin dominates retail heroin markets throughout the United States. This same analysis further indicates that heroin mixed with other controlled substances, mostly fentanyl, is increasingly widespread at the retail level. Historically, retail level heroin distributors have mixed or “cut” heroin with adulterants such as caffeine, procaine, and lidocaine, which increased their profits but also decreased the purity of their product. Adding fentanyl to heroin allows distributors to greatly increase their profits while maintaining product quality.
Next week: Part 2 - Methamphetamine.