Reducing the Supply of and Demand for Illicit Drugs: Strategic Approaches

Alan Piracha of the U.S. State Department's Bureau of International Narcotics and Law Enforcement Affairs at an OSCE-wide conference on counternarcotics, July 16, 2018, Vienna, Austria. (USOSCE/Colin Peters)

Reducing the Supply of and Demand for Illicit Drugs: Strategic Approaches

Session 1 of the OSCE-wide Conference on Combating the Threat of Illicit Drugs and the Diversion of Chemical Precursors

As delivered by Foreign Affairs Officer Alan Piracha
Bureau of International Narcotics and Law Enforcement Affairs
U.S. Department of State
Vienna, July 16, 2018

Thank you to the OSCE under the Italian Chairmanship for the opportunity to speak under this important and timely agenda item.

The United States is suffering through a drug crisis of unprecedented scale. In 2016, nearly 64,000 people died from drug overdoses, and over 30 percent of those deaths involved a synthetic opioid like fentanyl. Since 2012, the number of overdose cases involving synthetic opioids have increased nearly 640 percent, and preliminary data from 2017 suggest that this trend is continuing.

The overdose figures alone are staggering, and yet there are evermore numbers of families, friends, and communities affected.

We recognize that successful counternarcotics efforts require an approach balanced between supply side interventions along with strong support for policies and programs to address the underlying demand.

I’ll start by discussing our domestic approach: Domestically, in addition to law enforcement operations aimed at reducing the supply of dangerous drugs to U.S. markets, including by enhancing interdiction capabilities and identifying and prosecuting traffickers, we have taken a number of actions to address demand by supporting effective prevention, treatment, and recovery initiatives.

These actions include:

• Raising public awareness of the risks associated with opioid use;

• Reducing exposure to prescription opioids and preventing misuse, including through the use of prescription drug monitoring programs, state prescription drug laws, insurance strategies such as prior authorizations and quantity limits, evidence-based guidelines to the medical community on safer prescribing practices, youth substance abuse prevention programs, patient education on risks associated with opioids (including heroin), and safe storage and disposal.

• We are also working to promote the availability of the overdose reversing drug naloxone, and to assess the feasibility of training community members to safely administer it if they witness an overdose.

• Furthermore, our health and justice sectors are collaborating to support alternatives to incarceration with the objective of increasing individual access to drug treatment facilities for low-level drug offenders.

We also support this balanced approach in international drug policy and during program implementation. We continue to support the 2016 outcome document from the UN General Assembly Special Session on the World Drug Problem as the latest international consensus, and we are focused on practical implementation of its operational recommendations.

On the demand side, the United States recognizes that a balanced approach to drug policy means a focus on sustainable demand reduction interventions that incorporate effective and evidence-based public health responses in prevention, treatment and recovery for people with addiction.

Our international demand reduction framework follows a four pillar approach:

1. building the prevention and treatment workforce worldwide through evidence-based training;

2. professionalizing services around the world by supporting credentialing and accreditation systems;

3. building networks to connect the prevention and treatment workforce, academia, and policymakers; and

4. supporting populations with special clinical needs, such as women, children, and rural communities.

Work within this framework helps partner nations around the world prevent new initiates and build a strong foundation for the provision of treatment and recovery services.

On the supply side, the Department of State, in collaboration with other U.S. government agencies such as the Drug Enforcement Administration, works with international organizations and partner nations to support a variety of counternarcotics initiatives in line with the UNGASS recommendations.

This line of effort includes training, equipment, and technical support for eradication and interdiction; law enforcement partnerships to support best practices in policing; training for prosecutors and judges to strengthen criminal justice systems; and working to reduce the corrupting influence of drug-derived illicit finance.

However, our experience with the opioid crisis has uncovered a shift in the paradigm: Increasingly, illicit manufacturers in home, clandestine, or after-hours labs are producing potent new psychoactive substances, often without the need for large trafficking organizations or infrastructure.

The Dark Web gives buyers and sellers across the globe more anonymity than was ever before thought possible, and international mail and express consignment shipments can carry small amounts of potent drugs all around the world while evading traditional controls.

And while the opioid crisis has hit North America particularly hard, any country with a connection to the internet and international mail could be vulnerable to an overdose crisis like the one we are seeing in the United States today.

Moreover, by the time these drugs are sold on the streets, they are often heavily modified with adulterants and other psychoactive substances that the dealers themselves do not know what they are selling. This leads to another troubling aspect: of the thousands of Americans who die every month from opioid overdoses, many of them have no idea what is actually in the drugs they are consuming.

So today, we see fentanyl in the United States, but tomorrow it could be synthetic cannabinoids in the Southern Cone, or cathinones in Southeast Asia. According to the World Drug Report, a quarter of a billion people around the world use illicit drugs every year – and any one of them could unknowingly be exposed to a lethal dose of a new psychoactive substance at any time.

In short, our international approach must be able to adapt to emerging challenges.

Our international organization partners are already supporting valuable data-sharing mechanisms that can help us learn more from each other about the threats and possible solutions surrounding this crisis. Notably, the UN Office on Drugs and Crime, International Narcotics Control Board, and the World Health Organization are supporting online information sharing platforms that inform us about new and emerging threats, and yield essential data needed to inform the treaty-mandated scientific reviews undertaken by the WHO to generate scheduling recommendations to the UN Commission on Narcotic Drugs (CND).

Increasing the availability of advance electronic data for international mail items is another important measure to help authorities screen shipments. The State Department is working with the Universal Postal Union to expand the collection and sharing of advance electronic data globally to aid detection and interdiction efforts. Our authorities need to share experiences and best practices on how to keep our mail and consignment shipping services safe, and cooperate to shut down trafficking networks that exploit these essential services.

Furthermore, we are working with international partners to address issues and vulnerabilities in our current international drug control framework that have arisen due to the increased production, traffic, and use of new psychoactive substances.

In this context, we are promoting efforts to curb the rapid proliferation of new psychoactive substances. As a global community we must think innovatively about ways to restrict the illicit manufacture and production of harmful NPS and to accelerate the rate at which synthetic drugs are controlled under the international regime.

The United States looks forward to continuing the robust suite of supply and demand reduction partnerships we have built around the world, and to working innovatively with the international community to tackle emerging trends.

Thank you, and I look forward to the conversations today.