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Date: April 25, 2024 Thu
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7 results foundAuthor: U.S. Department of Health and Human Services. Office of the Surgeon General Title: Facing Addiction in America: The Surgeon General's Spotlight on Opioids Summary: Historically, opioids have been used as pain relievers. However, opioid misuse presents serious risks, including overdose and opioid use disorder. The use of illegal opioids such as heroin-a highly addictive drug that has no accepted medical use in the United States-and the misuse of prescription opioid pain relievers can have serious negative health effects. Fentanyl is a synthetic opioid medication that is used for severe pain management and is considerably more potent than heroin. Sometimes, prescription fentanyl is diverted for illicit purposes. But fentanyl and pharmacologically similar synthetic opioids are also illicitly manufactured and smuggled into the United States. PREVALENCE OF OPIOID MISUSE AND OPIOID USE DISORDER - Based on data from SAMHSA's National Survey on Drug Use and Health, in 2017, 11.1 million people aged 12 and older had misused prescription pain relievers in the past year. Repeated use of opioids greatly increases the risk of developing an opioid use disorder. In 2017, about 1.7 million people aged 12 and older had a prescription pain reliever use disorder in the past year. In 2017, 953,000 people received treatment for the misuse of opioid pain relievers. Heroin use is also a concern. In 2017, about 886,000 people aged 12 or older reported having used heroin in the past year. During that same time period, about 652,000 people aged 12 or These illicitly made synthetic opioids are driving the rapid increase in opioid overdose deaths in recent years. Illicitly made fentanyl and other pharmacologically similar opioids are often mixed with illicit substances such as heroin. They can also be made into counterfeit prescription opioids or sedatives and sold on the street. In 2017, about 1.7 million people aged 12 and older had a prescription pain reliever use disorder in the past year. In 2017, 953,000 people received treatment for the misuse of opioid pain relievers. Heroin use is also a concern. In 2017, about 886,000 people aged 12 or older reported having used heroin in the past year. During that same time period, about 652,000 people aged 12 or older were estimated to have a heroin use disorder. Specialty treatment is defined as receiving treatment at a substance use rehabilitation facility (inpatient or outpatient), hospital (inpatient services only), and/or mental health center. Only 54.9 percent of those aged 12 and older with heroin use disorder received treatment for illicit drug use at a specialty treatment facility. Details: Washington, DC: HHS, 2018. 40p. Source: Internet Resource: Accessed September 28, 2018 at: https://addiction.surgeongeneral.gov/sites/default/files/Spotlight-on-Opioids_09192018.pdf Year: 2018 Country: United States URL: https://addiction.surgeongeneral.gov/sites/default/files/Spotlight-on-Opioids_09192018.pdf Shelf Number: 151729 Keywords: Drug Abuse and Addiction FentanylIllicit Drugs Opioid Epidemic Opioids Prescription Drug Abuse |
Author: U.S. Senate. Committee on Homeland Security and Governmental Affairs Title: Combating the Opioid Epidemic: Intercepting Illicit Opioids at Ports of Entry Summary: U. S. Customs and Border Protection (CBP) plays a vital role in interdicting illicit narcotics before they can enter the United States. This role is particularly important given the rise of the opioid epidemic and the increasing use of fentanyl, which is overwhelmingly produced outside the United States. At the request of Ranking Member Claire McCaskill, the Democratic staff of the Senate Committee on Homeland Security and Governmental Affairs examined the efforts of CBP officers to interdict illicit opioids entering the United States. The investigation found that CBP Officers at ports of entry (Port Officers) play a key role in stopping opioids and that CBP has significant shortages of Port Officers that may be compromising efforts to seize additional opioids before they can reach U.S. communities. Currently, CBP collects data and statistics on opioid seizures made by its two primary law enforcement components, the Office of Field Operations, which controls operations at ports of entry, and Border Patrol, which maintains security between ports of entry. This report summarizes and analyzes data relating to the number and amount of opioid seizures at ports of entry over the last five years. Key findings include: - The vast majority of all opioids interdicted by CBP are seized at ports of entry. Between 2013 and 2017, approximately 25,405 pounds, or 88% of all opioids seized by CBP, were seized at ports of entry. Ports of entry located along the southern border are most active as those seizures accounted for 75% of all opioids seized at ports of entry during the same five year period. - Fentanyl seizures are rapidly increasing, and most occur at ports of entry. In a single year, the amount of fentanyl seized by CBP more than doubled, from 564 pounds in 2016 to 1,370 pounds in 2017. 85% of all CBP fentanyl seizures took place at ports of entry. - Large shipments of fentanyl entering the United States are seized at the ports of entry on the southern border, while a greater number of small shipments are interdicted in the international mail. Officers at ports of entry on the southern border seized 75% of the total poundage of fentanyl seized across all ports of entry between 2016 and 2017. Port Officers at international mail facilities had more than five times as many fentanyl seizures at mail facilities as Port Officers at land ports of entry. - Both mail and express carrier fentanyl seizures have increased over the past two years. When fentanyl is delivered through the international mail, a greater number of small shipments are sent through the U.S. Postal Service and larger amounts are shipped though express carriers like UPS, DHL, and Fed Ex. Although CBP depends on package data provided by express shippers in order to target packages likely to contain opioids and contraband, this information can be incomplete. While CBP has the authority to issue fines to compel shippers to provide complete data, express shippers have successfully negotiated $26 million in such penalties between 2014 and 2016 down to just $4 million. - Staffing shortages at ports of entry may be compromising interdiction efforts. Ports of entry across the United States have 4,000 Port Officers less than the number needed to staff all ports of entry. Ports of entry in the San Diego and Tucson areas, which together accounted for 57% of all opioid seizures by Port Officers between 2016 and 2017, have required CBP to assign temporary staff details to fulfill staffing needs at those locations. The practice of temporary details has become so systemic over the past two fiscal years that CBP has named it "Operation Overflow." - The opioid epidemic places disproportionate demands on Port Officers relative to other border security law enforcement officers. In its proposed FY 2019 budget, the Administration proposes to dramatically increase staffing at Border Patrol and Immigration and Customs Enforcement, but add no additional officers at ports of entry. This prioritization of other border security enforcement components over Office of Field Operations ignores the important role that Port Officers play in stemming the opioid crisis. Port Officers are, in the majority of cases, the last line of defense in preventing illicit opioids from entering the United States. To help stem the opioid crisis, increasing resources and staffing at ports of entry is critical. On February 15, 2018, Ranking Member McCaskill introduced The Border and Port Security Act, a bill that would authorize CBP to hire an additional 500 Port Officers each year until they meet the goals calculated in their workload staffing model. This legislation is a critical step in providing ports of entry with the resources they need to stop opioids before they can reach communities across the United States. Details: Washington, DC: The Committee, 2018. 17p. Source: Internet Resource: Accessed October 5, 2018 at: https://www.hsgac.senate.gov/imo/media/doc/Combating%20the%20Opioid%20Epidemic%20-%20Intercepting%20Illicit%20Opioids%20at%20Ports%20of%20Entry%20-%20Final.pdf Year: 2018 Country: United States URL: https://www.hsgac.senate.gov/imo/media/doc/Combating%20the%20Opioid%20Epidemic%20-%20Intercepting%20Illicit%20Opioids%20at%20Ports%20of%20Entry%20-%20Final.pdf Shelf Number: 152839 Keywords: Border Security Drug Abuse and Addiction Drug Trafficking FentanylIllegal Narcotics Opioid Epidemic Opioids Prescription Drug Abuse |
Author: Kilmer, Beau Title: Considering Heroin-Assisted Treatment and Supervised Drug Consumption Sites in the United States Summary: Current levels of opioid-related morbidity and mortality in the United States are staggering. Data for 2017 indicate that there were more than 47,000 opioid-involved overdose deaths, and one in eight adults now reports having had a family member or close friend die from opioids. Increasing the availability and reducing the costs of approved medications for those with an opioid use disorder (OUD) is imperative; however, jurisdictions addressing OUDs and overdose may wish to consider additional interventions. Two interventions that are implemented in some other countries but not in the United States are heroin-assisted treatment (HAT; sometimes referred to as supervised injectable heroin treatment) and supervised consumption sites (SCSs; sometimes referred to as overdose prevention sites). Given the severity of the opioid crisis, there is urgency to evaluate tools that might reduce its impact and save lives. In this mixed-methods report, the authors assess evidence on and arguments made about HAT and SCSs and examine some of the issues associated with implementing them in the United States. Key Findings -- Evidence from randomized controlled trials of HAT in Canada and Europe indicates that supervised injectable HAT - with optional oral methadone - can offer benefits over oral methadone alone for treating OUD among individuals who have tried traditional treatment modalities, including methadone, multiple times but are still injecting heroin. Although heroin cannot be prescribed in the United States because it is a Schedule I drug, it would be legal to conduct a human research trial on HAT. The literature on treating OUD with hydromorphone (e.g., Dilaudid) is less extensive than the literature on HAT; however, the existing results are encouraging. Hydromorphone trials in the United States would face fewer barriers than HAT trials. The scientific evidence about the effectiveness of SCSs is limited in quality and the number of locations evaluated. Many SCSs have been around for 15 to 30 years. Persistence does not imply effectiveness, but it seems unlikely that these SCSs - which were initially controversial in many places - would have such longevity if they had serious adverse consequences for their clients or communities. For drug consumption that is supervised, SCSs reduce the risk of a fatal overdose, disease transmission, and harms associated with unhygienic drug use practices; however, there is uncertainty about the size of the population-level effects of SCSs. There are significant legal issues surrounding the implementation of SCSs in the United States.. Both HAT and SCSs, as currently implemented, serve only a small share of people who use heroin. It is important to have a sense of potential scale limitations and costs when discussing HAT and SCSs. It might be constructive to view HAT and SCSs as exemplars of broader strategies, not as the only option within their class. Recommendations -- Given (1) the increased mortality associated with fentanyl, (2) the fact that some people who use heroin may not respond well to existing medications for OUD, (3) HAT's successful implementation abroad, and (4) questions concerning whether the success would carry over to the United States, HAT trials should be conducted in some of the U.S. jurisdictions that already provide a spectrum of social services and good accessibility to medication treatments for OUD. Conducting trials with HAT and hydromorphone are not mutually exclusive, and it may make sense to include both in the same study, as was done in Canada. Assessing the impact of injectable hydromorphone via clinical trials (with or without a HAT arm) would inform future regulatory decisions about using it as a medication treatment for OUD. Some researchers and advocates believe that, during an emergency like the present opioid crisis, the absence of a large downside risk for an intervention that has strong face validity (e.g., SCSs) may be sufficient for some decisionmakers to proceed, rather than waiting for further evidence. Nevertheless, if attempts to implement SCSs in the United States are successful, a strong research component should be incorporated into these efforts. Details: Santa Monica, CA: RAND, 2018. 93p. Source: Internet Resource: Accessed Dec. 6, 2018 at: https://www.rand.org/pubs/research_reports/RR2693.html?utm_source=WhatCountsEmail&utm_medium=Drug%20Policy%20Research%20Center%20(DPRC)+AEM:%20%20Email%20Address%20NOT%20LIKE%20DOTMIL&utm_campaign=AEM:363632650 Year: 2018 Country: United States URL: https://www.rand.org/pubs/research_reports/RR2693.html?utm_source=WhatCountsEmail&utm_medium=Drug%20Policy%20Research%20Center%20(DPRC)+AEM:%20%20Email%20Address%20NOT%20LIKE%20DOTMIL&utm_campaign=AEM:363632650 Shelf Number: 153920 Keywords: Drug Abuse and AddictionDrug Consumption FacilitiesDrug-Related DeathsFentanylOpioid EpidemicOpioidsPrescription Drug AbuseSubstance Abuse Treatment |
Author: Le Cour Grandmaison, Romain Title: No More Opium for the Masses: From the U.S. Fentanyl Boom to the Mexican Opium Crisis: Opportunitiee Amidst Violence? Summary: This report examines the effects of the upsurge in U.S. fentanyl use on opium producing areas in Mexico. By using available quantitative data on Mexican opium production as well as qualitative field research from opium producing communities in Nayarit and Guerrero, this paper offers valuable insights into Mexico's illicit drug trade. In particular, this paper demonstrates the extent to which certain villages in the Golden Triangle, but also in Guerrero, Nayarit, and Oaxaca rely on opium production for survival. The authors estimate that the opium economy channeled around 19 billion pesos ($1 billion dollars) to some of the poorest communities in Mexico in 2017. This is a vast amount, nearly three times the total legal agricultural output of the entire state of Guerrero. Up to around 2017, opium growers in Mexico were earning around 20,000 pesos ($1,050 dollars) a kilo of raw opium, and families could bring in up to 200,000 pesos ($10,500 dollars) per year. With the upsurge in fentanyl use, the demand for Mexican heroin has fallen sharply, by an estimated 7 billion pesos ($364 million dollars). This has had an immediate knock-on for opium producers. Farmers are now being paid around 6000 to 8000 pesos ($315 - 415 dollars) per kilo of raw opium. These losses have caused farmers' profits to disappear, village economies to dry up; and out-migration to increase. These findings have important implications for public security in Mexico, as well as major ramifications for international counter-drug efforts. Criminal groups in Mexico are nothing if not supple and adaptable to change. If current trends continue in the coming years, such groups may continue to dominate poppy-growing regions through other industries including illegal logging, illegal mining or the production of synthetic drugs. While legalization and crop substitution have been touted as possible alternatives, these should not be conceived of as silver bullets. However, if properly researched and managed, both policies could be introduced relatively cheaply and effectively. Initially at least, they would loosen the grip of organized crime groups on the regions and tie farmers to licit international markets. Combined with other broader security policies, they could integrate these marginalized areas into the country for good. Resolving this crisis requires further in-depth, policy-focused research in Mexico. It is urgent to design policies that are based on solid, updated knowledge about local dynamics of violence in the country. Any political response must be based on further research and diagnosis, conducted in the most critical opium producing regions of the country. Mexican government officials and international aid agencies should work to strengthen programs to promote long-term crop-substitution and economic development opportunities. Such policies are urgently needed to encourage local agricultural producers to focus on legitimate, locally sustainable crops and alternative industries. Recent proposals to legalize opium for the pharmaceutical industry should be considered seriously. Yet, legalization would only solve a one part of the issue, since Mexican demand for legal opioids is massively lower than the country's current illegal production. Hence, the solution must be articulated both at the national and international level, in order to tackle supply and demand simultaneously. Details: s.l.: Noria Research, Washington, DC: Mexico Institute at the Wilson Center. 2019. 35p. Source: Internet Resource: Accessed February 14, 2019 at: https://www.noria-research.com/app/uploads/2019/02/NORIA_OPIUM_MEXICO_CRISIS_PRO-1.pdf Year: 2019 Country: Mexico URL: https://www.noria-research.com/app/uploads/2019/02/NORIA_OPIUM_MEXICO_CRISIS_PRO-1.pdf Shelf Number: 154601 Keywords: FentanylIllegal DrugsIllicit Drug TradeOpioid EpidemicOpioidsOpiumOrganized Crime |
Author: Sherman, Susan Title: Safe Drug Consumption Spaces: A Strategy for Baltimore City Summary: In the United States, the opioid epidemic is one of the most pressing public health crises of our time. In 2015, overdose fatalities surpassed those of gun homicides for the first time; drug overdoses accounted for 52,404 deaths, 63% of which involved an opioid. The overdose death rate involving opioids has more than quadrupled since 1999, largely attributable to the rise of prescribed and synthetic opioids and subsequent non-medical use. With 259 million prescriptions annually, current opioid availability in the legal market is such that there is enough supply for every American adult have 75 pills. Many Americans whose first exposure to opioids is through these prescriptions later move to illegal drugs to sustain their use. As persons develop tolerance to the effects of prescription opioids, they require greater amounts or stronger medications to avoid painful withdrawal symptoms. High costs of diverted prescription medications and drug tolerance may drive persons to inject illicit drugs, such as heroin. Further, physicians are experienced increase pressure not to rescue or cut people off of opioids, many patients look to illicit means to obtain opioids or heroin. At the same time, the explosion of cheap and increasingly available synthetic opioids such as fentanyl has increased the magnitude of overdose risk. Fentanyl, increasingly prevalent in the U.S. setting, is 50-100 times more potent than heroin or morphine. Fentanyl is a profitable addition to the drug trade because it is cheaper to make and more potent than prescription opioids, heroin, and cocaine. For every overdose death, thousands more experience nonfatal overdose, problematic addiction, morbidities such as endocarditis and soft tissue infections (e.g., abscesses), and are at risk for infectious diseases such as HIV and hepatitis C virus (HCV). These negative health outcomes often occur in the context of unsterilized injection environments. These problems are exacerbated because people who inject drugs (PWID) are less likely to access medical, mental health and social services. Further, illicit drug use, particularly via injection in unsafe drug spaces (e.g., public bathrooms, parks, abandoned housings -"abadominiums") exacerbates the potential for fatal overdose as well as HIV and HCV transmission. Empirical evidence has demonstrated the short-comings of the U.S. war on drugs, underscoring the need for innovative approaches to address substance use disorders and related consequences. In addition to fueling some of the highest rates of incarceration worldwide, drug war supply-side strategies such as drug raids and crackdowns have had minimal, short-lasting impact and may lead to the displacement of drug activity zones. Furthermore, research has found that war on drugs' policing strategies are associated with increases in HIV transmission risk. Given the unprecedented effects of the opioid epidemic, there has never been a more critical time to implement innovative and humane public health approaches to address problematic drug use. In response to these unprecedented rates of overdose deaths, enduring morbidities associated with drug use, and the failed war on drugs, there has been increased interest in the U.S. in innovative and effective interventions aimed to reduce harm to people who use drugs and the broader community. This has led to many discussions about the establishment of safe consumption spaces (SCSs) throughout the U.S. Roughly 97 SCSs exist in 66 cities in 11 countries. Details: Baltimore, MD: Abell Foundation, 2017. Summary; Full Report. Source: Internet Resource: Vol. 29(2): Accessed March 12, 2019 at: https://www.abell.org/publications/safe-consumption-spaces-strategy-baltimore Year: 2017 Country: United States URL: https://www.abell.org/publications/safe-consumption-spaces-strategy-baltimore Shelf Number: 154895 Keywords: Drug Abuse and Addiction Drug Addicts Drug Consumption Facilities Drug Overdose Fatalities Drug Policy FentanylIllegal Drugs Opioid Epidemic Prescription Drug Abuse |
Author: InSight Crime Title: Criminal Game Changers 2018 Summary: Welcome to InSight Crime's Criminal GameChangers 2018, where we highlight the most important trends in organized crime in the Americas over the course of the year. From a rise in illicit drug availability and resurgence of monolithic criminal groups to the weakening of anti-corruption efforts and a swell in militarized responses to crime, 2018 was a year in which political issues were still often framed as left or right, but the only ideology that mattered was organized crime. Some of the worst news came from Colombia, where coca and cocaine production reached record highs amidst another year of bad news regarding the historic peace agreement with the region's oldest political insurgency, the Revolutionary Armed Forces of Colombia (Fuerzas Armadas Revolucionarias de Colombia - FARC). The demobilization of ex-FARC members has been plagued by government ineptitude, corruption, human rights violations, and accusations of top guerrilla leaders' involvement in the drug trade. And it may have contributed directly and indirectly to the surge in coca and cocaine production. It was during this tumult that Colombia elected right wing politician Ivan Duque in May. Duque is the protege of former president and current Senator Alvaro Uribe. Their alliance could impact not just what's left of the peace agreement but the entire structure of the underworld where, during 2018, ex-FARC dissidents reestablished criminal fiefdoms or allied themselves with other criminal factions; and the last remaining rebel group, the National Liberation Army (Ejercito de Liberacion Nacional - ELN), filled power vacuums in Colombia and neighboring Venezuela, making it one of our three criminal winners this year. Meanwhile, a new generation of traffickers emerged, one that prefers anonymity to the large, highly visible armies of yesteryear. Also of note in 2018 was a surge in synthetic drugs, most notably fentanyl. The synthetic opioid powered a scourge that led to more overdose deaths in the United States than any other drug. Fentanyl is no longer consumed as a replacement for heroin. It is now hidden in counterfeit prescription pills and mixed into cocaine and other legacy drugs. It is produced in Communist-ruled China and while much of it moves through the US postal system, some of it travels through Mexico on its way to the United States. During 2018, the criminal groups in Mexico seemed to be shifting their operations increasingly around it, especially given its increasing popularity, availability, and profitability. The result is some new possibly game changing alliances, most notably between Mexican and Dominican criminal organizations. Among these Mexican criminal groups is the Jalisco Cartel New Generation (Cartel Jalisco Nueva Generacion - CJNG), another of our three criminal winners for 2018. The CJNG has avoided efforts to weaken it with a mix of sophisticated public relations, military tactics and the luck of circumstance - the government has simply been distracted. That is not the say it is invulnerable. The group took some big hits in its epicenter in 2018, and the US authorities put it on its radar, unleashing a series of sealed indictments against the group. Mexico's cartels battled each other even as they took advantage of booming criminal economies. The result was manifest in the record high in homicides this year. The deterioration in security opened the door to the July election of leftist candidate Andres Manuel Lopez Obrador. AMLO, as he is affectionately known, did not necessary run on security issues, but he may have won on them, and in the process, inherited a poisoned security chalice from his predecessor. While Pena Nieto can claim to have arrested or killed 110 of 122 criminal heads, AMLO faces closer to a thousand would-be leaders and hundreds of criminal groups.... Details: s.l.: Insight Crime, 2019. Source: Internet Resource: Accessed March 25, 2019 at: https://www.insightcrime.org/wp-content/uploads/2019/01/CRIMINAL-GAMECHANGERS-2018-InSight-Crime.pdf Year: 2019 Country: Latin America URL: https://www.insightcrime.org/wp-content/uploads/2019/01/CRIMINAL-GAMECHANGERS-2018-InSight-Crime.pdf Shelf Number: 155157 Keywords: CocaineCriminal NetworksDrug CartelsDrug TraffickingFentanylIllicit DrugsOpioidsOrganized CrimeWar on Drugs |
Author: Felbab-Brown, Vanda Title: Mexico's Out-of-Control Criminal Market Summary: This paper explores the trends, characteristics, and changes in the Mexican criminal market, in response to internal changes, government policies, and external factors. It explores the nature of violence and criminality, the behavior of criminal groups, and the effects of government responses. Over the past two decades, criminal violence in Mexico has become highly intense, diversified, and popularized, while the deterrence capacity of Mexican law enforcement remains critically low. The outcome is an ever more complex, multi-polar, and out-of-control criminal market that generates deleterious effects on Mexican society and makes it highly challenging for the Mexican state to respond effectively. Successive Mexican administrations have failed to sustainably reduce homicides and other violent crimes. Critically, the Mexican government has failed to rebalance power in the triangular relationship between the state, criminal groups, and society, while the Mexican population has soured on the anti-cartel project. Since 2000, Mexico has experienced extraordinarily high drug- and crime-related violence, with the murder rate in 2017 and again in 2018 breaking previous records. The fragmentation of Mexican criminal groups is both a purposeful and inadvertent effect of high-value targeting, which is a problematic strategy because criminal groups can replace fallen leaders more easily than insurgent or terrorist groups. The policy also disrupts leadership succession, giving rise to intense internal competition and increasingly younger leaders who lack leadership skills and feel the need to prove themselves through violence. Focusing on the middle layer of criminal groups prevents such an easy and violent regeneration of the leadership. But the Mexican government remains deeply challenged in middle-layer targeting due to a lack of tactical and strategic intelligence arising from corruption among Mexican law enforcement and political pressures that makes it difficult to invest the necessary time to conduct thorough investigations. In the absence of more effective state presence and rule of law, the fragmentation of Mexican criminal groups turned a multi-polar criminal market of 2006 into an ever more complex multi-polar criminal market. Criminal groups lack clarity about the balance of power among them, tempting them to take over one another's territory and engage in internecine warfare. The Mexican crime market's proclivity toward violence is exacerbated by the government's inability to weed out the most violent criminal groups and send a strong message that they will be prioritized in targeting. The message has not yet sunk in that violence and aggressiveness do not pay. For example, the destruction of the Zetas has been followed by the empowerment of the equally aggressive Cartel de Jalisco Nueva Generacion (CJNG). Like the Zetas, the Jalisco group centers its rule on brutality, brazenness, and aggressiveness. Like the Zetas and unlike the Sinaloa Cartel, the CJNG does not invest in and provide socio- economic goods and governance in order to build up political capital. Equally, the internal re-balancing among criminal groups has failed to weed out the most violent groups and the policy measures of the Mexican governments have failed to reduce the criminal groups' proclivity toward aggression and violence. The emergence of the CJNG has engulfed Mexico and other supply-chain countries, such as Colombia,in its war with the Sinaloa Cartel. The war between the Sinaloa Cartel and CJNG provides space for local criminal upstarts, compounds instability by shifting local alliances, and sets off new splintering within the two large cartels and among their local proxies. To the extent that violence has abated in particular locales, the de-escalation has primarily reflected a "narco-peace," with one criminal group able to establish control over a particular territory and its corruption networks. It is thus vulnerable to criminal groups' actions as well as to high-value targeting of top drug traffickers. In places such as Ciudad Juarez, Tijuana, and Monterrey, local law enforcement and anti-crime socio-economic policies helped in various degrees to reduce violence. When the narco-peace was undermined, the policies proved insufficient. At other times, the reduction of violence that accompanied a local narco-peace gave rise to policy complacency and diminished resources. Socio-economic policies to combat crime have spread resources too thinly across Mexico to be effective. Violence in Mexico has become diversified over the past decade, with drug trafficking groups becoming involved in widespread extortion of legal businesses, kidnapping, illegal logging, illegal fishing, and smuggling of migrants. That is partially a consequence of the fragmentation, as smaller groups are compelled to branch out into a variety of criminal enterprises. But for larger groups, extortion of large segments of society is not merely a source of money, but also of authority. Violence and criminality have also become "popularized," both in terms of the sheer number of actors and also the types of actors involved, such as "anti-crime" militias. Widespread criminality increases the coercive credibility of individual criminals and small groups, while hiding their identities. Low effective prosecution rates and widespread impunity tempt many individuals who would otherwise be law-abiding citizens to participate in crime. Anti-crime militias that have emerged in Mexico have rarely reduced violence in a sustained way. Often, they engage in various forms of criminality, including homicides, extortion, and human rights abuses against local residents, and they undermine the authority of the state. Government responses to the militias-including acquiescence, arrests, and efforts to roll them into state paramilitary forces-have not had a significant impact. In fact, the strength and emergence of militia groups in places such as Michoacan and Guerrero reflect a long-standing absence of the government, underdevelopment, militarization, and abuse of political power. In places such as Guerrero, criminality and militia formation has become intertwined with the U.S. opioid epidemic that has stimulated the expansion of poppy cultivation in Mexico. The over-prescription of opioids in the United States created a major addiction epidemic, with users turning to illegal alternatives when they were eventually cut off from prescription drugs. Predictably, poppy cultivation shot up in Mexico, reaching some 30,000 hectares in 2017. Areas of poppy cultivation are hotly contested among Mexican drug trafficking groups, with their infighting intensely exacerbating the insecurity of poor and marginalized poppy farmers. Efforts to eradicate poppy cultivation have often failed to sustainably reduce illicit crop cultivation and complicated policies to pacify these areas, often thrusting poppy farmers deeper into the hands of criminal groups that sponsor and protect the cultivation. Eradication is easier than providing poppy farmers with alternative livelihoods. Combined with the Trump administration's demands for eradication, the Enrique Peea Nieto administration, and Mexico historically, showed little interest in seriously pursuing a different path. Poppy eradication in Mexico does not shrink the supply of illegal opioids destined for the U.S. market, since farmers replant poppies after eradication and can always shift areas of production. The rise of fentanyl abuse in the United States, however, has suppressed opium prices in Mexico. Drug trafficking organizations and dealers prefer to traffic and sell fentanyl, mostly supplied to the United States from China, because of its bulk-potency-profit ratio. The CJNG became a pioneer in fentanyl smuggling through Mexico into the United States, but the Sinaloa Cartel rapidly developed its own fentanyl supply chain. Although the drug is deadly, the Sinaloa Cartel's means of distribution remain non- violent in the United States. Fentanyl enters the United States from Mexico through legal ports of entry. In the short term, fentanyl has not altered the dynamics of Mexico's criminal market, but in the long term, fentanyl can significantly upend global drug markets and the prioritization of drug control in U.S. agendas with other countries. If many users switch to synthetic drugs, the United States may lose interest in promoting eradication of drug crops. Such a switch would also weaken the power of criminal and insurgent groups who sponsor illicit crop cultivation. Even if they switch to the production of synthetic drugs, they will only have the capacity to sponsor the livelihoods of many fewer people, thus diminishing their political capital with local populations and making it less costly for the government to conduct counter-narcotics operations. Mexico's violence can decline in two ways. First, a criminal group can temporarily win enough turf and establish enough deterrence capacity to create a narco-peace, as has been the case so far. Alternatively, violence can decline when the state at last systematically builds up enough deterrence capacity against the criminals and realigns local populations with the state, from which they are now often alienated. Mexico must strive to achieve this objective. Details: Washington, DC: Foreign Policy at Brookings Institute, 2019. 29p. Source: Internet Resource: Accessed March 27, 2019 at: https://www.brookings.edu/wp-content/uploads/2019/03/FP_20190322_mexico_crime-2.pdf Year: 2019 Country: Mexico URL: https://www.brookings.edu/wp-content/uploads/2019/03/FP_20190322_mexico_crime-2.pdf Shelf Number: 155192 Keywords: Criminal CartelsDrug MarketsDrug TraffickingFentanylHomicidesNarcoticsOpioidsOrganized CrimeSocioeconomic Conditions and CrimeViolence |