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U.S. Department of State

Diplomacy in Action

Readout of the 61st UN Commission on Narcotic Drugs: International Progress on Combating the Opioid Crisis

The Washington Foreign Press Center
Washington, DC
March 23, 2018

MODERATOR: As I mentioned, today we have with us [State Department Official]. For the purposes of this briefing, which is on background, we will refer to him as a State Department official. He is here to provide a readout of the 61st UN Commission on Narcotic Drugs and with the international progress on combating the opioid crisis. And with that, I will turn it over.

STATE DEPARTMENT OFFICIAL: I just want to say a few words about the commission last week, and then if there’s questions about the broader opioid crisis I’m happy to take those too and talk about those.

Last week we were in Vienna and the Commission on Narcotic Drugs met all week last week in Vienna. It’s the 61st time that commission has met. It’s the commission that was set up in the wake of the approval of 1961 Single Convention of Narcotic Drugs to kind of implement and be the oversight body for the convention.

So it’s a premier forum annually where countries can get together and talk about the world drug problem, trends in drug trafficking and consumption, and also kind of the latest modalities on treatment and cooperation.

The United States obviously is suffering from a really dramatic opioid crisis and an overdose crisis really writ large. Sixty-four thousand people died in the United States in 2016 due to overdose, due to overdose of drugs. And just to put that into context for us, if you look at all the soldiers that have died in any kind of conflict since Vietnam, if you go back to 1955 and through last year, it’s about the same number as died in one year due to drug overdoses. So it’s really a significant problem for us. The deaths due to opioids was about 42,000 of that 64, so about two-thirds of them were due to opioids. And if you kind of look at the daily figure, it’s about 115 people a day are dying in this country due to opioid overdoses.

Those overdoses come from a variety of different sources. Some of them come from prescription drug abuse, also – and also a number of them come from heroin overdoses, and a number of them come from synthetic drug overdoses. And the synthetic base is normally a drug called fentanyl, which is a very powerful synthetic opioid. It’s used medically for pain treatment, especially in terminal cancer patients and in terminal patients, but it’s been – but it’s now come out onto the illicit drug market, and about 20,000, or almost a third of the overdose deaths, was due to fentanyl.

One of the things that has really been driven home to our country, from our crisis, is that the synthetic problem that we have really – we really represent the new global threat. It just happened to manifest itself most seriously here first. The difference is in a traditional drug threat you have a farmer or a drug trafficker contracting with a farmer to grow some kind of plant-based drug – heroin poppy or coca plants or a marijuana plant, and they’ll harvest and synthesize those into the consumable form of the drugs, and then they’ll ship it to or smuggle it to the United States and it will be sold by street corner dealers or something like that.

The synthetic drug problem is really something entirely different. What’s happening now is we have illicit actors taking advantage of an individual country’s industrial chemical sector and using a chemical plant to synthesize a drug, and in the case of the United States it’s fentanyl. And then they sell it online, either in the dark net or via the open net to a large extent, and then they distribute it through the mail or express consignment couriers. An express consignment courier is like FedEx or DHL or UPS or something like that. And because of the volume of international mail services and express consignment courier services, and the difficulty to detect on all websites and all derivatives of different names of drugs on the websites, and kind of the unique nature of the dark web, this is a real challenge for law enforcement.

And we believe this is a threat – although it’s manifested most seriously and fastest in the United States, this is a threat to all countries. Anybody that has access to the mail and the internet and has a drug user who might like some form of synthetic drugs, whether it’s an opioid like fentanyl or something like tramadol or some other kind of synthetic drug, is susceptible to this new drug threat.

So when we went into the commission last week we really wanted to highlight that problem as manifested in our opioid problem and highlight that this is not – this is – while it’s most serious here at the moment, it is really a global threat that all countries should work together to find out ways we can tighten the international control regime.

So, we do a number of things that we believe were successful in starting to head down this path of working together as a global community to start to arrest this problem. One of the things was the international control of carfentanil, which, as you all may know, is a synthetic opioid that is by some counts 10,000 times more powerful than morphine. It’s only ever really been useful as an elephant tranquilizer, but somehow people found a way to traffic it to the illicit drug market and people take it. It’s very, very dangerous. It’s very, very difficult to mete out in small enough quantities such that a user can take it and not die. We’re seeing a lot of deaths here on it. The fact that the international community voted unanimously to control it, it means that within six months all parties to the International Drug Control Conventions, which is 186 countries, will have to establish control of the production, distribution, and sale of those chemicals.

In the past, we’ve had international controls on different synthetic chemicals. We’ve seen a reduction in the illicit market in the United States, and other countries we think have had the same experience. So we think it’s a big step forward. There are five other fentanyl-related drugs that were also controlled, as well as a bunch of what’s called cannabinoids. So we – that was – that’s one step forward. That’s just one – carfentanil is just one of a number of analogs of fentanyl, but it’s a step forward in helping to tackle the problem.

We also held an event together with our Chinese counterparts and also with the Universal Postal Union to highlight the dangers of the post – the global mail system by traffickers increasingly sending drugs through the mail. That was a well-attended event. It was standing room only. It was something that countries really tried to recognize as a problem, and it was a first step to start to talk about how can we all work together to put better controls on international mail and provide new best practices and new techniques to control what comes through the mail. So we thought that was really good too.

The United States also successfully passed a resolution, I think with about a dozen co-sponsors, that highlights the synthetic opioid challenge and calls on the international community to work together to have a follow-on meeting and also designate a global focal point to discuss the implications of the new kind of drug paradigm and the synthetic opioid challenge globally.

So that’s kind of what we accomplished last week at the commission, and so we think it was a significant step in kind of highlighting kind of this new threat to – posed by the new modalities in drug trafficking. It’s kind of a new drug-trafficking threat that’s global. And so we were pleased that countries seem to now more and more recognize the threat and be more and more willing to work together to come up with new controls and new best practices to tackle it.

So kind of that’s what I wanted to kind of leave the comments on the – on the commission last week, and I welcome your questions.

QUESTION: Thank you, I’m from China. You just mentioned China, and I know the President’s speech mentioned China too last year, and he said that he will talk about it with Mr. Xi. Sorry. So do you have a figure how much fentanyl from China into the United States in one year?

STATE DEPARTMENT OFFICIAL: Sure. It’s a very difficult question. We know the number of overdose deaths we have, but we don’t have a very good picture about the exact quantities and kilograms of fentanyl that comes in. We know that the fentanyl that we interdict, the vast majority of it comes from China. And I’ll just say that China is now working with us. Where we’ve worked very well, we believe, with the Chinese Government on this problem, and China’s been very responsive, and we’re very – we’re grateful to our cooperation with China on the synthetic drug problem.

I think in terms of talking about this, I think China has controlled about 143 new synthetic drugs, and we – and I know the President talks actively – and it was released in a statement last fall – about China looking into controlling fentanyl-class drugs – fentanyl is a class of drugs; in other words, somehow outlawing all or also restricting access to all fentanyl analogs. I know it’s something that I understand the Chinese Government is currently examining, and I’d refer you back to the Chinese Government for more details about that. But I know that the President talked with President Xi about that last fall.

So we’re pleased with our cooperation with China on the synthetic drug problem. I think we have more to do on it, and we look forward to kind of deepening our cooperation.

QUESTION: Yeah. And do you know the drug, fentanyl, is come from China directly to U.S. or through the other countries, such as Mexico or Canada?

STATE DEPARTMENT OFFICIAL: It’s all of the above. The sense we have is that – is that because of this modality about ordering on the dark net and having it shipped through the mail, it can go anywhere. So, for example, if a Mexican trafficker wants to order some – order some fentanyl and mix that with heroin that they then export to the United States, they can do that. If a user or a dealer in the United States wants to order fentanyl that they then mix with heroin, say, they got from Mexico, they can do that. Or if a user just wants to order fentanyl and just order amounts that they can use personally, that also happens. So it’s kind of all of the above.

QUESTION: Okay, thank you.


QUESTION: So I mean, I’m trying to understand what you are trying to do. I mean, because it’s like it’s mainly trafficking, or it seems so. I mean, you cannot control the synthesis of these analogs – and if I am wrong, correct me – because it’s done in different places and people are just smuggling – or are there steps taken to stop the smuggling? Which is not smuggling; the word even doesn’t work like – this is like sent by mail or – and through the Silk Road, whatever that website is, to order things. How U.S. as a policy is taking steps to block these things, or it’s just like – because chasing the – those who get it or those who get addict or those who get – died, it doesn’t mean anything – the last – the last – I mean, the last stop in the whole chain.


QUESTION: So what you are trying to do exactly?

STATE DEPARTMENT OFFICIAL: So in terms of disrupting the supply chain?


STATE DEPARTMENT OFFICIAL: Sure. We have a number of things we’re trying to do. Working with the international community, as I was just discussing about the commission, is one aspect of the overall policy. It’s an important aspect because it’s a global problem. The international community, the UN in particular, has a number of tools it can deploy to help with this problem. The INCB and UNODC each have these databases that – they’re kind of like early warning systems to detect – that law enforcement uses to detect diversion of precursor chemicals or illicit sale of actual synthetic drugs.

QUESTION: So at the beginning, you --

STATE DEPARTMENT OFFICIAL: That’s at the beginning, right. That’s before they ever leave a country.


STATE DEPARTMENT OFFICIAL: So in these databases, it helps – it shows all the shipping data that law enforcement from anywhere in the world can use, can access in order to try to detect and use different algorithms in order to detect abnormalities in the shipment. And that’s not just mail shipments; that’s cargo shipment, it’s any kind of shipment, right, of industrial chemicals. That’s one thing.

We’re also developing a relationship with the Universal Postal Union to develop training programs and capacity for countries to provide advanced electronic data so we can better – have a better handle on what’s coming through the mail, one. And then also develop kind of training programs for foreign customs officials to know how to inspect or to develop techniques to know how to inspect the outgoing mail in a more efficient basis. That’s another one.

We’re also working closely with Mexico, which is a major source of heroin – the major source of heroin for us – on a range of issues, from getting a better handle through a UN program on the yield of its poppy crop to a very robust and broad and longstanding program called the Merida Initiative, which works to build capacity in the Mexican judicial and police to be able to better go after, I guess, the transnational criminal organizations that are trafficking this stuff. They’ve had a lot of success already; they’ve – I think they’ve arrested a hundred of the top drug kingpins in Mexico. Many of them have been extradited to the United States, which has been very disruptive. It’s caused a lot of fragmentation in the cartels. But it’s a big challenge with – that will be ongoing for some time.

We’re – there’s also ongoing efforts in the cyber realm to both work – INCB is working kind of on a B2B basis with internet providers. So they agree to take down anything with the word “fentanyl” in it, for example. Like, for example, if Alibaba would take down anything that says “fentanyl” in it, that would curtail the availability of fentanyl on the open web. So INCB is working on that program. And there are other programs to curtail the sale of synthetic drugs via the dark and open net. And also law enforcement is building up – our law enforcement agencies are building up capacity to be able to go after the dark net actors.

QUESTION: Two kind of follow-up questions. One is most of it, from your presentation – I mean, it seems that most of it’s coming from outside. Is there local production coming out?


QUESTION: Whatever. Synthetic products, whatever. Or it’s hard to do it, or I don’t know?

STATE DEPARTMENT OFFICIAL: The – we don’t have evidence of fentanyl produced illegally in the United States and then sold by drug dealers. As far as we know, the vast majority of it is coming internationally. So there’s three legs of the problem – of our addiction problem, of our opioid crisis. One is the improper and over-prescription of legal opioid – OxyContin and different types of legal opioids. A big part of the plan that the President announced on March 19th is about reforming the prescription system or – and reforming the way pharmacies trash the drugs.

QUESTION: So it be less accessible.

STATE DEPARTMENT OFFICIAL: So it’ll be less accessible. And there’ll be a dramatic reduction in the amount of opioid prescriptions and the length of the average opioid prescription. So that’s one part of it. The other part of it is the heroin that’s coming from Mexico. So that’s another part of it, and our partnership with Mexico. Another part of it is the synthetic problem. That goes into this broader drug threat that I outlined at the beginning of my initial remarks. Does that make sense?

QUESTION: Yeah, I mean, I have a related question, because you say always with – because I had some interviews with some people who are dealing with physicians or psychiatrists. Anyway, one of the problems with this synthetic thing is, like, even some of them, they don’t know what is coming from what.


QUESTION: I mean, this is the danger of it. It’s not just like a – because to do an experiment as they told me, they are doing it – they try to sell it so they see how the people will react or the – as a – like lab animals.

STATE DEPARTMENT OFFICIAL: Yeah, and that’s – I think that’s actually a very sort of sophisticated question and it’s something that we’re seeing more of, is that in a traditional – drugs that are trafficked or smuggled to the United States are being adulterated with different kinds of toxins – not always fentanyl, but other kinds of toxins, usually to provide some kind of product differentiation. In other words, I have a – I have cocaine and I put some other kind of toxin in it, and it will give me maybe a longer high or a different kind of high, or it’ll be cheaper to produce that way.

QUESTION: And in order to know how – what – how it will be effective, they use it on people, so it’s like becoming like lab animals.

STATE DEPARTMENT OFFICIAL: Correct. Correct. And we have – we actually – the State Department has a project. It’s called a toxic adulterant project, which we’re working on to try to develop better lab test kits to be able to distribute to law enforcement worldwide, where it’ll test for a much bigger, wider number of toxins. A big thing we’re facing, a big part of the world drug problem that’s in synthetics is beyond opioids, is this thing called new psychoactive substances. And these are all the different kinds of chemicals that the drug dealers are synthesizing in order to differentiate their product, make it cheaper, all these different things.

We’ve identified about 700 – over 700 of these that are out there. The international control regime is only capable of scheduling or controlling about a dozen a year. That’s the capacity right now. So if you have 700 of them – and one recent study shows that they develop about one new substance a week – international – the international control regime is not – doesn’t have sufficient capacity to tackle this challenge. So one of the things that the State Department is looking into is what can we do to increase the capacity of the international scheduling regime. So the World Health Organization is the organization that runs this. It’s called the Expert Committee on Drug Dependence, is a subsidiary body of WHO that does this. And what can we do to increase their ability to schedule things faster, look at things faster?

Another idea that the United Kingdom has is how can we look at priority substances to do it, rather than first come first serve. What about looking at it perhaps with potency or potential for harm to sort of prioritize? So there’s a lot of innovation, I think, happening in this space right now. This is a new problem. It’s a problem that people are recognizing as a global problem and one that we’re more than committed in helping to address, not only for our own problem, not only for our own crisis, but to make sure that no other countries fall into the same kind of trap that we’re in.

QUESTION: Are you satisfied with the Chinese Government do, just the cooperation between the China and the United States in this field?

STATE DEPARTMENT OFFICIAL: Yes, I think we’re pleased with the cooperation we have with China in the counternarcotics field. I think we always – because the problem is ongoing, we’d like to continue to do more and to continue to build our relationship. We believe that the counternarcotics area is an area of positive cooperation between the United States and China. We think it’s important that it remain an area of positive cooperation, and we think that working together, we can do a lot not only for – bilaterally, but also globally, so it’s important that we keep doing it.

QUESTION: Yeah. Is there any system or – just working system with partners in China?

STATE DEPARTMENT OFFICIAL: We have a couple of dialogues with China. One is called the Joint Liaison Group. That is a group that was headed by our Department of Justice and I believe the Department of Homeland Security, and that’s been subsumed under a new ministerial group that was created between our two presidents. It’s called the Law Enforcement and Cyber Dialogue. So that’s going to become the premier working group, bilateral working that we’re going to work to counter narcotics issues together on.

QUESTION: What about the cooperation that you are participating with other countries in – all over the world? Is it like more law enforcement or politicians, or what kind of --

STATE DEPARTMENT OFFICIAL: Look, it varies. It varies.

QUESTION: Or health organizations or – I’m not sure.

STATE DEPARTMENT OFFICIAL: It’s all of the above. The – for example, the State Department engages heavily around the world in drug demand reduction. We believe that by – that – we set – what we’ve done is we’ve set up a network of about 100 countries that we work with in developing what we call the universal treatment and the universal prevention curriculum. We’ve distributed --

QUESTION: So this like a – like training program?

STATE DEPARTMENT OFFICIAL: It is the training program. It’s a training program designed specifically for people that actually are --

QUESTION: Working --

STATE DEPARTMENT OFFICIAL: -- work in the field in their countries. It’s a – we call it a universal curriculum because it’s applicable to humankind worldwide and can be adaptive based upon cultural norms or specific groups, like there’s modules for gender or for rural people or for different cultures. There’s about 30 different specializations. And we have developed it with international scientists over a number of years and have had very good results with it. So that’s one way we engage in the health sector. INL works in about – that’s where I work is International Narcotics and Law Enforcement Bureau within the State Department – we work worldwide with partners on a curriculum to improve judicial capacity, law enforcement capacity, different kind of technical setting programs.

QUESTION: So – to put laws or regulations for that?


QUESTION: The other question I was going to ask, I mean, you are focusing on opiates, and generally, the issue was discussed, especially on the level of State Department, others, was like, drug trafficking. What is the – how much is the – I mean, does – proportionally, how much is big and – I mean, comparative, like, what percentage of drug trafficking is opiates and what is --

STATE DEPARTMENT OFFICIAL: Well, because it’s smuggling, in terms of, like – if you talk about volume and/or weight of drugs smuggle, some --

QUESTION: But the others are no --

STATE DEPARTMENT OFFICIAL: It’s a bit hard to know because you don’t have – because it’s smuggled products, you don’t know for sure, right? The – what we do know is our overdose deaths, so we do know – so in terms of overdoses as a proxy for the problem, right? We know that opioids is about two-thirds of the deaths.

QUESTION: Okay. You – because of the victims, you call it?

STATE DEPARTMENT OFFICIAL: Because of the victims, yes.

QUESTION: Yeah, or whatever you call it.

STATE DEPARTMENT OFFICIAL: Yes, so we have the 54,000 victims, 42,000 were due to opioid-related deaths. Of those deaths, 20,000 were due to synthetic opioids and the rest was due to heroin or prescription.

QUESTION: This is in United States?

STATE DEPARTMENT OFFICIAL: This is in the United States only, yes.


STATE DEPARTMENT OFFICIAL: We have about 6,900, if I remember correctly, cocaine-related overdoses, and then the remainder would be other drugs including (inaudible).

QUESTION: And when you say this number, these are people – dead people, right?

STATE DEPARTMENT OFFICIAL: These are people that died, yes.



QUESTION: Who died, they are not – we cannot --

STATE DEPARTMENT OFFICIAL: Not an overdose but then were able to then survive, for example, yeah; they were hospitalized and survived or were resuscitated with naloxone or something like that.

QUESTION: Thank you.

STATE DEPARTMENT OFFICIAL: All right. Thanks so much. Appreciate you guys taking the time.

MODERATOR: Thanks for coming today.