Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
This report is one of several studies conducted by UNODC on organized crime threats around the world. These studies describe what is known about the mechanics of contraband trafficking - the what, who, how, and how much of illicit flows - and discuss their potential impact on governance and development. Their primary role is diagnostic, but they also explore the implications of these findings for policy. Publisher's note.
Opiates originating in Afghanistan threaten the health and well-being of people in many regions of the world. Their illicit trade also adversely impacts governance, security, stability and development in Afghanistan, in its neighbors, in the broader region and beyond. This report, the second such report of the United Nations Office on Drugs and Crime research project on the topic, covers worldwide flows of Afghan opiates, as well as trafficking in precursor chemicals used to turn opium into heroin. By providing a better understanding of the global impact of Afghan opiates, this report can help the international community identify vulnerabilities and possible countermeasures. This report presents data on the distribution of trafficking flows for Afghan opiates and their health impact throughout the world. A worrying development that requires international attention is the increasing use of Africa as a way station for Afghan heroin shipments to Europe, North America and Oceania. This is fuelling heroin consumption in Africa, a region generally ill-equipped to provide treatment to drug users and to fight off the corrupting effects of drug money. Another new trend is the growing use of sea and air transport to move Afghan heroin around the world, as well as to smuggle chemicals used in heroin production into Afghanistan. Traffickers in Afghan heroin have traditionally relied on overland routes, and law enforcement services will need to respond to this new threat. The findings of this report identify areas that need more attention. Strengthening border controls at the most vulnerable points, such as along Afghanistan's border with Pakistan's Baluchistan province, could help stem the largest flows of heroin, opium and precursor chemicals. Increasing the capacity to monitor and search shipping containers in airports, seaports and dry ports at key transit points and in destination countries could improve interdiction rates. Building capacity and fostering intelligence sharing between ports and law enforcement authorities in key countries and regions would help step up interdiction of both opiates and precursor chemicals. Addressing Afghan opium and insecurity will help the entire region, with ripple effects that spread much farther. Enhancing security, the rule of law and rural development are all necessary to achieve sustainable results in reducing poppy cultivation and poverty in Afghanistan. This will benefit the Afghan people, the wider region and the international community as a whole. But addressing the supply side and trafficking is not enough. We need a balanced approach that gives equal weight to counteracting demand for opiates.
This report offers one of the most comprehensive insights into global trends in international culture, production, seizure and price of illicit drugs. It examines trends in the world's four major markets: opium and heroin, coca and cocaine, cannabis, and amphetamine-type stimulants. This edition provides an in-depth examination of the link between transnational organized crime and drug trafficking. A detailed statistical appendix on production, prices and consumption completes this book, which gives the reader a comprehensive picture of the world's drug problem.
Methamphetamine (meth), a drug with limited medical use and high potential for abuse and addiction, is a subject of widespread concern. Once associated mainly with the West Coast and white, male, blue-collar workers, illicit meth is now used by diverse population groups nation-wide, with concentrations in the West, Southwest, and Midwest. Meth is supplied primarily by clandestine labs in California and Mexico. The drug is relatively simple to make from easily obtained recipes, but access to certain ingredients has become more difficult. Meth production in small, toxic labs (STLs) increased initially due to the successful closure of some "super-labs" (labs capable of making more than 10 pounds of meth in a 24-hour cycle), relative ease of making meth, continuing demand for the drug, and desire for potential wealth and involvement in a criminal underground social activity. Although the greater fraction of meth used and distributed across the nation comes from super-labs, the sheer number of STLs, their geographic diffusion, and their residual impacts have prompted concern across a wide spectrum of the country.
Gangs continue to commit criminal activity, recruit new members in urban, suburban, and rural regions across the United States, and develop criminal associations that expand their influence over criminal enterprises, particularly street-level drug sales. The most notable trends for 2011 have been the overall increase in gang membership, and the expansion of criminal street gangs' control of street-level drug sales and collaboration with rival gangs and other criminal organizations.
