New Challenges Call For A New Response

The increasing numbers of individuals overdosing and dying from illegally manufactured synthetic opioids show no signs of abating. The problem that the United States faces is more complicated and complex than those it has in the past, and is evolving quickly. U.S. drug policy must recognize the urgency of this situation and respond to the new challenges it presents. Toward this end, the Commission's final report includes five pillars of recommended actions.

Five Pillars of a U.S. Response to Illegally Manufactured Synthetic Opioids (with a blue hexagon graphic)

Pillar 1: Policy coordination and implementation

  • 1.1. Increase coordination of U.S. authorities, fill critical appointments, and ensure proper levels of staffing.
  • 1.2. Assess and update U.S. legislative and regulatory drug control frameworks.

Pillar 2: Supply reduction

  • 2.1. Enhance interdiction capabilities, especially in the mail and express consignment systems that facilitate trafficking of synthetic opioids.
  • 2.2. Bolster capabilities and capacity of domestic law enforcement efforts to investigate illegal distribution of synthetic opioids.
  • 2.3. Work with private-sector stakeholders to implement systems to prevent drug traffickers from acquiring chemicals used illegally to manufacture synthetic opioids.
  • 2.4. Target distribution of synthetic opioids and related chemicals advertised online.
  • 2.5. With the help of private entities, reduce online advertising and sales.
  • 2.6. Intensify efforts to counter TCOs' money laundering.

Pillar 3: Demand reduction and public health

  • 3.1. Support evidence-informed efforts to reduce substance misuse and progression to substance-use disorder.
  • 3.2. Expand access to evidence-based treatment.
  • 3.3. Enhance evidence-informed harm-reduction efforts.
  • 3.4. Take efforts to promote recovery from substance-use disorder.

Pillar 4: International cooperation

  • 4.1. Strengthen coordination with multilateral institutions to promote enhanced control and reporting of drugs and other chemicals.
  • 4.2. Examine how the international drug control regime can be improved, expanded on, or otherwise supplemented.
  • 4.3. Enhance efforts to ensure a collaborative U.S.—Mexico security and drug partnership by enhancing Mexican counternarcotic capabilities, strengthening institutions against corruption, and focusing greater resources on the illegal firearm trade.
  • 4.4. Establish a U.S. policy framework to engage with the PRC to improve oversight and enforcement of its chemical and pharmaceutical industries.
  • 4.5. Press the PRC to adopt clear rules to improve regulatory oversight and enforcement of industries, control over movements of chemicals and related equipment, and other restrictions on exports.
  • 4.6. Expand engagement with other countries to facilitate information-sharing and promotion of best practices to reduce supply and demand of illegally manufactured synthetic opioids, especially in countries most likely to experience such problems in the near future.

Pillar 5: Research and monitoring

  • 5.1. Direct federal efforts to improve understanding of the illegal supply of synthetic opioids.
  • 5.2. Analyze emergent trends in drug markets and related behaviors through a systematic and standardized approach.
  • 5.3. Use novel, high-frequency, and real-time systems to enhance market surveillance.