Researchers from the Homeland Security Operational Analysis Center evaluated publicly available data to better understand consumption and supply of illegally imported synthetic opioids. In this report, they provide their findings and recommendations.

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.

Deaths involving synthetic opioids, such as fentanyl, increased from roughly 3,000 in 2013 to more than 30,000 in 2018. This book provides readers with insights intended to improve their understanding of the synthetic opioid problem.

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.

In 2020, areas of particular importance for technology trends will include biotechnology, nanotechnology, materials technology, and information technology. This report, the companion document to The Global Technology Revolution 2020, Executive Summary (Silberglitt et al., MG-475-NIC, 2006), assesses in detail a sample of 29 countries with respect to their ability to acquire and implement 16 key technology applications.