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                 FENTANYL AND


                 Overview                                       Figure 1. Field Division Reporting of Fentanyl

                                                                Availability in CY 2018 and Comparison
                 Fentanyl remains the primary driver behind     to CY 2017
                 the ongoing opioid crisis, with fentanyl involved
                 in more deaths than any other illicit drug.                            Availability   Compared to
                 Fentanyl and other synthetic opioids are widely     Field Division     CY 2018     CY 2017
                 available throughout the Great Lakes, Midwest,   Atlanta Field Division  High       More
                 and the Northeast areas of the United States.   Caribbean Field Division  Low       More
                 The two primary sources of the fentanyl are    Chicago Field Division    High       More
                 Mexico and China, where drug traffickers       Dallas Field Division   Moderate     More
                 produce fentanyl and other synthetic opioids in   Denver Field Division  Low        More
                 clandestine operations. Fentanyl is smuggled   Detroit Field Division    High       Stable
                 into the United States across the SWB as well   El Paso Field Division  Moderate    More
                                                                Houston Field Division
                 as through international mail and express      Los Angeles Field Division  High     More
                 consignment shipping services, primarily in    Louisville Field Division  High      Stable
                 powder and counterfeit pill form, indicating   Miami Field Division      High       More
                 clandestinely produced fentanyl as opposed to   New England Field Division  High    More
                 pharmaceutical fentanyl. Increases in fentanyl-  New Jersey Field Division  Moderate  More
                 containing counterfeit pills and related fentanyl   New Orleans Field Division  Stable  More
                                                                New York Field Division
                 pill pressing operations in addition to other novel   Omaha Field Division  Moderate  More
                 preparations demonstrate traffickers’ continued   Philadelphia Field Division  High  More
                 efforts to expand the fentanyl user base.      Phoenix Field Division    High       More
                                                                San Diego Field Division  High       More
                 Availability                                   San Francisco Field     Moderate     More
                 Fentanyl availability was high and increasing   Seattle Field Division   High       More
                 across the majority of the United States in    St. Louis Field Division   High      More
                 2018, highlighting the rapid spread of the drug.   Washington Field Division  High  More
                 For Calendar Year (CY) 2018, 15 of 23 Field      Source: DEA
                 Divisions (FDs) (see Appendix A: Figure A1)    available. This illustrates that, although fentanyl
                 (65 percent) indicated fentanyl availability was   is trafficked across the SWB and is commonly
                 “high” and 21 of 23 FDs (91 percent) indicated   seized in the Southwestern United States, the
                 fentanyl was “more” available compared to      Midwest, Great Lakes, and Northeast regions
                 2017 (see Figure 1). The Caribbean, Dallas,    maintain the greatest availabilities of fentanyl.
                 Denver, Houston, New Jersey, Omaha, and San    The total number of fentanyl reports submitted
                 Francisco FDs did not rank fentanyl as highly   to forensic laboratories continues to increase

                                                          UNCLASSIFIED                                     9

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