2019 National Opioid and Emerging Drug Threats Policy and Practice Forum

Dr. Muhlhausen's remarks at the 2019 National Opioid and Emerging Drug Threats Policy and Practice Forum, which built off the momentum of the widespread stakeholder meetings convened to discuss the consequences of this national epidemic, including the impact it has had on public safety, public health, and the criminal justice response.

Good morning!

Thank you all for coming here so early, and in many cases, from so far, to hear about NIJ's research and programs to combat opioids, as well as NIJ's strategies to tackle any new drug threats that may emerge.

And welcome to those of you who are participating virtually, through the online forum portal.

NIJ's mission is to develop, sponsor, and support research to provide objective, evidence-based knowledge and tools to meet the challenges of the opioid crisis.

The overwhelming scale of this epidemic is known to all of you.

The CDC recently estimated that 72,000 drug overdose deaths occurred in 2017. That's about 19 people dying every day. Nearly 16,000 of those deaths involved heroin. Far more — over 29,000 deaths — involved synthetic opioids such as fentanyl and fentanyl analogs. (Learn more from CDC.gov.)

In addition to the misuse of prescription drugs, many of these deaths can be attributed to illicit production overseas.

The speed with which opioids are synthesized and shipped into the United States is virtually unprecedented in drug trafficking.

For example, according to a 2018 GAO report thousands of pharmaceutical and chemical companies and labs operate, both legally and illegally, in China. Many of them are suspected of producing illicit drugs destined for the United States.

About 155,000 packages arrive per night from China at the JFK Airport in New York.

And that's just New York. Similar numbers pour into mail facilities in Los Angeles and Chicago.

Of course, only a fraction of these packages contain illicit drugs. But the sheer volume makes it daunting for authorities to fully screen the flood of packages.

Furthermore, the ability to make slight changes to the chemical structure of these drugs makes the detection and identification of illicit drugs extremely challenging.

The financial incentive for drug dealers is clear. According to the DEA, dealers could buy a kilogram of illicit fentanyl for a few thousand dollars from a Chinese supplier.

Using pill presses, they can create counterfeit prescription pills and collect up to $20 million dollars in revenue.

The impact of the proliferation of fentanyl, fentanyl analogs, and other emerging drugs continues to be a crisis that we must face head on.

NIJ is ready and able to confront this crisis, as we have met other crises over the past 50 years.

Our drugs and crime research is dedicated to reducing crime and the traumas, effects, and pathologies of crime. To fight heroin and other opioids, we focus on five areas:

First, epidemiology. We search for patterns among drugs and emerging drugs, and drug-related crimes. These patterns help us to diagnose the extent of the epidemic, to inform communities, law enforcement, and service providers.

Second, prevention and intervention. We sponsor, support, fund and develop policies and programs to prevent or reduce drug-related crime and violence.

Third, drug markets. NIJ-supported research found that state laws worked to reduce the number of so-called "pill mills" –the clinics that prescribe large amounts of opioid drugs. State and local laws are indeed effective in reducing the number of these clinics.

Through interviews with law enforcement officers, NIJ researchers learned about the complexities involved in building a case against a pill mill.

NIJ has also supported those collecting data on the diversion of legally prescribed drugs for non-medical uses. This data is made available to help inform courts, corrections, and service providers.

Fourth, market disruption. Our researchers analyze and support law enforcement at every level to disrupt or deter opioid markets in their communities.

NIJ funds research to study Darknet websites and cryptocurrencies, and to develop tools that leverage artificial intelligence. This enables narcotics officers to target their investigations and build solid cases for successful prosecutions.

Fifth and finally, forensic science. It has never been more important to recognize drugs, and detect and identify newly emerging drugs. Forensic sciences support drug chemistry and toxicology forensic examinations.

Providing the tools and resources to our nation's medical examiner and coroner offices to support drug death investigations is a critical component to understand the scope and prevalence of this crisis, and to ring the alarm bells to alert our country to future drug threats.

For these reasons, this Policy and Practice Forum is heavily focused on strengthening our nation's forensic response to inform the critical work of both public safety and public health communities.

NIJ has made great strides to address the effect that the opioid crisis has had on our forensic laboratories as well as on our medical examiner and coroner offices.

NIJ's Paul Coverdell Forensic Science Improvement Grants Program provided over $27 million dollars in 2018 to improve the quality and timeliness of forensic science, and to improve the medical examiner and coroner's office services at the state and local levels.

This program has been administered by NIJ since 2002. Last year, NIJ made funds available specifically to target the challenges the opioid abuse crisis presents to the forensic science community.

And in 2017, NIJ established the "Strengthening the Medical Examiner-Coroner System Program." In the first 2 years of this program, NIJ awarded almost $5 million to provide resources necessary for medical examiner and coroner offices to achieve accreditation and to support forensic pathology fellowships. (View lists of awards from 2017 and 2018.)

Later this fall, NIJ looks forward to announcing the 2019 awards for these and other programs that address the opioid crisis.

Among the other studies we are spearheading right now is the Department's "Needs Assessment of Forensic Laboratories." This includes the needs of Medical Examiner and Coroner Offices. This study should be completed in the next few months. The published report will be provided to Congress, and made available to the public.

In this report, the Department of Justice, NIJ and our many critical partners examine the needs of those forensic science service providers who work on the front lines of drug detection and identification.

The needs assessment will provide an in-depth look at the workload, backlog, personnel and equipment requirements for the disciplines practiced by public crime laboratories and medical examiner and coroner offices — and will provide an overview of the academic forensic science resources and needs from a broad forensic science perspective.

Together with the Department, we held a series of listening sessions with stakeholders. We dedicated discussions on the impact and approaches to address the opioid epidemic effectively.

One thing that stood out is that the needs that were identified will require systems-based approaches to enhance forensic laboratory efficiencies and increase capacities – through coordination and collaboration among forensic laboratories, medical examiner and coroner offices, law enforcement, legal professionals, and other stakeholders, from the crime scene to the court room.

As with this Needs Assessment, this week's Forum will also identify systems-based approaches, to address the impact of the opioid crisis on forensic services, including the rising caseloads, analytical challenges, workforce safety and resiliency, and information sharing needs.

This Forum will provide the opportunity to share promising practices that result in operational solutions to strengthen the support of the forensic workforce and infrastructure.

Among the most significant and, we hope, long-lasting developments that have sprung from these NIJ initiatives are the working groups made up of state and local forensic science practitioners, supported by researchers, to advance coordination and collaboration across the country.

We at NIJ are proud to partner with the Forensic Technology Center of Excellence, known as FTCoE, which is a NIJ program managed as a cooperative agreement with RTI International, to form the Forensic Laboratory Needs – Technology Working Group. This group supports NIJ's mission to improve knowledge and understanding of the forensic technology needs of federal, state, local, and tribal forensic practitioners and crime laboratories.

In forming this working group, the Department and NIJ relied on feedback from forensic science stakeholders to ensure state, local, and tribal forensic needs would be considered.

Just last year, the Office of Justice Programs, of which NIJ is a part, formed a federal working group with the Department of Health and Human Services dedicated to Medico-legal Death Investigations. One product of this working group is a resources web site that serves as a centralized location to find information on federal programs, resources, and funding opportunities related to the work performed by our country's medical examiner and coroner offices predominantly at the state and local levels. We hope to update it soon, with current 2019 program information.

The development and coordination for this two-day Opioid and Emerging Drug Threats Policy and Practice Forum is due in large part to the work of the Forensic Technology Center of Excellence. The FTCOE has developed several products that are available to the forensic community, such as reports, best practices, webinars, podcasts and workshop series.

For example, the FTCOE hosted a 13-part webinar series, launched in 2017, that brought a multifaceted perspective focused on how criminal justice disciplines are addressing these challenges, sharing their knowledge, and advancing the field.

This was followed by a workshop series on Best Practices Guidance for Advancing Research Initiatives and Combatting the Synthetic Drug Epidemic. This series included methods to identify novel psycho-active substances, or NPS, in forensic casework. The workshops examined practical considerations and analytical approaches, as well as interpretation guidance for the toxicology of NPS. All of their impressive resources are available free online to you, at Forensiccoe.org.

Before we begin, I'd like to acknowledge Dr. Jeri Ropero-Miller from RTI, who led the FTCOE development for this Forum.

Jeri worked in collaboration with Dr. Jonathan McGrath from NIJ's Office of Investigative and Forensic Sciences, who serves as the NIJ senior policy analyst for the forensic sciences.

I welcome steering committee members who worked to assemble this Forum, particularly the state and local researchers and practitioners, as well as our federal partners from agencies with an impressive array of acronyms: the BJA, the DEA, the CDC, the CBP, and ONDCP.

A special shout out to Tara Kunkel from the Bureau of Justice Assistance, who manages the BJA Comprehensive Opioid Abuse Program. Tara and BJA have been tremendous partners in supporting several initiatives with a forensic nexus.

Special thanks as well to the Center for Disease Control and Prevention for their masterful coordination with NIJ, the Office of Justice Programs, and Health and Human Services, to establish the Medico-Legal Death Investigation Federal Interagency Working group last year.

This group is chaired both by our NIJ Deputy Director, Howard Spivak, and by CDC's Chris Jones, the Senior Advisor and Director of Strategy and Innovation at the CDC National Center for Injury Prevention and Control.

With so many fine minds, in this room and around the country, I know we will conquer this epidemic, as we have conquered so many challenges in the past.

And now it is my distinct privilege to introduce Katharine Sullivan, who is Principal Deputy Assistant Attorney General for the Office of Justice Programs.

Katie Sullivan is the new head of the Justice Department's Office of Justice Programs, which houses my office.

Katie spent the early part of her career as a local prosecutor, and she served 11 years as a state trial court judge in Eagle County, Colorado, where she heard more than 45,000 cases. During her days on the bench, she started a drug court and a DUI court, and she saw scores of clients, very few of whom returned to jail or prison for any significant period.

She joined the Department of Justice in 2017, first as Acting Director of the Office on Violence Against Women, and now as the Principal Deputy Assistant Attorney General for the Office of Justice Programs. Katie has the full confidence of Attorney General Bill Barr, who is committed to solving this national crisis. She knows the criminal justice system well and she understands the serious threat that opioids and illicit drugs pose to public safety.

I'm very glad she could join us today. Please join me in welcoming Principal Deputy Assistant Attorney General Katie Sullivan.