    [Joint House and Senate Hearing, 116 Congress]
    [From the U.S. Government Publishing Office]

              HOMELAND SECURITY IMPLICATIONS OF THE OPIOID CRISIS

    =======================================================================

                                 JOINT HEARING

                                  BEFORE THE

               SUBCOMMITTEE ON INTELLIGENCE AND COUNTERTERRORISM

                                    AND THE

                        SUBCOMMITTEE ON BORDER SECURITY,
                         FACILITATION, AND OPERATIONS,
                            HOUSE OF REPRESENTATIVES

                         ONE HUNDRED SIXTEENTH CONGRESS

                                 FIRST SESSION

                                   __________

                                 JULY 25, 2019

                                   __________

                               Serial No. 116-34

                                   __________

           Printed for the use of the Committee on Homeland Security

    [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

           Available via the World Wide Web: http://www.govinfo.gov/

                                   __________

                        U.S. GOVERNMENT PUBLISHING OFFICE
    39-417 PDF                  WASHINGTON : 2020

    --------------------------------------------------------------------------------------

                         COMMITTEE ON HOMELAND SECURITY

                   Bennie G. Thompson, Mississippi, Chairman
    Sheila Jackson Lee, Texas            Mike Rogers, Alabama
    James R. Langevin, Rhode Island      Peter T. King, New York
    Cedric L. Richmond, Louisiana        Michael T. McCaul, Texas
    Donald M. Payne, Jr., New Jersey     John Katko, New York
    Kathleen M. Rice, New York           John Ratcliffe, Texas
    J. Luis Correa, California           Mark Walker, North Carolina
    Xochitl Torres Small, New Mexico     Clay Higgins, Louisiana
    Max Rose, New York                   Debbie Lesko, Arizona
    Lauren Underwood, Illinois           Mark Green, Tennessee
    Elissa Slotkin, Michigan             Van Taylor, Texas
    Emanuel Cleaver, Missouri            John Joyce, Pennsylvania
    Al Green, Texas                      Dan Crenshaw, Texas
    Yvette D. Clarke, New York           Michael Guest, Mississippi
    Dina Titus, Nevada
    Bonnie Watson Coleman, New Jersey
    Nanette Diaz Barragan, California
    Val Butler Demings, Florida
                           Hope Goins, Staff Director
                     Chris Vieson, Minority Staff Director

                                    ------

               SUBCOMMITTEE ON INTELLIGENCE AND COUNTERTERRORISM

                          Max Rose, New York, Chairman
    Sheila Jackson Lee, Texas            Mark Walker, North Carolina,
    James R. Langevin, Rhode Island          Ranking Member
    Elissa Slotkin, Michigan             Peter T. King, New York
    Bennie G. Thompson, Mississippi (ex  Mark Green, Tennessee
        officio)                         Mike Rogers, Alabama (ex officio)
                      Vacancy, Subcommittee Staff Director
               Mandy Bowers, Minority Subcommittee Staff Director
                                     ------

         SUBCOMMITTEE ON BORDER SECURITY, FACILITATION, AND OPERATIONS

                     Kathleen M. Rice, New York, Chairwoman
    Donald M. Payne, Jr., New Jersey     Clay Higgins, Louisiana, Ranking
    J. Luis Correa, California               Member
    Xochitl Torres Small, New Mexico     Debbie Lesko, Arizona
    Al Green, Texas                      John Joyce, Pennsylvania
    Yvette D. Clarke, New York           Michael Guest, Mississippi
    Bennie G. Thompson, Mississippi (ex  Mike Rogers, Alabama (ex officio)
        officio)
                 Alexandra Carnes, Subcommittee Staff Director
              Emily Trapani, Minority Subcommittee Staff Director

                               C O N T E N T S

                                  ----------
                                                                       Page

                                   Statements

    The Honorable Max Rose, a Representative in Congress From the
      State of New York, and Chairman, Subcommittee on Intelligence
      and Counterterrorism:
      Oral Statement.................................................     1
      Prepared Statement.............................................     2
    The Honorable Mark Walker, a Representative in Congress From the
      State of North Carolina, and Ranking Member, Subcommittee on
      Intelligence and Counterterrorism:
      Oral Statement.................................................     3
      Prepared Statement.............................................     4
    The Honorable Kathleen M. Rice, a Representative in Congress From
      the State of New York, and Chairwoman, Subcommittee on Border
      Security, Facilitation, and Operations:
      Oral Statement.................................................     5
      Prepared Statement.............................................     7
    The Honorable Clay Higgins, a Representative in Congress From the
      State of Louisiana, and Ranking Member, Subcommittee on Border
      Security, Facilitation, and Operations:
      Oral Statement.................................................     7
      Prepared Statement.............................................     9

                                   Witnesses

    Ms. Sondra Mc Cauley, Assistant Inspector General for Audits,
      U.S. Department of Homeland Security:
      Oral Statement.................................................    10
      Prepared Statement.............................................    12
    Ms. Bridget G. Brennan, Special Narcotics Prosecutor for the City
      of New York:
      Oral Statement.................................................    18
      Prepared Statement.............................................    20
    Mr. Bryce Pardo, Ph.D., Associate Policy Researcher, Rand
      Corporation:
      Oral Statement.................................................    41
      Prepared Statement.............................................    44
    Mr. James Edward Hinson, Jr., Deputy Chief, Investigative Bureau
      Commander, Greensboro Police Department:
      Oral Statement.................................................    53
      Prepared Statement.............................................    55

                                    Appendix

    Questions From Chairman Thompson for Sondra McCauley.............    79
    Question From Chairman Thompson for Bridget G. Brennan...........    79
    Questions From Chairman Bennie G. Thompson for Bryce Pardo.......    79

              HOMELAND SECURITY IMPLICATIONS OF THE OPIOID CRISIS

                                  ----------

                            Thursday, July 25, 2019

                 U.S. House of Representatives,
    Subcommittee on Intelligence and Counterterrorism,
                                                and the
                              Subcommittee on Border Security,
                                  Facilitation, and Operations,
                                Committee on Homeland Security,
                                                        Washington, DC.
        The subcommittees met, pursuant to notice, at 10:06 a.m.,
    in room 310, Cannon House Office Building, Hon. Max Rose
    [Chairman of the Subcommittee on Intelligence and
    Counterterrorism] presiding.
        Present from the Subcommittee on Intelligence and
    Counterterrorism: Representatives Rose, Langevin, Slotkin,
    Walker, and Green.
        Present from the Subcommittee on Border Security,
    Facilitation, and Operations: Representatives Rice, Payne,
    Correa, Torres Small, Clarke, Higgins, and Guest.
        Also present: Representatives Underwood and Trone.
        Mr. Rose. OK. The Subcommittee on Intelligence and
    Counterterrorism and the Subcommittee on Border Security,
    Facilitation, and Operations will come to order.
        Today, the subcommittees I just mentioned are meeting to
    examine homeland security implications of America's
    unprecedented opioid epidemic.
        We look forward to the witnesses discussing the flow of
    illicit fentanyl into the United States, including China and
    Mexico's role; the role of the Department of Homeland Security
    and its partners in combating that flow; and how to best
    mitigate this threat.
        I think we would all agree, at this point, that this is a
    quintessentially nonpartisan issue of public health and
    National security of critical, critical importance. I certainly
    see in my own district where we have young people dying every
    week, growing rates, from fentanyl-laced heroin. I have spoken
    to too many mothers and fathers who have had to bury their
    child.
        Now, it is our responsibility to do everything we can to
    save lives. I believe that is our greatest responsibility here
    in these hallowed halls.
        Yes, we are seeing progress. For perspective, in New York
    City, the Centers for Disease Control indicates that in a 12-
    year span, from 2000 to 2012, fentanyl was identified in 2
    percent of all drug overdose deaths. Sadly, by 2016, that
    number had risen to 44 percent.
        What is critical, as we look at this on a high level, is we
    have to make sure that we are not just fighting the last war.
    So much of our focus here in Congress when it comes to the
    opioid epidemic is on prescription pills. That focus is
    justified, but as we see more and more fentanyl in our streets
    and it being harder and harder to get pills, more people will
    be moving to fentanyl-laced products.
        We have to get to the source of this. That source, as I
    said, is clearly China and then Mexico thereafter.
        As we consider this, though, it is critical to make two
    last points. The first is that it is critical that we use all
    the tools at our disposal: Intelligence gathering but also the
    operations centered around CBP at our ports of entry as well as
    our major airports.
        But we do all this with the understanding that no one here
    is seeking to criminalize this public health crisis. We are not
    seeking to make the same mistakes that we did a generation ago.
    But we do understand that law enforcement plays a critical role
    that cannot be ignored. This is, as I said, a critical homeland
    security issue.
        I am concerned, though, that we have not been taking this
    seriously enough. A recent DHS Office of Inspector General
    report from last September indicates DHS's Customs and Border
    Protection's mail inspection process needs improvement at JFK
    International Airport. Dealers on the dark web are already
    taking advantage of security gaps highlighted in this OIG
    report, and they are doing it flagrantly with a wanton
    disregard for our law enforcement officials, so much so that
    they even offer free return service if the first order doesn't
    work out.
        Equally concerning is last week's management alert
    indicating CBP did not adequately protect employees from
    possible fentanyl exposure. Accidental inhalation or physical
    contact with fentanyl is deadly.
        Folks, we have to fix this. We have to continue to be
    better here. I think we all have to come to the understanding
    that this fight is not going away. So one central question I
    will have today is, how do we build inflexibility into our
    systems? How do we continue to look down the road and adapt to
    future ways in which these horrific organizations, these
    transnational criminal organizations, these pharmaceutical
    companies overseas continue to think of new and innovate ways
    to kill our kids?
        [The statement of Chairman Rose follows:]
                         Statement of Chairman Max Rose
                                 July 25, 2019
        Today, the Subcommittee on Intelligence and Counterterrorism, and
    the Subcommittee on Border Security, Facilitation, and Operations are
    meeting to examine the homeland security implications of America's
    unprecedented opioid epidemic. We look forward to the witnesses
    discussing the flow of illicit fentanyl into the United States,
    including China and Mexico's role; the role of the Department of
    Homeland Security and its partners in combating that flow, and how to
    best mitigate this threat. I believe we can all agree that we have an
    opioid crisis in our country. Nothing about this is partisan and I know
    we can come together, Democrats and Republicans, to fight fentanyl and
    end this epidemic. While news that drug overdose deaths are on the
    decline is welcoming, the overall rate of overdose deaths linked to
    fentanyl continues to rise.
        My district has been one of the epicenters of the epidemic. I've
    spoken to too many mothers and fathers who have had to bury their
    child. So, are we seeing progress? Yes, but nowhere near enough. For
    perspective, New York City, the Center for Disease Control indicates
    that in a 12-year span, from 2000 to 2012, fentanyl was identified in 2
    percent of all drug overdose deaths. Sadly, by 2016, that number rose
    to 44 percent. And by 2017, 57 percent of all deaths that resulted from
    drug overdose had fentanyl involved. Nearly 1,500 lives gone. From 2
    percent of overdose deaths to over half of all overdose deaths in just
    5 years--that is shocking. Much of the fentanyl seized in New York City
    is produced by Mexican cartels, which acquire chemical precursors from
    China, the world's largest producer of illicit fentanyl. New York City
    is not an outlier here. Fentanyl and its analogues are devastating
    communities throughout this country.
        Just last year, 48,000 overdose deaths involved an opioid, and
    nearly 32,000 of which involved fentanyl or a similar drug. Most of
    that illicit fentanyl from China arrives via cargo ship and
    international mail. Illicit fentanyl seized from international mail
    facilities in the United States coming from China is over 90 percent
    pure. For perspective on the lethality of illicit fentanyl, it is 80 to
    100 times stronger than morphine and 30 to 50 times more potent than
    heroin. All it takes is 2 milligrams to kill most people. That's about
    the equivalent of a single grain of rice. And once exposed, it could
    kill in minutes. And that is just fentanyl, there are other forms of
    the drug that are far more deadly. Congress has been working hard to
    address this crisis. Earlier this year I introduced legislation, The
    Fentanyl Sanctions Act, that will impose sanctions on manufacturers who
    provide fentanyl to traffickers. And it gives more tools and resources
    to law enforcement go after illicit fentanyl traffickers in China,
    Mexico, and other countries. This bill passed with bipartisan support
    in the House of Representatives and the Senate. And I look forward to
    the President signing it into law soon.
        The days when a country could pump our streets full of illicit
    drugs and chemicals and face no consequences are over. I'm also proud
    to be co-leading the Joint Task Force to Combat Opioid Trafficking Act
    with my good friend Congressman Jim Langevin. This bipartisan bill will
    establish a Joint Task Force at the Department of Homeland Security to
    stop the inflow of fentanyl and other illicit opioids into the United
    States. This critical bill also encourages the Department of Homeland
    Security to be innovative and think outside the box to fight drug
    trafficking--including by looking at new ways to take advantage of
    public-private partnerships when carrying out this mission. Officials
    at the local, State, and Federal levels have also been working hard to
    address this crisis, and I applaud them for their efforts.
        In March of this year, the Drug Enforcement Administration and
    local law enforcement disrupted a fentanyl mill in Westchester, New
    York, seizing 5 kilograms of fentanyl, or enough to kill nearly 2
    million people. However, I am concerned about a recent DHS Office of
    Inspector General report from last September which indicates DHS's
    Custom and Border Protection's mail inspection process needs
    improvement at JFK International Airport in New York City. With much of
    the illicit fentanyl arriving via international mail from China, this
    is concerning. Already, dealers on the dark web take advantage of the
    existing security gaps highlighted in the OIG report. They guarantee
    delivery of their illicit fentanyl and even offer replacing orders that
    do not arrive. Equally concerning is last week's Management Alert
    indicating CBP did not adequately protect employees from possible
    fentanyl exposure. Accidental inhalation or physical contact of
    fentanyl is deadly. We need to protect those tasked to protect America
    and ensure CBP has the adequate equipment, training, and policies to
    ensure a safe work environment.

        Mr. Rose. With that, I thank the witnesses and Members for
    being here, and I now recognize the Ranking Member of the
    subcommittee, Mr. Walker, for an opening statement.
        Mr. Walker. I want to thank Chairman Rose and Chairwoman
    Rice and Ranking Member Higgins for holding this important
    joint hearing on the opioid crisis, which knows, as we all
    understand, no social status and has no party affiliation.
        I look forward to hearing from our distinguished panel
    today on the ways we can assist in their on-going efforts in
    combating this ever-present crisis.
        Today, we hope to gain insight in how the Department of
    Homeland Security is supporting our State and local agencies
    who are working on the front lines to identify and treat the
    on-going opioid crisis.
        Back in 2017, I went on a 2-day, 7-stop opioid crisis tour
    across North Carolina to try and grasp or better understand the
    full scope of what we were seeing as the, and rightly named,
    opioid epidemic. I received a first-hand account of the
    realities, the burdens, and struggles my fellow North
    Carolinians face every day. As a former minister, I can tell
    you first-hand accounts, being at the hospital and other
    places, and seeing the detriment that it has created for so
    many families.
        In my Congressional district, deaths related to fentanyl
    increased 195 percent in just 1 year alone, between 2016 and
    2017, real numbers that went from 64 fatalities to 189
    fatalities. Across North Carolina, it is rare for a day to go
    by without the news of an arrest for an opioid distribution,
    reports of overdose deaths, or first responders providing life-
    saving critical aid.
        I want to highlight the work at the Guilford County--that
    is our home county there in North Carolina--Emergency Services,
    specifically led by Director Jim Albright. They have partnered
    with a number of State and local agencies to develop the
    Guilford County Solution to the Opioid Problem.
        GCSTOP works to provide rapid response services to
    individuals who have overdosed or are at risk of overdosing.
    From March 2018 to April 2019, 13 months, GCSTOP administered
    1,661 doses of naloxone, performed 447 rescues from overdose,
    and provided treatment to 157 patients. I am greatly encouraged
    by this effort and am interested to hear from the witnesses
    today if they have recommendations on how to duplicate programs
    like GCSTOP across the country.
        I want to especially thank Deputy Chief James Hinson of the
    Greensboro, North Carolina, Police Department for testifying
    today. Your testimony will offer us an on-the-ground
    perspective on what local police are dealing with every day
    related to opioids.
        The successes that Chief Wayne Scott, my friend, and Deputy
    Chief Hinson and all of the Greensboro Police Department have
    accomplished has really been nothing short of incredible.
        I have enjoyed working with you in the past, and I am proud
    the committee will be able to hear your first-hand account on
    what you and the Department have done to help our home State.
        Today's hearing is an opportunity to better understand the
    threat facing law enforcement and communities across the United
    States. As legislators, we must continue to work in a
    bipartisan fashion to address the opioid crisis. I look forward
    to the panel's insight as to what is working well and
    recommendations for what could be done better.
        I want to thank all the witnesses for appearing here today,
    and I yield back the balance of my time.
        [The statement of Ranking Member Walker follows:]
                    Statement of Ranking Member Mark Walker
        I want to thank Chairman Rose, Chairwoman Rice, and Ranking Member
    Higgins, for holding this important joint hearing on the opioid crisis,
    which knows no social status and has no party affiliation. I look
    forward to hearing from our distinguished panel on ways we can assist
    in their on-going efforts in combating this crisis.
        Today, we hope to gain insight in how the Department of Homeland
    Security is supporting our State and local agencies who are working on
    the front lines to identify and treat the on-going opioid crisis.
        Back in 2017, I went on a 2-day, 7-stop opioid crisis tour across
    North Carolina to better understand the full scope of the opioid
    epidemic. I received a first-hand account of the realities, burdens,
    and struggles my fellow North Carolinians face every day. In my
    Congressional District, deaths related to fentanyl increased 195
    percent between 2016 and 2017 from 64 fatalities to 189 fatalities.
    Across North Carolina, it is rare for a day to go by without news of an
    arrest for opioid distribution, reports of overdose deaths, or first
    responders providing critical life-saving aid.
        I want to highlight the work at the Guilford County Emergency
    Services led by Director Jim Albright. They have partnered with a
    number of State and local agencies to develop the Guilford County
    Solutions To the Opioid Problem (GCSTOP). GCSTOP works to provide rapid
    response services to individuals who have overdosed or at risk of
    overdosing. From March 2018 to April 2019, CGSTOP administered 1,661
    doses of Naloxone, performed 447 rescues from overdoses and provided
    treatment to 157 patients. I am greatly encouraged by this effort and
    am interested to hear from the witnesses today if they have
    recommendations on how to duplicate programs like GCSTOP across the
    country.
        I want to especially thank Deputy Chief James Hinson of the
    Greensboro North Carolina Police Department for testifying today. Your
    testimony will offer us an on-the-ground perspective on what local
    police are dealing with every day related to opioids. The successes
    that Chief Wayne Scott, Deputy Chief Hinson, and all of the Greensboro
    Police Department have accomplished has been nothing short of
    incredible. I have enjoyed working with you in the past and I am proud
    the committee will be able to hear your first-hand account on what has
    been done to help our home State.
        Today's hearing is an opportunity to better understand the threat
    facing law enforcement and communities across the United States. As
    legislators, we must continue to work in a bipartisan fashion to
    address the opioid crisis. I look forward to the panel's insight as to
    what is working well and recommendations for what work could be done
    better.
        I want to thank all the witnesses for appearing here today and I
    yield back the balance of my time.

        Mr. Rose. Thank you, Ranking Member.
        I now recognize the Chairwoman of the Border Security,
    Facilitation, and Operations Subcommittee, Miss Rice, for an
    opening statement.
        Miss Rice. Thank you, Mr. Chairman.
        Good morning. As Chairman Rose has said, today, our
    subcommittees are examining the challenges we face in
    addressing one of the most severe health crises in our Nation's
    history.
        Last year alone, more than 48,000 people in the United
    States died as a result of an opioid overdose, with fentanyl
    and other synthetic opioids claiming the vast majority of the
    victims, nearly 40,000 in total.
        These numbers emphasize a critical fact: We are currently
    in a new phase, a third wave, of the devastating opioid crisis,
    one characterized by dangerous and deadly synthetic opioids
    known as fentanyl analogues. Today, we are here to learn what
    innovative solutions can be used to address this crisis.
        The third wave of the opioid crisis is distinct from
    earlier phases of the epidemic, which were characterized by
    prescription drug abuse and a surge in heroin addiction that
    overwhelmed public health officials. As destructive as the
    earlier stages were, the challenges we are now facing are far
    greater and more vexing than ever, and they demand an
    aggressive, bipartisan solution.
        As we all know, the prescription opioids that began this
    epidemic were produced and, for a time, obtained legally. The
    heroin epidemic that followed was primarily imported into the
    United States along traditional narcotics routes. However,
    traffickers in fentanyl and other synthetics are exploiting an
    entirely different model. Based on recent data, the majority of
    synthetic opioids originate in labs in China and often enter
    our country through the U.S. postal system.
        Furthermore, these substances can be ordered through dark-
    web e-commerce sites and arrive at mailing facilities in small,
    untraceable quantities. Because synthetics are difficult to
    detect using existing technology, it is extraordinarily hard to
    stop their distribution once they reach our mail facilities.
        It has become frustratingly apparent that we cannot tackle
    this problem using existing technology and law enforcement
    strategies. Effective solutions must be bold and innovative.
    First, we need to eliminate manufacturing centers for synthetic
    opioids, and, second, we need to prevent their movement through
    the international mail system.
        While successfully achieving these goals will take broad
    collaboration across government agencies, this committee has
    already taken a significant and, I am happy to say, a
    bipartisan step forward.
        Last week, we passed out of committee the Joint Task Force
    to Combat Opioid Trafficking Act, sponsored by Mr. Langevin.
    This vital piece of legislation was passed by bipartisan
    consensus in the 115th Congress before stalling in the Senate.
    It is essential that we now support its passage on the House
    floor and work with our colleagues in the Senate to ensure that
    it passes there as well.
        This important bill authorizes collaboration with the
    private sector on this challenge, allowing the new DHS joint
    task force to work with the private companies whose activities
    are being exploited by traffickers. Improved screening
    procedures, greater targeting of suspicious senders, and better
    information-sharing processes can all help our law enforcement
    agencies in interdicting fentanyl analogues before they reach
    our borders.
        Although our priority must be stopping synthetic opioids,
    we must also ensure the safety of DHS law enforcement
    personnel. A recent management alert issued by the DHS
    inspector general identified significant failures on the part
    of CBP to protect its front-line personnel tasked with handling
    and storing seized fentanyl and fentanyl analogues.
    Specifically, numerous CBP facilities failed to keep naloxone,
    an effective antidote to fentanyl, readily available in storage
    vaults and other locations where agents interact with fentanyl.
        DHS must have efficient methods for protecting its
    personnel from accidental contact with fentanyl, and Congress
    must conduct sufficient oversight to ensure that these
    protective steps are being taken at all facilities.
        With the goals in mind, I welcome the witnesses who have
    joined us here today. You all are experts in the field of
    narcotics interdiction and law enforcement, and I look forward
    to hearing your testimony.
        Thank you, Mr. Chairman.
        [The statement of Miss Rice follows:]
                     Statement of Chairwoman Kathleen Rice
                                 July 25, 2019
        Today our subcommittees are examining the challenges we face in
    addressing one of the most severe health crises in our Nation's
    history. Last year alone, more than 48,000 people in the United States
    died as a result of an opioid overdose, with fentanyl and other
    synthetic opioids claiming the vast majority of the victims . . .
    nearly 40,000 in total. These numbers emphasize a critical fact: We are
    currently in a new phase--a third wave--of the devastating opioid
    crisis, one characterized by dangerous and deadly synthetic opioids,
    known as fentanyl analogues.
        Today, we are here to learn what innovative solutions can be used
    to address this crisis. The third wave of the opioids crisis is
    distinct from earlier phases of the epidemic, which were characterized
    by prescription drug abuse and a surge in heroin addiction that
    overwhelmed public health officials. As destructive as the earlier
    stages were, the challenges we are now facing are far greater and more
    vexing than ever. And they demand an aggressive bipartisan solution. As
    we all know, the prescription opioids that began this epidemic were
    produced and, for a time, obtained legally. And the heroin epidemic
    that followed was primarily imported into United States along
    traditional narcotics routes.
        However, traffickers in fentanyl and other synthetics are
    exploiting an entirely different model. Based on recent data, the
    majority of synthetic opioids originate in labs in China and often
    enter our country through the U.S. postal system. Furthermore, these
    substances can be ordered through dark web e-commerce sites and arrive
    at mailing facilities in small, untraceable quantities. Because
    synthetics are difficult to detect using existing technology, it is
    extraordinarily hard to stop their distribution once they reach our
    mail facilities. It has become frustratingly apparent that we cannot
    tackle his problem using existing technology and law enforcement
    strategies. Effective solutions must be bold and innovative. First, we
    need to eliminate manufacturing centers for synthetic opioids and
    second, we need to prevent their movement through the international
    mail system.
        While successfully achieving these goals will take broad
    collaboration across Government agencies, this committee has already
    taken a significant--and I am happy to say a bipartisan--step forward.
    Last week we passed out of committee the Joint Task Force to Combat
    Opioid Trafficking Act, sponsored by Mr. Langevin. This vital piece of
    legislation was passed by bipartisan consensus in the 115th Congress,
    before stalling in the Senate. It is essential that we now support its
    passage on the House floor and work with our colleagues in the Senate
    to ensure that it passes there as well. This important bill authorizes
    collaboration with the private sector on this challenge, allowing the
    new DHS Joint Task Force to work with the private companies whose
    activities are being exploited by traffickers. Improved screening
    procedures, greater targeting of suspicious senders, and better
    information-sharing processes can all help our law enforcement agencies
    in interdicting fentanyl analogues before they reach our borders.
        Although our priority must be stopping synthetic opioids, we must
    also ensure the safety of DHS law enforcement personnel. A recent
    management alert issued by the DHS inspector general identified
    significant failures on the part of CBP to protect its front-line
    personnel tasked with handling and storing seized fentanyl and fentanyl
    analogues. Specifically, numerous CBP facilities failed to keep
    Naloxone, an effective antidote to fentanyl, readily available in
    storage vaults and other locations where agents interact with fentanyl.
    DHS must have efficient methods for protecting its personnel from
    accidental contact with fentanyl and Congress must conduct sufficient
    oversight to ensure that these protective steps are being taken at all
    facilities. With these goals in mind, I welcome the witnesses who have
    joined us here today. You all are experts in the fields of narcotics
    interdiction and law enforcement and I look forward to hearing your
    testimony.

        Mr. Rose. Thank you, Madam Chairwoman.
        I now recognize the Ranking Member of the subcommittee, Mr.
    Higgins, for an opening statement.
        Mr. Higgins. Thank you, Mr. Chairman. I thank you, Chairman
    Rose and Chairwoman Rice, for calling this hearing today.
        The opioid crisis is a symptom of a cultural crisis in our
    country. We have created--we have allowed to manifest a culture
    of dependency in America.
        I grew up on a horse ranch, raised and trained horses, and
    injuries were common. My father was a hard and tough man, born
    in 1922 in the era after World War I. We had a suture kit on
    the horse ranch. When the horses got cut sometimes, we would
    sew them up.
        We used that kit on ourselves too. I remember my father
    sewing up his left hand one time and remarking to me--I was
    helping him--he was glad he got his left hand busted because he
    didn't think he could do the suturing with his left hand if he
    had busted his right hand.
        We have moved from an America that was made up of very
    hard, tough men and women to a country that is addicted to
    painkillers. It is an incredible transformation from the
    America that we once knew.
        Fentanyl, 2017, 28,000 deaths, because Americans are
    addicted to opioids. More than 130 Americans die every day
    after overdosing on opioids. In my home State of Louisiana, 400
    lives were lost last year alone.
        Addiction doesn't always start with substance abuse. Many
    Americans become hooked after receiving a prescription for
    temporary pain relief. This requires a deep look in the mirror
    for all America.
        Once a prescription expires, some turn to the streets.
    Others become addicted and even overdose when illegal drugs
    they buy on the street are, unbeknownst to them, laced with
    fentanyl, an opioid maybe 100 times stronger than morphine. I
    have never seen anything like it.
        The pandemic has also affected innocent newborn children. A
    study published in the Journal of Addiction Medicine shows a
    500 percent increase in the number of children that are
    addicted to opioids at birth in the United States. Our young
    ones in the womb are being born addicted at an alarming rate
    because of this culture of dependency and weakness we have
    allowed to manifest in our country.
        We need to get these drugs off the street. They are coming
    from China and Mexico; we know it. This is why it was
    courageous for Chairman Rose and Chairwoman Rice to combine
    these subcommittee endeavors to look at this thing hard. Today,
    we have the opportunity to hear more about the impact of
    opioids on our communities and the gaps in our enforcement
    capability.
        Fentanyl and other synthetic opioids are being produced
    mostly, as we said, in China and in Mexico. Most opioids enter
    the United States through the mail or concealed within vehicles
    or cargo coming through ports of entry. We have 328 ports of
    entry in America; we have to get traffic through there. These
    drugs are also coming across in backpacks on the backs of
    illegal immigrants, cartel drug runners crossing between ports
    of entry.
        The fast movement of commerce that powers our economy
    through the ports of entry require Customs and Border
    Protection to X-ray just a fraction. They utilize canine drug-
    sniffing dogs for just a portion of the mail and packages, the
    vehicles and trucks that enter our international mail
    facilities and cross the border every day.
        To combat this, we have to enhance security capabilities at
    our international mail facilities and our ports of entry. We
    must increase the detection capabilities of law enforcement on
    every level. Action to address this crisis will require
    Federal, State, local, and Tribal governments to work together.
        Finally, we have to hit the cartels. If you are listening,
    cartels, and I am sure you are, you have very expensive
    attorneys, American-educated attorneys. We are paying attention
    to what you are doing in our country, and we are going to hit
    back.
        Further resources need to be dedicated to our law
    enforcement agencies that investigate money laundering, bulk
    cash smuggling, and other methods that are used by drug cartels
    to conceal cash. American cash-flowing south; fentanyl death
    flowing north. We are going to stand together and fight this.
        I look forward to your testimony. I thank you for being
    here. I again thank the Chairwoman and Chairman for holding
    this hearing today.
        [The statement of Ranking Member Higgins follows:]
                    Statement of Ranking Member Clay Higgins
        Thank you Chairman Rose and Chairwoman Rice for calling this
    hearing today.
        More than 130 Americans die every day after overdosing on opioids.
    In my home State of Louisiana 400 lives were lost just last year alone.
        Addiction does not always start with illicit substance abuse, many
    Americans become hooked after receiving a prescription for temporary
    pain relief. Once their prescription expires, some turn to the streets.
    Others become addicted and even overdose when illegal drugs they buy on
    the street are, unbeknownst to them, laced with fentanyl, an opioid
    about 100 times stronger than morphine.
        The pandemic has also affected innocent newborn children. A study
    published in the Journal of Addiction Medicine shows more than a 500
    percent increase in the number of children that are addicted to opioids
    at birth in the United States. This equates to an addicted child born
    every 15 minutes.
        We need to get these drugs off the street and find
    Constitutionally-sound legal ways to lower prescription practices.
    Today we have the opportunity to hear more about the impact of opioids
    on our communities and the gaps in our enforcement capability.
        Synthetic opioids such as fentanyl are being produced illegally in
    large quantities, mostly in China, but also increasingly in Mexico.
    Most opioids enter the United States through the mail, concealed within
    vehicles or cargo coming through the ports of entry, and in backpacks
    of cartel drug runners.
        To ensure the speedy movement of commerce that powers our economy,
    Customs and Border Protection can only X-ray or utilize drug-sniffing
    dogs for a fraction of the mail, packages, vehicles, and trucks that
    enter our international mail facilities and cross the border every day.
        To combat this, we must enhance security capabilities at our
    international mail facilities, ports of entry, and along the border.
        In addition, we must increase the detection capabilities of law
    enforcement, on every level. Action to address this crisis will require
    Federal, State, local, and Tribal governments to work together.
        Finally, we must hit the cartels. Further resources need to be
    dedicated to our law enforcement agencies that investigate money
    laundering, bulk cash smuggling, and other methods that are used by
    drug cartels to conceal cash.
        I look forward to the testimony from our witnesses today, thank you
    for being here, and I yield back.

        Mr. Rose. Thank you, Ranking Member Higgins. I definitely
    do support this idea that this is something we can work
    together on. There are lives on the line.
        Before we continue, I do ask unanimous consent that the
    gentleman from Maryland, Mr. Trone, be permitted to sit and
    question the witnesses at today's joint subcommittee hearing.
        Without objection, so ordered.
        Other Members of the committee are reminded that, under the
    committee rules, opening statements may be submitted for the
    record.
        I welcome our panel of witnesses here today.
        Our first witness is Ms. Sondra McCauley, assistant
    inspector general for Audits, U.S. Department of Homeland
    Security. Ms. McCauley has been an auditor since 1985 and is an
    experienced inspector general with a demonstrated history of
    serving in the government administration industry.
        Next we are joined by Ms. Bridget Brennan, special
    narcotics prosecutor for the city of New York, the best city in
    America. Ms. Brennan is the first woman to hold this position
    and has been serving in the Office of the Special Narcotics
    Prosecutor since 1992. Her office plays an important role in
    developing innovative strategies to stem the flow of drugs into
    New York City.
        Next we have Dr. Bryce Pardo, associate policy researcher,
    RAND Corporation. Dr. Pardo has over 10 years of experience
    working with National, State, and local governments in crime
    and drug policy. Prior to RAND Corporation, he served as a
    legislative and policy analyst at the Inter-American Drug Abuse
    Control Commission within the Organization of American States.
        Last we have James Edward Hinson, Jr., deputy chief,
    Greensboro Police Department. Deputy Chief Hinson has been a
    part of the Greensboro Police Department since 1991. He
    previously served as commander of Eastern Division and
    executive officer of the Special Operations Division in
    District 1 and 3.
        Without objection, the witnesses' full statements will be
    inserted in the record. I now ask each witness to summarize his
    or her statement for 5 minutes, beginning with Ms. McCauley.

    STATEMENT OF SONDRA MC CAULEY, ASSISTANT INSPECTOR GENERAL FOR
              AUDITS, U.S. DEPARTMENT OF HOMELAND SECURITY

        Ms. McCauley. Chairman Rose, Chairwoman Rice, Ranking
    Members Walker and Higgins, and members of the subcommittees,
    thank you for inviting me to discuss CBP's challenges in
    interdicting illegal drugs at our Nation's ports of entry.
        Opioids such as fentanyl are a huge problem. In 2016, more
    people in the U.S. died from opioids than from traffic
    accidents.
        Airports are a major entry point for illegal drugs. In
    September 2018, we reported on CBP mail inspections at JFK
    Airport, the largest of nine international mail facilities
    Nation-wide. JFK processes over half of the hundreds of
    millions of pieces of mail arriving annually. CBP makes
    subjective and risk-based determinations on what to inspect. It
    also uses a decision support tool, the Automated Targeting
    System, known as ATS, to identify mail posing a high risk of
    containing contraband.
        We identified several deficiencies in the mail inspection
    processes we examined at JFK.
        First, CBP did not inspect all inbound international mail.
    It had inadequate canine teams trained to detect narcotics,
    outdated X-ray devices to examine mail, and outdated guidance
    that did not address inspections for fentanyl.
        Second, given the large volume, CBP did not inventory all
    mail selected for inspection. As a result, CBP could not ensure
    the Postal Service provided all mail required and also could
    not ensure that all mail selected was actually inspected.
        Third, the ATS pilot for targeting high-risk mail had
    limited impact. Not all foreign post offices provided data on
    inbound mail for input to ATS. Though ATS was intended to help
    identify high-risk mail, CBP used ATS to target only 0.01
    percent of the mail at JFK each day. Even at this low
    percentage, Postal Service could not locate and hand over to
    CBP all requested mail. Postal Service staff had to search
    through large bags for the targeted items.
        Fourth, CBP's chemical analysis process was problematic.
    Officers had to open and insert a handheld device into each
    suspicious package to read the chemical makeup. If the reading
    indicated a prohibited item, officers took a second digital
    reading and sent it to the labs for diagnosis. CBP could only
    send the labs what lab staff could turn around in 24 hours.
        Fifth, CBP officers did not track or physically safeguard
    suspicious packages. Officers placed them on carts that were
    relocated to a secure room. After extracting small test
    samples, the packages remained open, in piles with other
    packages, and were not placed in evidence bags until test
    results were received. Officers also did not always input
    required data into test case files.
        Last, suspicious packages were not secured from loss or
    damage. JFK lacked physical barriers to separate Postal Service
    and CBP operations. Cleared mail and suspicious mail remained
    in open carts side-by-side in the same area.
        CBP concurred with all 9 of our report recommendations and
    agreed to take correction actions. Eight of our 9
    recommendations remain open.
        Last week, we issued a management alert to notify CBP of
    the urgent need to protect its employees from the dangers of
    fentanyl. Seven vaults for storing seized assets that we visit
    lacked ways to protect CBP staff from opioid exposure.
        Even in small quantities, opioids can cause death by
    slowing and eventually stopping a person's breathing. When
    available, the drug naloxone can be administered to treat
    opioid overdose and prevent brain injury or death. However, 2
    of the 7 vaults contained fentanyl but did not also have
    naloxone available. The other 5 vaults had it in lockboxes with
    codes.
        One of the 2 vaults with naloxone held the largest seizure
    of fentanyl in CBP history, as well as the lockbox code taped
    to the wall. Staff could not remember the code for the other
    vault.
        These issues occurred because of outdated CBP policy that
    lacked standard practices for handling fentanyl. While CBP
    personnel usually take some precautions, training is not
    required. CBP is now taking corrective action to address these
    issues.
        Finally, we now have several related audits on-going to
    determine whether DHS effectively transports, stores, and
    destroys seized illicit drugs; examine CBP's use of drug
    interdiction technology at ports of entry; and follow up on
    physical security and mail inspection processes at JFK.
        Mr. Chairman and Ms. Chairman, this concludes my testimony.
    I look forward to further discussing these issues with you and
    other Members of the subcommittees.
        [The prepared statement of Ms. McCauley follows:]
                     Prepared Statement of Sondra McCauley
                                 July 25, 2019
        Chairman Rose, Chairwoman Rice, Ranking Members Walker and Higgins,
    and Members of the subcommittees, thank you for inviting me to testify
    today about fentanyl and the challenges the U.S. Customs and Border
    Protection (CBP) faces in its efforts to interdict this dangerous
    substance at our Nation's ports of entry and multiple mail facilities.
        Imports of opioids such as fentanyl are a tremendous problem in the
    United States. In 2016, more people died from opioid-related causes
    than traffic accidents.

                           OPIOID DEATHS BY COMPARISON

    ------------------------------------------------------------------------
                                                                    Traffic
                           Year                          Opioids   Accidents
    ------------------------------------------------------------------------
    2015..............................................     33,000     35,485
    2016..............................................     42,249     37,461
    ------------------------------------------------------------------------
    Source: Office of Inspector General (OIG)-developed, based on web-based
      information from the Centers for Disease Control, White House, and
      National Highway Traffic Safety Administration.

        These illegal drugs have a devastating impact on the Nation's
    population, tearing apart families and communities. Therefore, the
    White House has declared the opioid epidemic a Nation-wide public
    health emergency that requires the mobilization of Government, local
    community, and private organizations.
        Given CBP's front-line responsibility to secure the Nation's
    borders from imports of illegal drugs and contraband, the component
    plays a major role in helping to end the opioid crisis. Recognizing
    that airports are a major entry point for illegal drug imports,
    Congress has held multiple hearings on the threats inherent in arriving
    international air mail. At a May 2017 hearing, CBP's Executive
    Assistant Commissioner for the Office of Operations Support stated:

    ``The majority of U.S. trafficked illicit fentanyl is produced in other
    countries such as China, and is principally smuggled through
    international mail facilities, express consignment carrier facilities
    (e.g., FedEx and UPS), or through POEs [ports of entry] along the
    Southern land border.''

        Today my testimony will focus on the results of 2 audits recently
    conducted by the Department of Homeland Security Office of Inspector
    General (OIG). In September 2018, we reported that CBP had ineffective
    processes and IT security controls to support air mail inspection
    operations at John F. Kennedy International Airport (JFK).\1\
    Additionally, as a result of an on-going audit of CBP's storage of
    seized drugs, last week we issued a management alert detailing CBP's
    inadequate protection of its staff from powerful synthetic opioids.\2\
    The results of both reports are discussed further in my testimony.
    ---------------------------------------------------------------------------
        \1\ CBP's International Mail Inspection Processes Need Improvement
    at JFK International Airport (Redacted), OIG-18-83 (September 2018).
        \2\ Management Alert--CBP Did Not Adequately Protect Employees from
    Possible Fentanyl Exposure, OIG-19-53.
    ---------------------------------------------------------------------------
       cbp's international air mail inspection is not effective to stop
                 illegal drugs from entering the united states
        With limited exceptions, all inbound international air mail is
    subject to CBP inspection.\3\ The Transportation Security
    Administration requires that foreign airports and air carriers
    initially screen international cargo headed to the United States. Then,
    when a flight lands, ground handlers at the airport provide all mail to
    the United States via the United States Postal Service (USPS), which
    transports the mail through a CBP radiation scanning portal for
    preliminary examination. CBP officials make subjective as well as risk-
    based determinations as to what portion of the mail to select for
    further inspection. For example, CBP officials at JFK use knowledge
    gained from past experience to identify arriving international mail
    that may contain illegal or prohibited items. When, upon CBP
    examination, a mail article is found to contain prohibited material,
    the article is subject to seizure and forfeiture.
    ---------------------------------------------------------------------------
        \3\ CBP does not inspect mail believed to contain only documents
    for U.S. Government officials or mail addressed to Ambassadors of
    foreign countries.

    [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

        Our audit focused on CBP's air mail inspection processes at the
    John F. Kennedy International Airport (JFK) airport. The USPS
    International Service Center at JFK is the largest of 9 USPS facilities
    Nation-wide that receive and process incoming international mail. In
    fiscal year 2016, USPS recorded an inbound international mail volume at
    JFK that constituted more than half of the hundreds of millions of
    pieces of international mail arriving annually at all international
    mail facilities. Given its inability to inspect the total volume of
    international mail arriving at the airport daily, CBP requires by
    memorandum of understanding that USPS provide for inspection specific
    subsets of the international mail that arrives daily at JFK.\4\
    ---------------------------------------------------------------------------
        \4\ ``Memorandum of Understanding Between the U.S. Department of
    Homeland Security, U.S. Customs and Border Protection and the U.S.
    Postal Service Regarding Cooperation in the Inspection of Goods
    Imported or Exported Through the Post,'' September 1, 2017.
    ---------------------------------------------------------------------------
        CBP officials treat the various categories of international mail
    (First Class, Registered Mail, Express Mail, and Priority Parcel)
    differently based on their experience and perceptions of potential
    risk. Additionally, beginning in July 2014, CBP piloted, to a limited
    extent, the use of the Automated Targeting System (ATS) to help
    identify mail at JFK that may pose a high risk of containing narcotics
    or other contraband. ATS is a decision support tool that compares
    traveler, cargo, and conveyance information against law enforcement,
    intelligence, and other enforcement data using risk-based scenarios and
    assessments.
        Of the mail selected for inspection, CBP screens and physically
    examines packages deemed to be high-risk. If a problem is found, mail
    is held for secondary inspection (i.e., manual inspection and chemical
    analysis, as appropriate). During secondary inspection, CBP determines
    whether the package should be seized or returned to USPS for
    processing. If illegal drugs or contraband are discovered, CBP must
    maintain documentation pertaining to the mail seizure and preserve the
    integrity of the item to the extent possible.
          deficiencies in cbp's international mail inspection process
        We identified a number of deficiencies in CBP's inspection
    processes at JFK that inhibit CBP's ability to prevent illegal drugs
    and contraband from entering the country, including: (1) CBP does not
    inspect all international mail selected for inspection; (2) CBP does
    not inventory all mail selected for inspection; (3) the ATS pilot for
    targeting mail has limited impact; and, (4) CBP's chemical analysis
    process for detecting illegal opioids in arriving air mail is
    problematic.
    1. CBP Does Not Inspect All International Mail
        CBP does not inspect all international mail selected for inspection
    for a number of reasons. For example, CBP did not have an adequate
    number of canine teams trained to detect narcotics. Further, CBP's
    inspection of international mail was limited because CBP staff did not
    have the equipment needed to inspect the hundreds of thousands of
    pieces of international air mail that arrive at JFK each day. CBP has
    limited, outdated X-ray devices at JFK that officers use daily to
    examine only a portion of the incoming mail, one piece at a time.
    According to the memorandum of agreement with USPS, CBP requests that
    USPS provide mail packages based, for example, on knowledge and
    experience regarding whether that the country is a primary source of
    illegal drug smuggling to the United States.
        Moreover, CBP staff told us that certain items arriving from China
    may be considered high-risk. Despite the large volume and high-risk
    nature, CBP largely overlooks these items because of a lack of
    guidance. Although the nature of international mail has changed
    significantly, CBP has not updated its International Mail Operations
    and Enforcement Handbook since August 2001. CBP also has not updated
    the guidance to identify new illegal substances such as fentanyl
    arriving in international mail.
    2. CBP Does Not Inventory Mail Selected for Inspection
        CBP does not keep record of mail selected for inspection, asserting
    that the large volume of daily arriving air mail and the labor-
    intensive process of examining selected mail piece-by-piece do not lend
    themselves to inventory. Without an inventory, CBP could not ensure
    that USPS provided all the mail it requested for inspection purposes.
    We determined that USPS scans and inventories all mail it provides to
    and receives from CBP. However, CBP has no agreement with USPS to
    leverage this inventory to keep an account of the mail it selects for
    inspection. CBP's International Mail Operations and Enforcement
    Handbook also does not require staff to maintain an inventory of the
    mail they X-ray.
        CBP also lacks a process to substantiate that all mail selected for
    inspection is actually inspected. Without an inventory process, CBP has
    no means of ensuring it inspects all the high-risk mail it selects for
    examination and therefore might be allowing prohibited items to be
    delivered undetected. CBP officials asserted they inspected all
    international air mail that they requested of USPS; however, CBP had no
    means of proving this assertion.
    3. ATS Pilot Had Limited Impact on the Inspection Process
        The ATS pilot for targeting mail has had limited impact due to
    USPS's difficulty in locating the mail targeted for inspection. ATS is
    intended to help CBP identify mail that might pose a high risk of
    containing narcotics or other contraband, but CBP used this system to
    target only 0.01 percent of the packages arriving each day at JFK. This
    was based on an agreement between USPS and CBP as to what USPS could
    reasonably provide to CBP on a daily basis. Even with targeting set at
    this low percentage, USPS is not able to physically locate and hand
    over all requested items to CBP. Searching through hundreds of
    thousands of pieces of mail each day to identify the targeted ones is a
    huge, labor-intensive process. Instead, if the targeted mail is in a
    large bag, USPS will provide the entire bag to CBP. CBP officers must
    then search through the bag to locate the targeted item, in addition to
    carrying out their routine inspection responsibilities.
        The limited targeting is also due to a lack of advance data on
    inbound mail for input to ATS to support the mail targeting process.
    Specifically, the data CBP uses for targeting comes from foreign post
    offices that provide the data to USPS in advance of the mail being
    transported. Not all foreign post offices provide sufficient data for
    use in ATS for targeting purposes. Further, the USPS does not have
    agreements with all foreign post offices (e.g., China) to provide this
    data in advance.
    4. CBP's Chemical Analysis Process Is Problematic
        CBP's chemical analysis process for detecting illegal opioids in
    arriving suspicious air mail is problematic because of inadequate
    equipment and processes and potential hazards to workers. This process
    entails CBP officers opening the mail and inserting a hand-held device
    in a suspicious package to get a preliminary reading of the chemical
    makeup of the contents. If the reading indicates a potential prohibited
    item, the officers take a small sample and use a separate chemical
    analysis device to get a second digital reading of the chemical
    composition of the sample. Officers then forward the digital reading to
    CBP's Laboratories and Scientific Services Directorate for additional
    remote diagnostics. If the results conclusively indicate a prohibited
    item, CBP officers seize the item and prevent its import to the United
    States.
      cbp enforcement blitz has helped determine extent of air mail drug
                               smuggling problem
        CBP managers may conduct enforcement ``blitzes''--periodic, short-
    term offensive operations--to determine the risks inherent in specific
    classes or subsets of arriving international mail. CBP managers
    determine the selection criteria for such blitzes. The blitzes can help
    validate existing presumptions regarding mail provided by USPS and
    identify additional areas to focus enforcement or revenue activities.
        In January 2017, CBP conducted a 5-day blitz, Operation Mail Flex,
    to verify that USPS was being used to mail opioids to the United
    States. For this operation, CBP targeted a specific subset of arriving
    mail: Express mail from China and Hong Kong. From Operation Mail Flex,
    CBP estimated the number of pieces of express mail that arrived at JFK
    from just those 2 countries. CBP randomly examined pieces of the mail
    and seized 43 percent of the express mail packages included in its
    review. The seized packages included fentanyl shipments that
    collectively totaled 5.31 pounds. We can conclude that if CBP had
    examined the remaining universe of mail, it might have discovered and
    seized a higher number of packages possibly containing additional
    pounds of fentanyl.
        Although the results of Operation Mail Flex have largely been
    helpful in estimating the extent of illegal imports in express mail
    from China and Hong Kong, they have been inadequate in identifying
    other threats. To more fully understand the extent of the problem, CBP
    would need to regularly perform and document blitz operations on
    additional mail. CBP would then be better able to prioritize and apply
    its limited resources toward inspecting the types of international mail
    that likely contain the highest number of illegal opioids.
        To address these deficiencies, we recommended that:
       The Executive Assistant Commissioners for Field Operations
            and Operations Support conduct an analysis to determine the
            additional staff, canines, X-ray scanning machines, and hand-
            held chemical analysis devices needed to adequately address the
            threat from opioids arriving daily in the large volume of
            international mail.
       The Executive Assistant Commissioners for Field Operations
            and Operations Support assign and dedicate canine teams as
            appropriate to detect opioids at the international mail
            facility on a daily basis.
       The Assistant Commissioner for the Office of Information and
            Technology (OIT) and the Executive Assistant Commissioners for
            Field Operations and Operations Support jointly document
            arriving international air mail received from USPS, scanned by
            CBP, and returned to USPS.
       The Executive Assistant Commissioners for Field Operations
            and Operations Support update CBP's International Mail
            Operations and Enforcement Handbook to reflect all types of
            arriving international mail.
       The Executive Assistant Commissioners for Field Operations
            and Operations Support perform and document periodic ``Mail
            Flex'' operations, including use of canine teams, to better
            determine the size and scope of the threat inherent in specific
            classes of mail and from specific countries.
        CBP concurred with these recommendations and planned to take a
    number of steps to address these issues. For example, CBP planned to
    conduct a cost-benefit analysis to determine the staff levels, canine
    teams, and technology needed to address the threat of illicit opioids
    in international mail at the JFK International Mail Facility (IMF). CBP
    also replaced all X-ray machines as of November 2017. CBP also planned
    to revise the International Mail Operations and Enforcement Handbook to
    reflect the current operational conditions in relation to arriving
    international mail.
       international air mail suspected of containing contraband is not
                      inventoried or physically controlled
        Despite mail handling requirements, CBP officers responsible for
    inspecting arriving international air mail identify, but do not track
    or physically safeguard, packages suspected of containing contraband.
    CBP provides overarching guidance for its airmail inspection processes
    \5\ and standards that CBP personnel must follow when initiating and
    handling seized mail.\6\ According to CBP's International Mail
    Operations and Enforcement Handbook, and Seized Asset Management and
    Enforcement Procedures Handbook, mail items should be secured, any
    suspicious substance must be positively identified, and the substance
    must be extracted from its conveyance, weighed or counted, and placed
    in a seizure bag. Also, according to CBP's Seized Asset Management and
    Enforcement Procedures Handbook timely input of data into CBP's Seized
    Assets and Case Management System (SEACATS) is critical.
    ---------------------------------------------------------------------------
        \5\ International Mail Operations and Enforcement Handbook, and
    Seized Asset Management and Enforcement Procedures Handbook.
        \6\ U.S. Customs and Border Protection, Office of Field Operations,
    Fines, Penalties & Forfeitures Division, Seized Asset Management and
    Enforcement Procedures Handbook, U.S. CBP, HB 4400-01B, July 2011.
    ---------------------------------------------------------------------------
        However, CBP does not track a suspicious package until several days
    after the package is initially held for further review. Specifically,
    upon identifying a suspicious package, CBP officers place it on a cart
    that is subsequently relocated to a secure room. Officers take a small
    sample of the contents of the package, place it in a Fourier-Transform
    Infrared and Raman device for analysis, and submit the resulting report
    to CBP's lab for verification of the chemical contents. Given lab
    staffing constraints, at the time of our audit, CBP officers could only
    send a limited number of samples a day for chemical verification--the
    amount that available lab officials could typically turn around in a
    24-hour period.
        Not until the CBP lab provides positive confirmation of prohibited
    chemical contents is the suspicious package considered to warrant
    formal mail seizure. CBP officers still have additional time to input
    data on the seized asset into SEACATS. With this data input, the
    officers can begin to track the item.
        CBP officials do not physically control all mail suspected, but not
    yet confirmed, of containing contraband. During the entire process
    leading up to asset seizure and SEACATS data input, the suspicious
    package is not physically secured. The package remains open, stowed on
    a cart amid piles of other packages. The open mail package also is not
    placed in an evidence bag to secure the contents prior to formal
    seizure.
        Further, during the process leading up to asset seizure and SEACATS
    data input, the suspicious package is not secured from potential loss
    or damage to its contents. The physical layout of the JFK IMF inhibits
    CBP's ability to demonstrate that an identifiable person always has
    physical custody of suspicious mail. Specifically, the JFK IMF is a
    large, old, shared facility that has not been retrofitted with physical
    barriers to compartmentalize USPS and CBP operations. Similarly, there
    are no physical control points to separate international mail
    ``cleared'' by CBP for delivery from ``suspect mail'' held for
    secondary inspection. The mail that USPS initially provides for
    inspection, as well as mail that CBP clears and returns to USPS, is
    stored in open carts at the JFK IMF side-by-side in the same area.
        Due to outdated equipment, CBP officials do not always include
    required documentation in the SEACATS case files on seized assets. The
    International Mail Operations and Enforcement Handbook requires X-rays
    of seized packages, which are needed to document the contents of the
    unopened package. However, according to the officers, outdated X-ray
    machines were in use at the time of our July 2017 site visit.
        To address these deficiencies, we recommended that:
       The Assistant Commissioner for the OIT and the Executive
            Assistant Commissioners for Field Operations and Operations
            Support jointly establish adequate internal control processes,
            including maintaining inventories and physically securing
            suspicious mail that may be seized following additional review.
       The Executive Assistant Commissioners for Field Operations
            and Operations Support jointly update the Seized Asset
            Management and Enforcement Procedure Handbook and the
            International Mail Operations and Enforcement Handbook to
            outline all of the precautions necessary to safeguard
            suspicious mail prior to formal seizure.
        CBP concurred with these recommendations and planned to take a
    number of steps to address these issues. For example, CBP planned to
    develop an automated technical solution to maintain an accurate
    inventory of segregated international mail items that are subject for
    further scrutiny but not yet seized. CBP also planned to revise the
    International Mail Operations and Enforcement Handbook and the Seized
    Asset Management and Enforcement Procedure Handbook.
        CBP has already taken action to close 1 of the total 9
    recommendations in our report. We are in the process of reviewing the
    actions CBP has taken to implement the other 8 recommendations.
       cbp lacks necessary precautions to protect its staff from fentanyl
        Last week, we issued a management alert notifying CBP about an
    issue requiring immediate attention. During an on-going audit of CBP's
    storage of seized drugs we visited 7 permanent vaults and determined
    that the component does not adequately protect its staff from the
    dangers of accidental exposure to powerful synthetic opioids,\7\ such
    as fentanyl, because CBP has not always made available naloxone, a
    medication for treating narcotic overdose. OFO officials could not
    explain why OFO does not by policy require naloxone to treat staff in
    case of potentially lethal exposure. Officials also could not explain
    why they sometimes stored naloxone in lock-boxes at vaults, which are
    secure facilities.
    ---------------------------------------------------------------------------
        \7\ Examples of opioids include heroin, morphine, oxycodone, and
    fentanyl.
    ---------------------------------------------------------------------------
        Specifically, 7 permanent vaults we visited during fieldwork were
    missing the necessary precautions to protect CBP staff (i.e., Office of
    Field Operations (OFO) Seized Property Specialists) from opioids such
    as fentanyl. Two of the vaults did not have naloxone. The other 5
    vaults contained naloxone, but 2 of the 5 had the medication locked in
    boxes with codes. One of the 2 vaults with naloxone in a lock-box also
    contained the largest recent seizure of fentanyl in CBP history. At
    that vault, staff had taped a piece of paper bearing the code to this
    vault on the wall next to the lock-box. However, when asked to open the
    lock-box at the other vault, staff could not do so because they could
    not remember the code. If actually exposed to fentanyl, a person could
    die without prompt access to naloxone.
        This lack of access to naloxone occurred because CBP does not have
    an official policy with required standard practices for handling
    fentanyl and safeguarding personnel against exposure. Although SPS's
    use CBP's Seized Asset Management and Enforcement Procedures Handbook
    to guide daily vault operations, the handbook was last updated in July
    2011 and it does not include specific procedures for managing fentanyl.
    OFO also does not require mandatory training for its staff who
    typically come into contact with fentanyl so they understand the
    hazards and the methods to combat accidental exposure. OFO personnel
    typically take some precautionary measures when seizing suspected
    fentanyl, such as wearing personal protective equipment; not disturbing
    packaging and sending fentanyl to a laboratory for testing; and double
    bagging, sealing, and clearly labeling seized property. However,
    lacking updated guidance and training, some CBP offices have
    established their own practices for handling fentanyl.
        As of April 2019, CBP had stored about 3,500 pounds of fentanyl--up
    from 70 pounds in 2015, and OFO may store fentanyl in its permanent
    vaults for up to 60 days and, in cases of prosecution, for years.
    Without easy access to naloxone in case of exposure, CBP is
    unnecessarily jeopardizing the lives, health, and safety of its staff.
    CBP's lack of guidance and training on safely handling fentanyl further
    increases the risk of injury or death to its employees.
        We recommended that CBP include guidance in its handbook for
    handling and storing opioids, which at a minimum should include a
    requirement to make naloxone available to all employees and training in
    administering naloxone. CBP concurred with our recommendation and
    issued a memo on June 24, 2019, directing that all OFO permanent vaults
    be equipped with naloxone nasal spray kits and lock boxes and that
    SPS's be trained on the proper usage of the spray, an understanding of
    fentanyl, and methods to combat accidental exposure. We consider these
    actions responsive to the recommendation and will close the
    recommendation after CBP confirms distribution of materials to all 62
    vaults, confirms personnel have received training, includes training at
    the Federal Law Enforcement Training Centers as part of the seized
    property basic course, and updates guidance in its handbook.
       on-going oig work related to interdiction of dangerous substances
        The OIG has a number of on-going audits related to the Department's
    ability to interdict dangerous substances, like fentanyl. We will be
    reporting on these issues later this year. These audits include:
       An on-going audit to determine whether DHS effectively
            transports, stores, and destroys seized illicit drugs.
       Two audits covering the Department's drug interdiction
            technology. In the first audit, we are assessing to what extent
            CBP's Office of Field Operations uses small-scale chemical
            screening devices at ports of entry to identify fentanyl and
            other illicit narcotics. In the second audit, we will determine
            to what extent the Department ensures components are
            coordinating the procurement and use of small-scale drug
            interdiction technology.
       Our office is also conducting a follow-up audit of CBP's
            physical security and international mail inspection processes
            at JFK to determine whether CBP air mail inspection processes
            at JFK are adequate and to identify impediments to effective
            screening, tracking, and safeguarding of incoming mail.
        Mr. Chairman and Ms. Chairwoman, this concludes my testimony. I am
    happy to answer any questions you or other Members of the subcommittees
    may have.

        Mr. Rose. Thank you for your testimony, Ms. McCauley.
        Before we continue, I do ask unanimous consent that the
    gentlelady from Illinois, Ms. Underwood, a Member of the
    committee, be permitted to sit and question the witnesses at
    today's joint subcommittee hearing.
        Without objection, so ordered.
        I now recognize Ms. Brennan to summarize her statement for
    5 minutes.
        Thank you again.

     STATEMENT OF BRIDGET G. BRENNAN, SPECIAL NARCOTICS PROSECUTOR
                        FOR THE CITY OF NEW YORK

        Ms. Brennan. Good morning. And thank you, Chairman Rose,
    Ranking Member Walker, Chairwoman Rice, and Members of the
    Subcommittees on Intelligence and Counterterrorism and Border
    Security, Facilitation, and Operations, for inviting me to this
    critically important hearing. It is critically important
    because of the devastating impact of fentanyl on New York City
    and on our country.
        I am New York City's special narcotics prosecutor. My
    office is unique in its exclusive focus on felony narcotics
    prosecution in the 5 boroughs of New York City. I am appointed
    by the city's 5 elected DAs and prosecute cases under New York
    State law.
        As head of the office for more than 20 years, I have
    grappled with each phase of the opioid crisis, from the
    overprescribing of pain medication to surging supplies of
    heroin, lethal fentanyl, and now fentanyl analogues.
        New York is a major regional narcotics trafficking hub, and
    so my office targets the importation and distribution of
    fentanyl, heroin, cocaine, and addictive pills. We work with
    local, State, and Federal law enforcement partners to reduce
    the supply of drugs at the highest levels.
        The many sources of deadly opioids paired with escalating
    volume and toxicity present daunting challenges. Mexican
    cartels manufacture the fentanyl using chemical components
    obtained from Chinese laboratories. Chinese labs are also
    primarily responsible for the manufacturing of fentanyl
    analogues.
        Local prosecutors cannot effectively address this issue
    alone. We rely on Federal leadership and strategies to prevent
    the lethal drugs from saturating our vulnerable communities. I
    commend the bipartisan efforts of this House committee to hold
    governments which regulate producers of fentanyl responsible
    for the deaths of tens of thousands of Americans each year.
        A decade ago, as the prescription opioid epidemic emerged
    in New York, we observed a simultaneous rise in large-scale
    heroin packaging operations in the Bronx and Upper Manhattan.
    Heroin sold on the streets was purer and more plentiful than
    ever before. We began to intercept truckloads containing
    heroin. Intelligence linked these shipments to Mexico-based
    operations.
        Soon, in 2016, bulk shipments of illicit fentanyl began
    turning up alongside those loads of heroin. Local drug networks
    had not requested the fentanyl and were not necessarily aware
    they were receiving it.
        At the street level, cheap fentanyl was sold
    interchangeably with more expensive heroin, driving up profits.
    Overdose deaths skyrocketed in New York City, increasing by 51
    percent 2016 over 2015. Last year, nearly 1,500 people died of
    drug overdose, more than half with fentanyl and fentanyl
    analogues as contributing factors.
        Investigations by my office have interdicted 4 tons of
    narcotics in the past 5 years, and fentanyl has grown from a
    sliver of our drug seizures to a significant portion. In our
    single largest fentanyl interdiction, my office, the DEA, and
    the New York City Police Department seized 213 pounds of
    narcotics in a nondescript Queens apartment building, including
    140 pounds of fentanyl. A married couple linked to a Mexican
    source of supply was prosecuted.
        Fentanyl and fentanyl analogues have thoroughly saturated
    the black market for drugs, mixed into heroin, cocaine, and
    other substances or pressed into counterfeit prescription
    pills. And that source has spread around the East Coast into
    Ohio and Pennsylvania.
        The influx of fentanyl analogues is the next wave in this
    epidemic. Thus far, roughly 900 people have died of overdoses
    involving analogues in New York City since the beginning of
    2017. These deaths have steadily increased.
        Yet the majority of fentanyl analogues are unregulated in
    New York State. More than a dozen different types have been
    identified in the city, and most trace back to China. Most are
    sold on the dark web and shipped in small packages through
    parcel delivery services and the U.S. mail, as you have heard.
    We have also seized analogues that are mixed into shipments
    from Mexico, but that is few and far between.
        Given the piecemeal nature of our regulation in New York
    State, it is increasingly difficult for law enforcement to
    seize the dangerous compounds and disrupt organizations dealing
    them. My office is unable to obtain search warrants or make
    arrests in cases involving uncontrolled fentanyl analogues,
    even when deaths have resulted.
        Our police labs and medical examiners also struggle to
    detect analogues. This week, we announced a grand jury report
    on the subject of analogues which recommended that New York
    State adopt the Federal emergency schedule-type provision,
    which is now being considered by Congress.
        Leveraging our relationships to shut down the supply chain
    for these dangerous substances before they ever reach our soil
    must be a priority. We must do all we can to protect vulnerable
    people suffering from addiction from ever-more-lethal
    substances on the black market.
        Thank you for the opportunity to testify today. I look
    forward to answering your questions and to future collaboration
    on this urgent problem. Thank you.
        [The prepared statement of Ms. Brennan follows:]
                    Prepared Statement of Bridget G. Brennan
                                 July 25, 2019
                                  introduction
        Thank you, Chairman Rose, Ranking Member Walker, and the
    Subcommittee on Intelligence and Counterterrorism, Chairwoman Rice,
    Ranking Member Higgins, and the Subcommittee on Border Security,
    Facilitation, and Operations for inviting me to testify at this
    critically important hearing.
        My name is Bridget Brennan and I am special narcotics prosecutor
    for the city of New York. The Office of the Special Narcotics
    Prosecutor (SNP) is unique in its exclusive focus on felony narcotics
    in the 5 counties that comprise New York City. Narcotics smuggled into
    New York City are distributed throughout the East Coast and as far west
    as Pennsylvania and Ohio. As a result we target the importation and
    both regional and local distribution of fentanyl, heroin, cocaine,
    addictive pills, and related crimes. We work with local, State, and
    Federal law enforcement and prosecute cases under New York State law. I
    am appointed by the city's 5 elected district attorneys.
        As head of the office for more than 20 years, I have grappled with
    each phase of the opioid crisis, first the overprescribing of opioid
    medications, then importation of heroin in volume and purity never seen
    before, next the emergence of lethal fentanyl and finally the
    proliferation of fentanyl analogs. Our goal is to reduce the supply of
    deadly drugs at the top of the distribution chain. My office embraces a
    strategic supply reduction approach and has long been a proponent of
    prevention and treatment as an alternative to incarceration.
        Only the first wave of the crisis, the flood of addictive
    prescription drugs, involved drugs manufactured in the United States.
    Considering the many sources of deadly narcotics drugs, and the
    escalating volume and toxicity of opioids, our work has been
    challenging. Facing foreign sources of supply and unprecedented volume,
    a local prosecutor cannot effectively address this crisis without
    substantial assistance and from the Federal Government.
        I commend the bipartisan efforts of the Committee on Homeland
    Security to hold the governments which regulate suppliers of lethal
    fentanyl and fentanyl analogs accountable for the deaths of tens of
    thousands of Americans each year. I welcome the opportunity to describe
    the difficulties we face trying to prevent the distribution of fentanyl
    and analogs, and how you can assist us.
                   fentanyl and the role of mexico and china
        I will describe our experience with fentanyl and fentanyl analogs,
    which we have observed enter the United States from different countries
    and via different transport routes.
        Mexican cartels manufacture illicit fentanyl using chemical
    components obtained from Chinese laboratories. Chinese laboratories are
    also primarily responsible for the manufacturing of fentanyl analogs,
    which are similar to fentanyl but with slightly modified chemical
    compositions. Some fentanyl analogs are considerably more potent than
    fentanyl. Opportunistic drug producers profit from an unprecedented
    epidemic of opioid addiction in the United States.
        A decade ago, when my office first saw the prescription opioid
    epidemic emerge in New York City, we observed a simultaneous rise in
    the number of large-scale heroin packaging operations in the Bronx and
    Upper Manhattan. They were situated in inconspicuous apartment
    buildings, employed shifts of workers around the clock, and packaged
    tens of thousands of tiny envelopes of heroin for distribution
    throughout the region. We began intercepting truckloads containing
    dozens of kilograms of heroin in the greater metropolitan area.
    Intelligence linked these shipments to Mexico-based organizations. The
    heroin mills were run by local criminal organizations.
        In 2016, bulk shipments of illicit fentanyl began turning up in
    tractor trailers and packaging mills controlled by the same criminal
    organizations, mixed in with loads of heroin. Local drug distributors
    had not requested fentanyl, and were not necessarily aware they were
    receiving it. Fentanyl is 50 times more potent than heroin, so one
    kilogram can produce many more bags for individual sale. It is cheaper
    and easier to produce than heroin because it is a chemically-based
    synthetic, unlike heroin which is organic. Sold interchangeably with
    more expensive heroin at the street level, the profit margin for
    fentanyl is substantially higher than heroin. Because it is also more
    lethal, and often mixed in with heroin and other drugs, overdose deaths
    have skyrocketed in New York City, increasing by 51 percent in 2016
    over 2015.
        Investigations by my office have interdicted 4 tons of narcotics in
    the past 5 years, and we have seen fentanyl grow from a sliver of our
    drug seizures to a significant portion. In 2016, fentanyl accounted for
    just 2 percent of drugs we seized. By 2018, fentanyl was present in 40
    percent of narcotics recovered. It should be noted that we rarely,
    interdict medicinal fentanyl manufactured in the United States. We have
    seized hundreds of pounds of illicit fentanyl in recent years, and most
    can be traced back to Mexico.
        To give you an idea of what we see, I will describe our single
    largest interdiction of fentanyl. In August 2017, my office, the U.S.
    Drug Enforcement Administration (DEA) and the New York City Police
    Department (NYPD) seized the largest amount of fentanyl recovered in
    the United States at that time (since surpassed by U.S. Customs and
    Border Protection in Arizona). A total of 97 kilograms of narcotics
    (213 pounds) were stashed in a inconspicuous apartment in Kew Gardens,
    Queens, including 64 kilograms of fentanyl (over 140 pounds) and
    quantities of heroin, cocaine, and other substances. A married couple
    linked to a Mexican source of supply was prosecuted.

    [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

        At present, fentanyl has thoroughly saturated the black market for
    drugs in New York City. More often than not, drug users in New York
    City are unaware of the contents of the narcotics they are purchasing.
    Fentanyl and fentanyl analogs are mixed into heroin, cocaine, and other
    substances, or pressed into counterfeit prescription pills and sold as
    oxycodone and Xanax.
        The bulk of the fentanyl we see in New York City is transported in
    vehicles across the Southwest Border, and cross-country to New York
    City or the surrounding area. The further fentanyl gets from its
    source, the more integrated it becomes in local black markets, and the
    greater the risk of overdose and death. We need your help to prevent it
    from ever reaching us. I urge the Committee on Homeland Security to
    support effective measures to prevent precursor chemicals from China or
    other countries, which are necessary to manufacture fentanyl, from
    being obtained in Mexico. I further urge the committee to support
    adequate resources to allow for better detection of fentanyl concealed
    in vehicles at border crossings into the United States.
                    new challenges posed by fentanyl analogs
        An influx of fentanyl analogs is the latest wave in the opioid
    epidemic. Fentanyl analogs are readily available through the Dark Web
    and are sold by street-level dealers. Unlike fentanyl and heroin,
    fentanyl analogs are typically shipped in small packages via
    international parcel delivery services and the U.S. Mail, passing
    through John F. Kennedy International Airport and other busy
    transshipment points. More than a dozen different analogs have been
    identified in New York City, and most are traced back to China,
    although they may be shipped to a distributor intermediary in another
    country before reaching the United States.
        We have most frequently seen a pattern of low-level narcotics
    organizations obtaining the analogs and selling them alone mixed with a
    dilutant, or selling them mixed with heroin or fentanyl. We have also
    seized analogs alongside fentanyl and heroin in shipments transported
    overland from Mexico.
        The analogs are typically much higher in purity than bulk fentanyl
    coming from Mexico. As a result, not only can a minute amount cause
    death, but police laboratories and medical examiners must recalibrate
    their equipment and obtain new standards for comparison to detect these
    substances which appear in extremely low concentrations. This pertains
    to laboratory tests involving drugs seized in investigations as well as
    post-mortem investigations by coroners and medical examiners.

    [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

        Approximately 900 people died of overdoses involving fentanyl
    analogs in New York City since the beginning of 2017. Fentanyl analogs
    are currently present in approximately 40 percent of all overdose
    deaths resulting from a non-prescription opioid. These deaths have been
    steadily increasing.
        Yet the majority of fentanyl analogs are legal to possess and sell
    in New York State, where regulation has been piecemeal. As a result,
    foreign laboratories need only tweak the chemical composition to create
    new analogs and evade enforcement.
        The results are predictable. In 2018, the New York State
    Legislature proscribed certain synthetic opioids, including the analog
    acetyl fentanyl, which is responsible for the highest number of deaths.
    However, new variations continue to emerge. For example, since the fall
    of 2018 valeryl fentanyl has been linked to dozens of fatalities, yet
    still remains legal to possess.
        Currently, if unregulated, it is difficult for local law
    enforcement agencies to intercept these dangerous compounds and disrupt
    organizations dealing them. My office is unable to obtain search
    warrants or make arrests in cases involving uncontrolled fentanyl
    analogs, even when deaths have resulted, unless controlled substances
    are also involved.
        Earlier this week, my office announced a New York State Grand Jury
    Report on the subject of fentanyl analogs. The report built upon joint
    investigations with the NYPD, the DEA, the New York Drug Enforcement
    Task Force (NYDETF) and other partners. The Grand Jury heard evidence
    regarding lack of regulation of these substances and the overdoses and
    deaths associated with them. The Report (attached to my testimony)
    recommends that the New York State Legislature prohibit all fentanyl
    analogs and recommends that additional funding be allocated for police
    labs and the offices of medical examiners.
        I urge Congress to pass legislation permanently banning all
    fentanyl analogs, which are currently the subject of an emergency order
    set to expire in February 2020. States are reliant upon the Federal
    Government to effectively control the influx of these dangerous
    substances from foreign sources. I am hopeful that if Congress
    permanently bans all forms of fentanyl analogs on the Federal level,
    States, including New York, will follow suit.
                                   conclusion
        Sadly, overdose is the leading cause of accidental death across the
    country. In New York City, overdoses claim more lives than homicides
    and car crashes combined. Overdose killed more than 6,000 people in the
    past 5 years in the city, with the current rate just below 1,500 deaths
    per year. Fentanyl and fentanyl analogs are now involved in well over
    half of these deaths. While overdose rates are stabilizing Nationally,
    the lethal toll remains unacceptably high and some of our most
    vulnerable communities have not seen their overdose rates decline.

    [GRAPHIC NOT AVAILABLE IN TIFF FORMAT]

        All of the fentanyl and analogs which are responsible for a high
    percentage of deaths are smuggled into the United States from countries
    with whom we have robust trade relationships. Additional resources for
    border interdictions are crucial. Leveraging our relationships to shut
    down the supply chain for these dangerous substances before they ever
    reach our soil should be a priority. We must do all we can to protect
    vulnerable people suffering from addiction from the ever more lethal
    substances on the black market.
        Thank you for the opportunity to testify today. I look forward to
    answering your questions and to future collaborations with Members of
    the Subcommittee on Intelligence and Counterterrorism and the
    Subcommittee on Border Security, Facilitation, and Operations to
    address this urgent problem.
                 Attachment.--New York State Grand Jury Report

    [GRAPHICS NOT AVAILABLE IN TIFF FORMAT]

        Mr. Rose. Thank you for your testimony, Ms. Brennan.
        I now recognize Dr. Pardo to summarize his statement for 5
    minutes.

     STATEMENT OF BRYCE PARDO, PH.D., ASSOCIATE POLICY RESEARCHER,
                            RAND CORPORATION

        Mr. Pardo. Chairs Rose and Rice, Ranking Members Walker and
    Higgins, and other distinguished Members of the subcommittees,
    thank you very much for the opportunity to testify before you
    today.
        For 30 years, the RAND Drug Policy Research Center has
    worked to help decision makers in the United States and
    throughout the world understand and address issues involving
    alcohol and other drugs.
        I was asked to speak to you about the on-going developments
    related to the illicit importation and supply of synthetic
    opioids. First, I will briefly describe the emergence of these
    drugs. I will then focus on elements related to their supply.
    Finally, I will conclude with some policy options aimed at the
    challenges that they pose.
        The opioid crisis was initially fueled by oversupply of
    prescription painkillers. Yet, according to provisional
    mortality data, by 2018, synthetic opioids such as fentanyl
    were involved in approximately two-thirds of the almost 50,000
    opioid overdose deaths that year and are now twice as prevalent
    as fatal overdoses involving heroin or prescription opioids.
        Initially sold mixed with powered heroin and later pressed
    into counterfeit prescription tablets, exposing many
    unsuspecting individuals, synthetic opioids may now be entering
    non-opioid drug markets. While half of the heroin-involved
    deaths in 2017 included synthetic opioids, approximately an
    equal share of fatal cocaine overdoses did as well.
        An examination of available data shows that this problem is
    geographically concentrated in the Eastern half of the United
    States. The 10 States with the highest synthetic opioid
    overdose deaths in 2017 compromised 12 percent of the country's
    population yet made up 35 percent of all reported fatal
    overdoses involving synthetic opioids. This concentration
    suggests that the overdose crisis could get worse should these
    substances reach major illicit opioid markets west of the
    Mississippi River.
        The upward trend in overdoses is mirrored by supply-side
    indicators. The number of fentanyl seizures submitted by State
    and local authorities jumped from about 1,000 in 2013 to more
    than 59,000 in 2017. Similarly, Customs and Border Protection
    seized nearly 1,000 kilograms of fentanyl in fiscal year 2018,
    up from just 1 kilogram in fiscal year 2013.
        Those seizures of drugs containing fentanyl near or at the
    Southwest Border significantly outweighed those at mail or
    express consignment carrier facilities. Calculations in my
    written statement show that, after adjusting for purity, the
    majority of fentanyl seized by CBP arrives by air, mostly
    originating from China. Mexico is a source of illicitly
    imported fentanyl, yet many of the precursors or finished
    products trafficked by these groups also originate in China.
        China is an important source of many legitimate chemicals
    and pharmaceutical inputs. Today, it is the world's largest
    exporter of active pharmaceutical ingredients and a leading
    exporter of chemicals for industrial and commercial use.
    However, economic growth in these sectors has outpaced the
    central government's ability to monitor producers.
        As detailed in my written statement, there are several
    factors that allow manufacturers to operate with impunity.
    First, regulatory design and enforcement is scattered across a
    handful of agencies, creating gaps in oversight. Second,
    misaligned incentives between those who write the rules and
    those who enforce them allow for regulatory capture and
    corruption. Third, the central government's enforcement
    capacity is inadequate relative to the number of producers and
    distributors. Such conditions create a favorable environment
    for firms to operate in illegal margins, allowing them to
    produce and export synthetic drugs to global markets.
        Considering the future, there are several things that
    Congress and Federal authorities could do. However, given the
    scope of this problem and the new challenges it presents,
    Congress must look beyond available drug policy tools.
        First, given the lack of information about supply and
    demand, there is dire need to improve how agencies collect and
    analyze drug market indicators such as prevalence, overdoses,
    and drug seizures. Our drug policy data collection and analysis
    systems are not well-suited to these new drugs. This is
    crucial, considering the need for early warning systems, to
    safeguard communities that have not been exposed to synthetic
    opioids.
        Second, Congress could continue to encourage Federal
    authorities to work with Chinese counterparts to strengthen
    that country's regulatory and enforcement capabilities. This
    includes constructively engaging China at relevant multilateral
    institutions, building greater bilateral research and technical
    exchanges, and streamlining information sharing. Congress could
    consider appropriating additional resources to U.S. authorities
    to that end.
        Third, there is need to better understand and target
    producers, importers, and high-level distributors both in the
    United States and in China. Building cases and sharing actual
    information with Chinese authorities are needed to effectively
    prosecute those who flaunt Chinese law. Greater research is
    needed to understand decision-making and operational processes
    of importers so as to disrupt and detour on-line sourcing and
    distribution by individuals in the United States.
        Last and most importantly, there is need to strengthen
    Federal, State, and local efforts aimed at reducing overdoses
    and demand for opioids. This includes expanding pharmacological
    treatments covered by private and public health insurance,
    subsidizing the cost of medication therapies for those who
    cannot afford them, and reviewing and reducing regulatory
    barriers on their provision.
        The arrival of illicitly-manufactured synthetic opioids
    creates uncertainty in illicit drug markets, raising the risk
    of overdose. These substances are changing the drug policy
    landscape and stretching our ability to respond effectively.
    Decision makers will need to consider new challenges presented
    by fentanyl in order to stem the rising tide in overdoses.
        Thank you, and I look forward to questions.
        [The prepared statement of Mr. Pardo follows:]
                   Prepared Statement of Bryce Pardo \1\ \2\
    ---------------------------------------------------------------------------
        \1\ The opinions and conclusions expressed in this testimony are
    the author's alone and should not be interpreted as representing those
    of the RAND Corporation or any of the sponsors of its research.
        \2\ The RAND Corporation is a research organization that develops
    solutions to public policy challenges to help make communities
    throughout the world safer and more secure, healthier, and more
    prosperous. RAND is nonprofit, nonpartisan, and committed to the public
    interest.
    ---------------------------------------------------------------------------
                                 July 25, 2019
        Chairman Rose, Chairwoman Rice, Ranking Member Walker, Ranking
    Member Higgins, and other distinguished Members of the Subcommittee on
    Intelligence and Counterterrorism and Subcommittee on Border Security,
    Facilitation, and Operations, thank you very much for the opportunity
    to testify before you today. For 30 years, the RAND Drug Policy
    Research Center has worked to help decision makers in the United States
    and throughout the world address issues involving alcohol and other
    drugs. The center brings an objective and data-driven perspective to
    this often emotional and fractious policy arena. I was asked to speak
    to you today about on-going developments related to the current opioid
    crisis in the United States, focusing on some of the research we at
    RAND are doing to better understand the illicit supply of fentanyl and
    other synthetic opioids.
        The introduction of illicitly-manufactured synthetic opioids to
    U.S. drug markets presents new challenges for contemporary drug policy.
    The potency of synthetic opioids raises the risk to those who use drugs
    and challenges first responders. In addition, the development of novel
    opioids that fall outside existing drug controls impedes regulatory
    efforts, and the ability with which these substances can be produced
    and shipped with ease complicates traditional supply reduction efforts.
        Today, I will begin briefly describing our country's on-going
    opioid overdose crisis. Understanding recent developments and the
    shifting supply of opioids is critical to developing effective policy
    responses. I will then describe the emergence of synthetic opioids and
    the harms they generate. Given the topic of this hearing, I will focus
    most of my testimony on illicit imports of fentanyl and other synthetic
    opioids. Although most of these substances reportedly come from China
    and Mexico, many aspects of supply and distribution remain unclear.
    That said, China's export-led economic strategy and lack of regulatory
    oversight have created favorable conditions for the mass production and
    exportation of inexpensive synthetic opioids and related chemicals.
    Similarly, Mexican drug trafficking organizations might view fentanyl
    as an attractive, cheaper alternative to heroin. I conclude with some
    policy options going forward, aimed at the new challenges posed by
    these substances.
                arrival of synthetic opioids to illicit markets
        The drivers behind overdose deaths in the United States have
    changed in the last 10 years. Although the overdose crisis was
    initially fueled by oversupply of prescription painkillers, such as
    oxycodone and hydrocodone, by 2018, synthetic opioids, such as
    fentanyl, were involved in approximately two-thirds of all opioid
    overdose deaths.\3\ While diversion of prescription fentanyl, such as
    transdermal patches and transmucosal lozenges, has been documented,\4\
    today's problem largely comes from illicitly manufactured synthetic
    opioid powders, particularly fentanyl.\5\ Unlike traditional street-
    sourced opioids, such as heroin or diverted prescription painkillers,
    synthetic opioids are often much more potent. Some of these chemicals
    are active in the tens of micrograms,\6\ making precise dosing very
    difficult without sophisticated equipment. As fentanyl permeates U.S.
    markets, so does the risk of fatal overdose.
    ---------------------------------------------------------------------------
        \3\ F.B. Ahmad, L.A. Escobedo, L.M. Rossen, M.R. Spencer, M.
    Warner, and P. Sutton, ``Provisional Drug Overdose Death Counts,''
    National Center for Health Statistics, 2019. As of July 19, 2019:
    https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm.
        \4\ J. Kuhlman, R. McCaulley, T.J. Valouch, and G.S. Behonick,
    ``Fentanyl Use, Misuse, and Abuse: A Summary of 23 Postmortem Cases,
    Journal of Analytical Toxicology, Vol. 27, No. 7, 2003, pp. 499-504.
        \5\ M. Spencer, M. Warner, B.A. Bastian, J.P. Trinidad, and H.
    Hedegaard, ``Drug Overdose Deaths Involving Fentanyl,'' National Vital
    Statistics Reports, Vol. 68, No. 3, 2019; Drug Enforcement
    Administration (DEA), 2018 National Drug Threat Assessment,
    Springfield, Va., DEA-DCT-DIR-032-18, October 2018b; R. Matthew
    Gladden, Pedro Martinez, and Puja Seth, ``Fentanyl Law Enforcement
    Submissions and Increases in Synthetic Opioid-Involved Overdose
    Deaths--27 States, 2013-2014,'' Morbidity and Mortality Weekly Report,
    Vol. 65, No. 33, 2016, pp. 837-843.
        \6\ According to the European Monitoring Centre for Drugs and Drug
    Addiction, the lethal dose of ingested fentanyl for those without
    opioid tolerance is approximately 2 milligrams (2,000 micrograms),
    roughly the amount of 2 grains of salt. See European Monitoring Centre
    for Drugs and Drug Addiction, ``Fentanyl Drug Profile,'' webpage, 2015.
    As of July 19, 2019: http://www.emcdda.europa.eu/publications/drug-
    profiles/fentanyl#pharmacology. Transdermal patches containing fentanyl
    release 12.5 to 100 micrograms per hour, depending on the prescription.
    ---------------------------------------------------------------------------
        Provisional numbers from the Centers for Disease Control and
    Prevention demonstrate a slowdown in total overdose deaths in recent
    years. Still, today's drug overdose crisis, which now claims some
    70,000 lives a year, surpasses major public health epidemics of prior
    generations, including the HIV/AIDS epidemic, which peaked at 50,000
    deaths a year in the mid-1990's.\7\ And while the annual number of
    opioid-involved deaths remained steady at just under 50,000 in each
    2017 and 2018,\8\ the majority of these deaths involved synthetic
    opioids. In 2018 this amounted to double the number of overdoses from
    heroin or prescription opioids.\9\ Overall, overdose deaths involving
    synthetic opioids have jumped tenfold between 2013 and 2018.
    ---------------------------------------------------------------------------
        \7\ Holly Hedegaard, Arialdi M. Minio, and Margaret Warner, ``Drug
    Overdose Deaths in the United States 1999-2017,'' NHCS Data Brief, No.
    329, November 2018. As of July 19, 2019: https://www.cdc.gov/nchs/data/
    databriefs/db329-h.pdf Centers for Disease Control and Prevention,
    ``Thirty Years of HIV--1981-2011,'' Morbidity and Mortality Weekly
    Report, Vol. 60, No. 21, June 3 2011.
        \8\ Ahmad et al., 2019.
        \9\ Ahmad et al., 2019.
    ---------------------------------------------------------------------------
        In addition, overdose figures and law enforcement reports suggest
    that synthetic opioids, initially sold as powdered heroin or
    prescription tablets, may be entering non-opioid drug markets.\10\
    While half of heroin-involved deaths in 2017 included synthetic
    opioids, approximately an equal share of fatal cocaine overdoses did as
    well. Figure 1 shows national trends regarding the presence of
    synthetic opioids among fatal overdoses across several drug categories.
    ---------------------------------------------------------------------------
        \10\ DEA, Special Testing and Research Laboratory, Emerging Threat
    Report, Annual 2017, Springfield, Va., 2018a.

        Examination of overdose fatalities by State shows that the
    synthetic opioid problem is concentrated in the eastern half of the
    United States.\11\ The 10 States with highest synthetic opioid overdose
    death rates in 2017 contain only 12 percent of the country's population
    yet comprised 35 percent of the 28,500 fatal overdoses involving
    synthetic opioids. Ohio's share alone was almost 12.5 percent, although
    the State only has about 3.5 percent of the country's total population.
    ---------------------------------------------------------------------------
        \11\ Michael Zoorob, ``Fentanyl Shock: The Changing Geography of
    Overdose in the United States,'' International Journal of Drug Policy,
    Vol. 70, 2019, pp. 40-46.
    ---------------------------------------------------------------------------
        In several acutely affected States, fatal overdoses involving
    heroin free of synthetic opioids have continued to decline, only to be
    replaced by a rising number of overdoses involving synthetic opioids.
    For example, in Ohio, the total number of deaths mentioning heroin
    actually fell in 2017, for the first time since 2009; few heroin
    overdose deaths in Ohio do not involve synthetic opioids as well. In
    New Hampshire, only one-quarter of heroin overdoses do not involve
    synthetic opioids and total heroin overdoses have fallen dramatically,
    suggesting that illicit drug markets in that State may be far along in
    the transition to fentanyl or other synthetic opioids.
        An examination of State-level drug seizures shows similar spatial
    and temporal patterns. In States acutely affected by synthetic opioids,
    law enforcement seizures of heroin have been declining since around
    2014. The same cannot be said for seizures of fentanyl and related
    substances. An examination of data from U.S. Drug Enforcement
    Administration's National Forensic Laboratory Information System
    (NFLIS) through 2017 suggests that several regional markets appear to
    be transitioning toward synthetic opioids and away from heroin. The
    overdose crisis could worsen if synthetic opioids enter major illicit
    opioid markets west of the Mississippi river.\12\
    ---------------------------------------------------------------------------
        \12\ For example, recent spikes in fentanyl-involved overdose
    deaths in San Francsisco, California may be an early indicator of such
    expansion. See Erin Allday, ``Fentanyl Rising as Killer in San
    Francisco--57 Dead in a Year,'' San Franscisco Chronicle, June 23,
    2019. As of July 19, 2019: https://www.sfchronicle.com/health/article/
    Fentanyl-rising-as-killer-in-San-Francisco-57-14030821.php?psid=dlc8z.
    ---------------------------------------------------------------------------
                      shifting supply of synthetic opioids
        The country's upward trend in synthetic opioid overdoses is
    mirrored by the trend in drug seizures. U.S. Customs and Border
    Protection (CBP) seized approximately 1 kilogram of fentanyl in fiscal
    year 2013; by fiscal year 2018, CBP seized nearly 1,000 kilograms.\13\
    Likewise, reports from NFLIS show a sharp increase in the number of
    seizures containing fentanyl or fentanyl analogues submitted by State
    and local drug laboratories. Although these increases may be partially
    explained by changes in law enforcement procedures or priorities, the
    number of fentanyl seizures submitted to NFLIS also jumped from about
    1,000 in 2013 to more than 59,000 in 2017.\14\ State-level analysis
    shows a strong correlation between the number of law enforcement drug
    seizure exhibits containing fentanyl or fentanyl analogues and reported
    synthetic opioid overdose deaths.\15\
    ---------------------------------------------------------------------------
        \13\ U.S. Customs and Border Protection, CBP Enforcement
    Statistics, Washington, DC, 2019. These seizures are not adjusted for
    purity and reflect the gross total weight. It is important to adjust
    seizures for purity, as Federal law enforcement has noted the disparity
    in purity of seizures originating from China, which are nearly pure,
    versus those originating from Mexico, which are often of low purity.
        \14\ DEA. 2018b.
        \15\ Zoorob, 2019.
    ---------------------------------------------------------------------------
        In addition to the rise in reports of fentanyl seized in domestic
    drug markets, DEA has noted increases in the number of novel synthetic
    opioids. According to DEA's Emerging Threat Reports, 10 synthetic
    opioids were seized and identified for the first time in 2017, followed
    by 7 in 2018.\16\ These chemicals were previously unknown in U.S. drug
    markets. Even though producers continue to manufacture new substances
    and the overall mix of analogues found in markets changes over time,
    fentanyl remains the dominant synthetic opioid reported in seizure
    reports and overdose death certificates.
    ---------------------------------------------------------------------------
        \16\ DEA, Special Testing and Research Laboratory, 2018a; DEA,
    Special Testing and Research Laboratory, 2019.
    ---------------------------------------------------------------------------
        This is not the first time the United States has experienced an
    outbreak of illicitly manufactured fentanyl in drug markets. During a
    brief period in the mid-2000's, illicitly manufactured fentanyl
    appeared in major heroin markets in the Midwest and mid-Atlantic,
    claiming about 1,000 lives.\17\ Federal and local response was swift,
    expanding access to naloxone and seizing product from the street. In
    May 2006, Mexican law enforcement and the DEA identified and closed the
    illicit manufacturing operation in Toluca, Mexico.\18\ Illicitly
    manufactured fentanyl would not return to drug markets until late 2013.
    ---------------------------------------------------------------------------
        \17\ Centers for Disease Control and Prevention,
    ``Nonpharmaceutical Fentanyl-Related Deaths--Multiple States, April
    2005-March 2007,'' Morbidity and Mortality Weekly Report, Vol. 57, No.
    29, July 25, 2008.
        \18\ DEA, National Drug Intelligence Center, Fentanyl: Situation
    Report, Springfield, Va., SR-000001, June 5, 2006.
    ---------------------------------------------------------------------------
        However, much has changed since the closure of the lab in Toluca.
    Law enforcement in the United States and Canada report that most
    synthetic opioids and precursors originate not from a single
    clandestine source, but from what could be many semi-legitimate
    manufacturers and vendors, most of whom are in China.\19\ Chinese
    suppliers ship these substances via the international postal system and
    private express consignment carriers, such as FedEx and DHL, as well as
    by cargo.\20\ According to DEA, Mexican drug traffickers are another
    major source.\21\ Given that drug trafficking organizations in Mexico
    have a history of importing methamphetamine precursors from China,\22\
    it would appear that they are doing the same with fentanyl and fentanyl
    precursors. Regardless of their source, nearly all of today's illicitly
    manufactured synthetic opioids are imported. DEA last reported a
    seizure of a clandestine fentanyl laboratory in the United States
    almost 15 years ago.\23\
    ---------------------------------------------------------------------------
        \19\ C. Bairns, ``Charges to Be Laid Involving Fentanyl Shipments
    from China: RCMP,'' Globe and Mail, September 18, 2017; U.S. Drug
    Enforcement Administration, Counterfeit Prescription Pills Containing
    Fentanyls: A Global Threat, Springfield, Va., 2016.
        \20\ U.S. Senate, Committee on Homeland Security and Governmental
    Affairs, Permanent Subcommittee on Investigations, Combatting the
    Opioid Crisis: Exploiting Vulnerabilities in International Mail,
    Washington, DC, 2018; CBP, ``Philadelphia CBP Seizes Nearly $1.7
    Million in Fentanyl Shipped from China,'' press release, June 28, 2018.
    As of July 19, 2019: https://www.cbp.gov/newsroom/local-media-release/
    philadelphia-cbp-seizes-nearly-17-million-fentanyl-shipped-china.
        \21\ DEA, 2018b.
        \22\ S. O'Connor, Meth Precursor Chemicals from China: Implications
    for the United States, Washington, DC: U.S.-China Economic and Security
    Review Commission, 2016.
        \23\ DEA, 2006.
    ---------------------------------------------------------------------------
        Seizure data at ports of entry offer some insights into the
    dimensions of illicit imports. CBP reports seizing synthetic opioids,
    including fentanyl, at land points of entry and checkpoints on the
    Southwest Border, as well as at mail and express consignment facilities
    and other air ports of entry. Table 1 shows that in fiscal year 2018,
    seizures of fentanyl near or at the border ports of entry significantly
    outweighed those at mail and express consignment carrier facilities.
    However, after adjusting for purity, almost 70 percent of fentanyl
    seized by CBP in fiscal year 2018 arrived by air, mostly at mail and
    express consignment carrier facilities. Analysis of fiscal year 2017
    seizure data reports a similar breakdown.\24\ Law enforcement and
    Congressional investigations have suggested that many of the packages
    at mail and express consignment facilities originate from China.\25\ If
    CBP seizures represent the true nature of trafficking patterns, then
    these preliminary calculations support law enforcement's conclusion
    that China is an important source country of illicitly manufactured
    synthetic opioids.
    ---------------------------------------------------------------------------
        \24\ Bryce Pardo, Evolution of the U.S. Overdose Crisis:
    Understanding China's Role in the Production and Supply of Synthetic
    Opioids. Santa Monica, Calif.: RAND Corporation, CT-497, 2018. As of
    July 19, 2019: https://www.rand.org/pubs/testimonies/CT497.html.
        \25\ U.S. Senate, Committee on Homeland Security and Governmental
    Affairs, Permanent Subcommittee on Investigations, 2018; T. Owen,
    testimony before the U.S. Senate Committee on Homeland Security and
    Governmental Affairs, January 25, 2018.

        TABLE 1.--CBP SEIZURES OF FENTANYL IN FISCAL YEAR 2018 BY MODE OF
                                    TRANSPORT
    ------------------------------------------------------------------------
                                             Estimated              Average
                                              Purity-              Weight of
          Mode of Transport         Weight    Adjusted   Seizure    Seizure
                                     (kg)      Weight   Incidents    (gross
                                                (kg)                  kg)
    ------------------------------------------------------------------------
    Land (mostly Southwest           654.00      49.05        182       3.59
     Border)....................
    Border Checkpoints (Border       176.36      13.23  .........  .........
     Patrol)....................
    Express consignment.........      52.62      47.36         76       0.69
    Mail........................      61.72      55.55        455       0.14
    Air (other).................      50.06      45.05          2      25.03
                                 -------------------------------------------
    Total.......................     994.76     210.24        715  .........
    ------------------------------------------------------------------------
    Source: CBP, Strategy to Combat Opioids, Washington, DC, 2019; DEA,
      National Drug Threat Assessment, Springfield, Va., 2017.
    Note: According to DEA, the purity of fentanyl arriving at mail and
      express consignment facilities is often 90 percent or more, while
      seizures at the Southwest Border are reportedly 5 to 10 percent pure;
      here we use the midpoint of 7.5 percent.

        The smuggling of synthetic opioids from China may be evolving. In
    late June 2018, CBP at the Philadelphia port of entry seized 50
    kilograms of 4-fluoroisobutyryl fentanyl hidden in barrels of iron
    oxide in an air shipment from China.\26\ CBP noted that the shipment
    was high purity, which would make this seizure one of the largest to
    originate from China and perhaps the largest single seizure of a
    fentanyl-like substance.
    ---------------------------------------------------------------------------
        \26\ CBP, 2018.
    ---------------------------------------------------------------------------
    China: A Source of New Drugs and Chemical Precursors
        The manufacture of many of these new drugs and precursors is linked
    to China's large and underregulated chemical and pharmaceutical
    sectors. China is a leading exporter of active pharmaceutical
    ingredients and chemicals that can be used in the production of
    controlled substances and other medications. These include
    methamphetamine precursors and cocaine reagents, such as ephedrine,
    pseudoephedrine, and potassium permanganate.\27\ To avoid detection by
    customs authorities, Chinese producers or distributors often use
    technically legal workarounds and, when necessary, outright deception.
    It has been reported that Chinese traffickers and chemical exporters
    will mislabel shipments, modify chemicals, or ship pre-precursors that
    fall outside international controls.\28\
    ---------------------------------------------------------------------------
        \27\ O'Connor, 2016; U.S. Department of State, International
    Narcotics Control Strategy Report, Washington, DC, 2017.
        \28\ O'Connor, 2016.
    ---------------------------------------------------------------------------
        Lack of international control manifested by the U.N. system of drug
    conventions has allowed Chinese manufacturers to export fentanyl
    precursors. Although they have been scheduled in the United States for
    over a decade, N-Phenethyl-4-piperidinone (NPP) and 4-anilino-
    Nphenethylpiperidine (4-ANPP) were not subject to international
    controls until October 2017.\29\ In late 2016, the U.S. Department of
    State identified nearly 260 producers of these precursors, more than
    half of which were in China.\30\ These chemicals were finally scheduled
    in China early last year.\31\ Previously, there was little scrutiny on
    their manufacture, and producers faced little, if any, reporting
    requirements or production and exporting restrictions.
    ---------------------------------------------------------------------------
        \29\ International Narcotics Control Board, ``INCB: Scheduling of
    Fentanyl Precursors Comes into Force,'' October 18, 2017.
        \30\ J. Whalen, ``U.S. Seeks Curb on Chemicals Used to Make
    Fentanyl, a Powerful Opioid,'' Wall Street Journal, October 14, 2016.
        \31\ DEA, ``China Announces Scheduling Controls on Two Fentanyl
    Precursor Chemicals,'' press release, January 5, 2018. As of July 19,
    2019: https://www.dea.gov/press-releases/2018/01/05/china-announces-
    scheduling-controls-two-fentanyl-precursor-chemicals.
    ---------------------------------------------------------------------------
        Much like circumvention of precursor regulations, Chinese
    manufacturers often synthesize new substances that fall outside
    National and international laws, including drugs that mimic the effects
    of cannabis, stimulants, benzodiazepines, and opioids. To stem the
    growing production of uncontrolled and novel psychoactives, the Chinese
    government has added new chemicals to national drug schedules. In late
    2015, China added 116 new substances, including 38 synthetic
    cannabinoids, 26 synthetic cathinones (e.g., ``bath salts''), 23
    phenethylamines (e.g., MDMA analogues), and 6 synthetic opioids to its
    drug control laws.\32\ Since then, China has scheduled additional
    fentanyl analogues as U.S. and Canadian law enforcement bring them to
    the attention of Chinese authorities.\33\ In January 2017, China's
    Ministry of Public Security listed 4 additional synthetic opioids,
    including the highly potent carfentanil.\34\ This was followed 6 months
    later with 4 new substances, including 2 non-fentanyl synthetic
    opioids, U-47700 and MT-45.\35\ Most recently, the Chinese government,
    at the request of the U.S. Government, has adopted a generic ban on all
    substances that are ``structurally related to fentanyl;'' the ban went
    into effect in May of this year.\36\
    ---------------------------------------------------------------------------
        \32\ United Nations Office on Drugs and Crime Early Warning
    Advisory on New Psycoactive Substances, ``China Announces Controls over
    116 New Psychoactive Substances,'' press release, October 2015. As of
    July 19, 2019: https://www.unodc.org/LSS/Announcement/Details/83b02e73-
    4896-4ed5-944c-51a7646647aa.
        \33\ U.S. Drug Enforcement Administration, 2018; Royal Canadian
    Mounted Police, ``RCMP and Chinese Ministry of Public Security Commit
    to Combat the Flow of Fentanyl into Canada,'' November 16, 2016. As of
    July 19, 2019: http://www.rcmp-grc.gc.ca/en/news/2016/24/rcmp-and-
    chinese-ministry-public-safety-commit-combat-the-flow-fentanyl-canada.
        \34\ Chinese Ministry of Public Security, ``Notice on Inclusion of
    Four Fentanyl Substances, Such as Fentanyl, in the Supplement to the
    Catalog of Nonmedical Narcotic Drugs and Psychotropic Substances
    Control,'' March 1, 2017.
        \35\ DEA, ``China Announces Scheduling Controls of New Psychoactive
    Substances/Fentanyl-Class Substances,'' June 19, 2017.
        \36\ Liu Yuejin, ``SCIO Briefing on Fentanyl-Related Substances
    Control,'' webpage, April 2, 2019. As of July 19, 2019: http://
    www.china.org.cn/china/2019-04/02/content_74637197.htm.
    ---------------------------------------------------------------------------
        Alhough China has made efforts to control fentanyl and fentanyl
    analogues, many of these chemicals continue to show up in drug seizures
    at ports of entry and in domestic drug markets. The ease of ordering
    these substances on-line and having them shipped directly to the United
    States hampers supply reduction efforts.\37\ Chinese chemical and
    pharmaceutical firms openly advertise these substances on English-
    language websites accessible by a simple internet search. Vendors will
    sometimes purposefully conceal shipments through freight forwarding
    systems, mislabel packages, or route them through a third country to
    conceal efforts to trace packages to their original source.\38\
    ---------------------------------------------------------------------------
        \37\ U.S. Senate, Committee on Homeland Security and Governmental
    Affairs, Permanent Subcommittee on Investigations, 2018.
        \38\ U.S. Senate, Committee on Homeland Security and Governmental
    Affairs, Permanent Subcommittee on Investigations, 2018.
    ---------------------------------------------------------------------------
        In addition to the supply of synthetic opioids and their chemical
    inputs, U.S. and Canadian law enforcement have also seized industrial-
    grade press machines, dies, and stamps imported from China that are
    used in the manufacture of counterfeit prescription tablets.\39\
    According to the DEA, drug distributors in the United States use
    imported powder formulations of synthetic opioids and press machines to
    manufacture counterfeit tablets.\40\ The distribution of fake tablets
    is of great concern because they resemble regulated products of known
    dose and consistency. They might also appeal to a broader population of
    individuals who do not inject drugs or are averse to using heroin.
    ---------------------------------------------------------------------------
        \39\ DEA, 2018b; Royal Canadian Mounted Police. ``RCMP Arrest
    Opioid Drug Trafficker,'' press release, December 6, 2018. As of July
    19, 2019: http://www.rcmp-grc.gc.ca/en/news/2018/rcmp-arrest-opioid-
    drug-trafficker DEA, Counterfeit Prescription Pills Containing
    Fentanyls: A Global Threat, Springfield, Va., July 2016. As of July 19,
    2019: https://content.govdelivery.com/attachments/USDOJDEA/2016/07/22/
    fileattachments/590360/fentanyl%2Bpills%2Breport.- pdf.
        \40\ DEA, 2016.
    ---------------------------------------------------------------------------
    Other Sources of Synthetic Opioids
        Mexico is another important source of illicit fentanyl destined for
    U.S. drug markets. Drug trafficking organizations in that country have
    long supplied much of the heroin that is used in the United States. In
    recent years, there has been a noticeable increase in the amount of
    fentanyl seized at the U.S.-Mexico border by U.S. law enforcement and
    Mexican authorities.\41\ The DEA has noted that Mexican drug
    trafficking organizations are importing fentanyl and fentanyl
    precursors from China. Drug traffickers are smuggling powder fentanyl
    alongside heroin or pressing it into counterfeit tablets made to look
    like genuine pharmaceutical-grade products.\42\ Synthetic opioids,
    which can be readily made in a lab, are attractive alternatives to
    poppy-based heroin, which is susceptible to blight, drought,
    eradication, and labor shortages. Also, the very high potency-to-weight
    ratio of fentanyl makes it ideal for smuggling.
    ---------------------------------------------------------------------------
        \41\ CBP, 2019; J. Nacar, ``Fentanilo Tiene Sus Epicentros en BC y
    CDMX,'' Eje Central. February 9, 2019.
        \42\ DEA, 2016.
    ---------------------------------------------------------------------------
        Since late 2017, 5 clandestine labs have been seized in Mexico.
    Most were in densely-populated residential areas in such major cities
    as Mexicali and Mexico City.\43\ The scale and access of chemical
    precursors and pill press machines from China, combined with easier
    synthesis techniques allows for the minimally trained to manufacture
    fentanyl virtually anywhere--making supply disruption more challenging.
    ---------------------------------------------------------------------------
        \43\ DEA, 2018b; ``PGR Asegura Supuesto Laboratorio de Fentanilo en
    CDMX,'' El Financiero, December 12, 2018; ``Aseguran en Culiacan,
    Sinaloa Presunto Laboratorio de Fentanilo,'' El Debate, April 11, 2019;
    PGR. Comunicado DPE/6719/17. Inicia PGR investigacion por aseguramiento
    de laboratorio clandestino en Sinaloa. November 23, 2017. ``Medico
    Bulgaro, Exmilitar, Kulkin Tenia, en un Cuartito de Mexicali,
    Laboratorio `AAA' de Fentanilo,'' Que Hacer Politico, September 18,
    2018.
    ---------------------------------------------------------------------------
        The DEA also notes Canada as another source of fentanyl.\44\ Parts
    of that country are also experiencing a surge in synthetic opioid
    overdoses, much like the United States. Rather than a source of
    production of synthetic opioids, Canada may serve as a transshipment
    point. DEA notes that synthetic opioids are imported from China into
    Canada, where they are pressed into counterfeit tablets, some of which
    are smuggled into the United States.\45\
    ---------------------------------------------------------------------------
        \44\ DEA, 2018b.
        \45\ DEA, 2016.
    ---------------------------------------------------------------------------
        India is another country with a robust pharmaceutical industry
    which faces limited regulatory oversight.\46\ It is unclear to what
    extent Indian-sourced fentanyl is arriving in the United States, but in
    2018, Indian authorities reported two relatively large seizures of
    fentanyl destined for North America.\47\
    ---------------------------------------------------------------------------
        \46\ India Brand Equity Foundation, ``Indian Pharmaceuticals
    Industry Analysis,'' May 2019. A. Altstedter and A. Edney, ``Culture of
    `Bending Rules' in India Challenges U.S. Drug Agency,'' Bloomberg,
    January 31, 2019.
        \47\ ``Three, Including Mexican National, Held with Drugs Worth Rs
    100 Cr in Madhya Pradesh,'' Business Standard, September 28, 2018; D.
    Singh, ``Mumbai: Anti-Narcotics Cell Seizes Drug Worth Rs 1000 Crore,''
    India Today, December 28, 2018.
    ---------------------------------------------------------------------------
        Currently, U.S. authorities believe China to be the primary source
    for fentanyl, fentanyl analogues, precursor chemicals, and press
    machines used in the manufacture of counterfeit tablets. As such, I
    turn to China's chemical and pharmaceutical industries.
              china's industry growth and regulatory deficiencies
        Although the Chinese central government has taken steps to control
    new chemicals and precursors, the problem persists. Regulatory capacity
    in China is inadequate to police the country's expansive pharmaceutical
    and chemical industries. Unauthorized manufacture and handling of
    fentanyl is prohibited in China, but not fentanyl itself. In fact, the
    country legitimately produces fentanyl for medical purposes.\48\ And
    fentanyl remains the most common synthetic opioid reported in overdose
    deaths and drug seizures in the United States, suggesting inadequate
    regulatory capacity and enforcement on the part of Chinese authorities.
    ---------------------------------------------------------------------------
        \48\ W. Zheng, ``China's Fentanyl Firms Back Crackdown on Opioid,''
    South China Morning Post, December 3, 2018.
    ---------------------------------------------------------------------------
        Government-led market reforms in the past 30 years have helped
    China become a global manufacturing center driven by exports. The
    expansion of e-commerce and inexpensive shipping have made global trade
    cheaper and more convenient. Together, these phenomena helped make many
    of China's industries important links in international supply chains.
    The same is true for its expansive pharmaceutical and chemical
    industries.
        Today, China's pharmaceutical industry counts some 5,000
    manufacturers that produce more than 2,000 products, with an annual
    production capacity of more than 2 million tons, making the country the
    single largest exporter of active pharmaceutical ingredients (APIs) in
    the world.\49\ According to the World Health Organization (WHO),
    China's pharmaceutical industry is now the second-largest in the world,
    with recent annual sales revenues of more than $100 billion.\50\
    ---------------------------------------------------------------------------
        \49\ World Health Organization, China Policies to Promote Local
    Production of Pharmaceutical Products and Protect Public Health, 2017.
        \50\ World Health Organization, 2017.
    ---------------------------------------------------------------------------
        In addition to its pharmaceutical industry, the Department of State
    estimates that China could have as many as 400,000 chemical
    manufacturers or distributors, some of which are operating without
    legal approval.\51\ These firms produce tons of chemicals each week
    intended for industrial and commercial use.\52\ One private-sector
    analysis estimates that China's chemical industry has grown by an
    annual average of 9 percent in recent years and made up 3 percent of
    the national economy in 2016, generating more than $100 billion in
    profits that year.\53\
    ---------------------------------------------------------------------------
        \51\ U.S. Department of State, International Narcotics Control
    Strategy Report, Washington, DC: Bureau of International Narcotics and
    Law Enforcement Affairs, 2014; U.S. Department of State, International
    Narcotics Control Strategy Report, Washington, DC: Bureau of
    International Narcotics and Law Enforcement Affairs, 2015.
        \52\ O'Connor, 2016.
        \53\ Atradius, ``Market Monitor: Focus on Chemicals Performance and
    Outlook,'' 2017.
    ---------------------------------------------------------------------------
        Rapid commercial growth brought on by market reforms has outpaced
    the capacity and design of China's regulatory regime.\54\ Regulatory
    gaps and bureaucratic fragmentation continue to hamper China's ability
    to oversee its pharmaceutical and chemical industries. In the past
    decade, the China Food and Drug Administration (CFDA) has made efforts
    to adopt better enforcement and production guidelines, including good
    manufacturing practices (GMPs). The GMP standards cover most basic
    aspects of manufacturing, including environmental protections, sanitary
    working conditions, product testing and tracking, and record
    keeping.\55\
    ---------------------------------------------------------------------------
        \54\ Li and Sun, 2014; World Health Organization, 2017.
        \55\ World Health Organization, 2017.
    ---------------------------------------------------------------------------
        However, the division of regulatory design and enforcement
    responsibilities among national governmental entities is a commonly-
    noted problem. Lack of coordination and competing regulatory oversight
    create opportunities for some firms to hide unregulated activities in
    plain sight. According to one report written by staff of the U.S.-China
    Economic and Security Review Commission, at one time there were 8
    governmental entities involved in promulgating and enforcing production
    and export requirements for pharmaceuticals or chemicals.\56\
    ---------------------------------------------------------------------------
        \56\ O'Connor, 2017.
    ---------------------------------------------------------------------------
        In addition to the patchwork of responsible agencies, competing
    incentives between levels of government impede enforcement. Provincial
    authorities protect, promote, and sometimes manage local economies and
    industries.\57\ Although the central government, through the CFDA,
    designs rules to govern GMP standards, it relies on provincial
    governments to enforce them. According to the WHO, provincial
    governments are mainly tasked with inspecting and certifying companies
    for GMP approval.\58\ This division in regulatory design and
    enforcement generates opportunities for regulatory capture,
    nonenforcement, or outright corruption when the economic incentives of
    provincial governments misalign with those of good governance.
    ---------------------------------------------------------------------------
        \57\ T. Gong, ``Corruption and Local Governance: The Double
    Identity of Chinese Local Governments in Market Reform,'' Pacific
    Review, Vol. 19, No. 1, 2006, pp. 85-102.
        \58\ World Health Organization, 2017.
    ---------------------------------------------------------------------------
        Beyond gaps in regulatory design and misaligned incentives, the
    government's regulatory capacity is limited. The division in
    enforcement strategy, in which the CFDA inspects only a subset of
    manufacturers, leaving the rest up to provincial authorities, may
    reflect this limitation. The CFDA and other regulators are unable to
    effectively inspect and police the large number of pharmaceutical
    manufacturers. The WHO notes that, although the CFDA is attempting to
    hire more inspectors, its efforts are complicated by lack of time and
    resources; private industry salaries are highly competitive,
    complicating efforts to retain qualified staff.\59\
    ---------------------------------------------------------------------------
        \59\ World Health Organization, 2017.
    ---------------------------------------------------------------------------
        Data from the CFDA show that regulators are increasing the number
    of inspections, yet gaps remain. Annual reports indicate an increase in
    inspected firms and applicants from 698 in 2015 to 751 in 2017,
    although there was a dip in inspections in 2016.\60\ The number of CFDA
    inspectors has remained around 2,000 over the same period; however,
    regulators have shifted focus to GMP certification inspections away
    from other forms of inspections, such as preapproval and overseas
    inspections. These regulatory efforts, which have traditionally been
    assigned to provincial governments, more than doubled, from just over
    200 in 2015 and 2016 to 428 in 2017.\61\ The number of unannounced
    inspections remained steady over this period, while those that included
    international inspectors (such as the U.S. Food and Drug Administration
    [FDA]) modestly increased in recent years.
    ---------------------------------------------------------------------------
        \60\ CFDA, Center for Food and Drug Inspection, Annual Report of
    Drug Inspection 2015, 2016; CFDA, Center for Food and Drug Inspection,
    Annual Report of Drug Inspection 2016, 2017; CFDA, Center for Food and
    Drug Inspection, Annual Report of Drug Inspection 2017, 2018.
        \61\ CFDA, Center for Food and Drug Inspection, 2016, 2017, 2018.
    ---------------------------------------------------------------------------
        Of the 428 GMP inspections carried out in 2017, 37 firms or
    applicants did not pass, and one-quarter were issued warning letters
    for violations. According to the most recent CFDA annual report, 15
    firms that manufacture narcotic or psychotropic drugs, precursors, or
    pharmaceuticals were inspected that year; 3 did not pass inspection for
    failure to properly handle mailing and transportation certificates or
    failure to control samples.\62\ These numbers suggest that regulators
    are inspecting a small share of companies and that a sizable portion of
    manufacturers of controlled substances inspected in 2017 failed
    inspection for improper handling and transport.
    ---------------------------------------------------------------------------
        \62\ CFDA, Center for Food and Drug Inspection, 2018.
    ---------------------------------------------------------------------------
        The situation is similar for China's chemical regulators, which
    cannot adequately enforce regulations on all manufacturers and
    distributors.\63\ Regulatory gaps have led to a large increase in the
    number of unlicensed or ``semi-legitimate'' chemical manufacturers or
    distributors.\64\ There are reports that use of shell facilities and
    weak oversight lets some chemical and pharmaceutical manufacturers
    avoid scrutiny, allowing companies to produce and sell beyond their
    legal limits.\65\ In 2007, industry insiders estimated that uncertified
    chemical manufacturers produced half of the APIs sold in China, with
    most exported to foreign markets.\66\ It is unclear how many
    uncertified manufacturers are supplying international API markets today
    or how many synthetic opioids or other precursors are produced and
    exported via shell entities. The Department of State also points to
    insufficient regulatory oversight and corruption of local government
    officials as explanations behind illicit drug and chemical
    production.\67\
    ---------------------------------------------------------------------------
        \63\ O'Connor, 2017.
        \64\ O'Connor, 2016.
        \65\ O'Connor, 2016.
        \66\ W. Bogdanich, ``Chinese Chemicals Flow Unchecked onto World
    Drug Market,'' New York Times, October 31, 2007.
        \67\ U.S. Department of State, 2017.
    ---------------------------------------------------------------------------
        Chinese authorities recognize these problems, and the government
    has made some efforts to expel corrupt officials. In 2015, President Xi
    Jinping demanded that authorities increase penalties and stiffen drug
    regulation.\68\ In March 2018, the central government proposed another
    reorganization of the CFDA, combining it with other regulatory
    entities.\69\ Industry observers suggest that this reorganization is
    intended to extend the agency's regulatory reach and reduce gaps in
    oversight.\70\
    ---------------------------------------------------------------------------
        \68\ World Health Organization, 2017.
        \69\ Xinhua News Agency, ``Explanation of the State Council's
    Institutional Reform Plan,'' March 14, 2018.
        \70\ A. Liu, ``China Creates New Drug Regulator in Biggest
    Government Overhaul in Years,'' FiercePharma, March 13, 2018.
    ---------------------------------------------------------------------------
                           potential policy responses
        Congress and Federal authorities have several existing options to
    combat the synthetic opioid crisis. However, given the scope of this
    problem and the new challenges it presents, Congress and executive
    agencies must look beyond available drug policy tools.
        First, given the lack of information about supply and demand, there
    is dire need to improve how agencies collect and analyze drug market
    indicators. Greater effort and resources are needed to improve
    measurement and analysis of seizures and overdoses, which are likely to
    be undercounted because of the novelty of analogues.\71\ Most of our
    drug policy data collection and analysis systems are inadequate to
    accurately estimate the number of drug-using individuals that are at
    risk of exposure to fentanyl or assess the arrival of synthetic opioids
    in a locality. Congress could direct Federal authorities to reintroduce
    expanded data collection systems, such as the Arrestee Drug Abuse
    Monitoring Program (ADAM) and the Drug Abuse Warning Network (DAWN) or
    other novel analysis methods, such as wastewater testing, which can be
    used to enhance measures of prevalence of use estimates as well serve
    as early warning systems to alert to the arrival of synthetic opioids
    in a market. Given how fast new substances emerge, we need to improve
    measurement and reduce data lags. This is crucial, considering the need
    for early warning systems to safeguard communities that have not yet
    been exposed to synthetic opioids. Additionally, more research is
    needed to understand the decisionmaking and operational processes of
    mid- and high-level importers so as to better craft policy responses to
    disrupt and deter on-line sourcing and distribution from individuals in
    the United States.
    ---------------------------------------------------------------------------
        \71\ C. J. Ruhm, ``Corrected US Opioid-Involved Drug Poisoning
    Deaths and Mortality Rates, 1999-2015,'' Addiction, Vol. 113, No. 7,
    2018.
    ---------------------------------------------------------------------------
        Second, Congress could encourage Federal authorities to work with
    Chinese counterparts to strengthen the country's regulatory and
    enforcement capabilities. In the short term, China needs to be
    approached as a steward of the international system and a global
    partner in protecting the public against the harms from drugs. This
    includes constructively engaging China and other partner countries at
    relevant multilateral institutions. In the medium term, efforts could
    be made to enhance joint partnerships in other areas of drug policy.
    The DEA has opened a new office in Guangzhou, yet greater collaboration
    is needed. For example, the problems of methamphetamine misuse in China
    may give way to enhanced U.S.-Chinese research into improved treatments
    and responses or joint law enforcement investigations that result in
    disruption of supply. In the long term, Congress could encourage U.S.
    regulators to engage with Chinese authorities to improve joint
    monitoring and evaluation efforts of regulation violations, as well as
    aid the CFDA hire, train, and retain qualified personnel. Congress
    could also consider appropriating additional resources to aid U.S.
    authorities that work with international partners and direct the FDA,
    DEA, Department of Homeland Security, and Department of State to
    improve interagency coordination and cooperation on synthetic opioids
    with Chinese counterparts.
        Third, there is a need to better understand and target producers,
    importers, and high-level distributors both in the United States and in
    China. The supply of synthetic opioids deviates from the traditional
    paradigm of plant-based drugs. Synthetic opioids are advertised and
    sold on the internet and often distributed via the postal system. This
    presents a challenge but also an opportunity to U.S. law enforcement in
    gathering evidence and informing threat detection. Additional resources
    and innovative thinking will be needed; Congress may consider
    strengthening cyber-intelligence gathering efforts already under way,
    such as the Department of Justice's Joint Criminal Opioid Darknet
    Enforcement team, or encourage new efforts aimed at producers and
    vendors that operate outside of the darknet. Additionally, enhancing
    DEA's ability to chemically analyze fentanyl seizures, through its
    existing Fentanyl Signature Profiling Program, might offer insights
    into illicit manufacture. With additional tools, resources, and a
    greater understanding of the problem, law enforcement might be able to
    rapidly build cases against importers as well as quickly share
    actionable information and intelligence with Chinese authorities to
    effectively prosecute producers and distributors that flaunt Chinese
    laws.
        Last and most importantly, we need to strengthen Federal efforts
    aimed at reducing demand for opioids and overdose risk. Demand
    reduction could lessen economic incentives for drug dealers and save
    the lives of those suffering from opioid-use disorder. Demand reduction
    for opioids includes improving access to existing and proven therapies,
    such as methadone and buprenorphine. Some steps that Congress could
    take are encouraging the expansion of pharmacological treatments
    covered by private and public insurance, subsidizing the cost of
    medication treatments to those who cannot afford them, and reviewing
    and reducing regulatory barriers on their provision. Congress could
    also direct Federal health authorities, such as the FDA, to assess
    additional innovative and evidence-informed medication treatments.\72\
    While expanding access to treatment may take time, greater efforts are
    immediately needed to reduce overdose risk. Increasing the availability
    of naloxone is one possible short-term, life-saving intervention.
    Recent analysis has found that direct dispensing of naloxone by
    pharmacists is associated with reductions in fatal overdoses.\73\
    Congress could look to reduce barriers to access to naloxone or
    subsidize its provision. Additionally, expanding access to
    interventions aimed at informing those who use drugs, especially
    stimulants, about the presence of synthetic opioids might be worth
    exploring. This could entail developing and disseminating tools, like
    test strips, aimed at detecting the presence of fentanyl or other
    synthetic opioids.
    ---------------------------------------------------------------------------
        \72\ There have been several randomized control trials examining
    the efficacy of other agonist therapies, including injectable
    hydromorphone and diacetylmorphine when treating those who have not
    benefited from routine treatments like methadone, see Beau Kilmer,
    Jirka Taylor, Jonathan P. Caulkins, Pam A. Mueller, Allison J. Ober,
    Bryce Pardo, Rosanna Smart, Lucy Strang, Peter H. Reuter, Considering
    Heroin-Assisted Treatment and Supervised Drug Consumption Sites in the
    United States, Santa Monica, Calif.: RAND Corporation, 2018. As of July
    19, 2019: https://www.rand.org/pubs/research_reports/RR2693.html.
        \73\ R. Abouk, R.L. Pacula, and D. Powell, ``Association Between
    State Laws Facilitating Pharmacy Distribution of Naloxone and Risk of
    Fatal Overdose,'' JAMA Internal Medicine, Vol. 179, No. 6, 2019, pp.
    805-811.
    ---------------------------------------------------------------------------
        The arrival of illicitly-manufactured synthetic opioids creates
    uncertainty in illicit drug markets, raising the risk of overdose.
    These substances are changing the drug policy landscape and stretching
    our ability to respond effectively. Decision makers will need to
    consider the new challenges presented by fentanyl and related
    substances to stem the rising trend in overdoses.

        Mr. Rose. Thank you for your testimony.
        I now recognize Mr. Hinson to summarize his statement for 5
    minutes.

         STATEMENT OF JAMES EDWARD HINSON, JR., DEPUTY CHIEF,
      INVESTIGATIVE BUREAU COMMANDER, GREENSBORO POLICE DEPARTMENT

        Mr. Hinson. Good morning, Chairman Max Rose, Ranking Member
    Mark Walker, Chairwoman Kathleen Rice, Ranking Member Clay
    Higgins, and Members of the subcommittee. Thank you for the
    opportunity to testify before you today.
        It is an honor to speak on behalf of the many dedicated
    professionals at the Greensboro Police Department, Chief Wayne
    Scott, City Manager David Parrish, and Assistant Manager over
    Public Safety Nathaniel Davis.
        As deputy chief, I currently serve as the bureau commander
    of the Investigative Bureau. I have had the honor of serving
    this agency for over 28 years and have served in various
    functions, including but not limited to Special Operations
    Division and the Patrol Bureau commander.
        The Greensboro Police Department is located in North
    Carolina. It is compromised of 667 officers and 101 non-sworn
    employees. The city has a population of over 290,000 citizens.
    The mission of our agency is: Partnering to fight crime for a
    safer Greensboro.
        I come before you today to discuss the opioid crisis.
    Eighty percent of all heroin users have started with
    prescription opioids. Seventy percent of all those who have
    received treatment for heroin addiction have relapsed. The age
    range most affected by heroin overdose is 25 years of age to 54
    years of age.
        There has been a 500 percent increase in overdose calls
    since 2014 for the Greensboro Police Department. In 2018, the
    Greensboro Police Department responded to 67 heroin deaths, 418
    overdose calls. In 2019, our agency responded to 56 heroin
    deaths and 319 overdose calls. In 2018, the Vice/Narcotics
    Division seized over 1,366 grams of heroin. In 2019, from
    January through June, we have seized 8,478 grams of heroin.
        Greensboro police officers are assigned as task force
    officers for short durations during their tenure. The officers
    are assigned to local, State, and Federal agencies for the
    purpose of providing coordinated investigative and enforcement
    functions.
        Federal law enforcement agencies tend to have a small
    number of special agents assigned to their field offices and
    rely on the assistance of local law enforcement agencies and
    TFOs to assist in accomplishing their missions. Task force
    officers have the ability to initiate Federal investigations,
    to include serving as sworn officers on a Federal warrant,
    Federal indictments, and Federal court orders.
        Drug Enforcement Administration and Homeland Security
    investigations coordinate with the Greensboro Police Department
    through Vice/Narcotics Division. Federal Bureau of
    Investigations-Counterterrorism and United States Secret
    Service coordinate with our agency through our Criminal
    Investigations Division.
        The detectives in the Vice/Narcotics Division utilize
    fusion centers, such as the El Paso Information Center, on a
    weekly basis, especially in the realm of interdiction. The
    information-sharing center allows the detectives to quickly run
    information they are gathering and make a rapid determination
    if the subjects of the investigation are involved with large-
    scale investigations that are on-going by other agencies.
        The Greensboro Police Department utilizes a small group of
    detectives assigned to Vice/Narcotics Division and are cross-
    designated as Federal task force officers with Homeland
    Security. These detectives are designed to identify,
    infiltrate, disrupt, dismantle narcotics trafficking and bulk
    currency smuggling organizations operating within our city.
        The Greensboro Police Department has assisted the DEA with
    providing statistical data regarding arrests and seizures in
    our area, which ultimately led to this area being classified as
    a High-Intensity Drug Trafficking Area initiative.
        November 2018, the interdiction group noticed a pattern of
    packages being shipped through the United States Postal
    Service. Through investigative methods, the group developed
    sufficient information to initiate a phone wire case on a
    particular group of individuals trafficking heroin and cocaine.
        After 6 months of the investigation, utilizing resources
    from the United States Postal Service, the DEA, and the North
    Carolina State Bureau of Investigation to conduct this
    investigation, the group was able to arrest 16 individuals and
    seize 4 kilograms of heroin, 1.5 kilograms of cocaine, 1.5
    pounds of marijuana, 8 firearms, and over $128,000 in cash.
    This was very significant for our city.
        The opioid crisis has left few untouched, with Americans
    dying every day from the opioid overdose. During my 28 years of
    service, I have witnessed families being destroyed, from
    children being born with neonatal abstinence syndrome or
    experiencing trauma as a result of a parent or family member's
    addiction.
        Families are being ripped apart because of the opioid
    crisis, resulting in higher criminal activity. Partnering law
    enforcement agencies are implementing solutions and addressing
    the problem through comprehensive approaches that include but
    are not limited to educational seminars.
        I thank you for the opportunity to testify before this
    committee today.
        [The prepared statement of Mr. Hinson follows:]
                 Prepared Statement of James Edward Hinson, Jr.
                                 July 25, 2019
        Good morning, Chairman Max Rose, Ranking Member Mark Walker,
    Chairwoman Kathleen Rice, Ranking Member Clay Higgins, and Members of
    the subcommittee. Thank you for the opportunity to testify before you
    today. It is an honor to speak on behalf of the many dedicated
    professionals at the Greensboro Police Department (GPD), Chief Wayne
    Scott, City Manager David Parrish, and Assistant City Manager over
    Public Safety Nathaniel Davis. As deputy chief, I currently serve as
    the Bureau Commander of the Investigative Bureau of the Greensboro
    Police Department. I'd had the honor of serving this agency for 28
    years and have served in various functions, included but not limited to
    the Special Operations Division, and as patrol bureau commander.
        The Greensboro Police Department is located in North Carolina and
    is comprised of 667 officers and 101 non-sworn employees. Our city has
    a population of over 290,000 citizens. The mission of our agency is,
    Partnering to fight crime for a safer Greensboro. Our vision states as
    the following: The Greensboro Police Department will be a National
    model for exceptional policing, through our commitment to excellence,
    selfless public service, and effective community partnerships. I come
    before you today to discuss the opioid crisis.
                                 opioid crisis
        An opioid is a prescribed controlled substance commonly used for
    pain management. With overuse or experimentation, anyone can become
    addicted. This addiction can drive users to heroin.
        Heroin is an illegal opioid and is typically injected into the
    blood stream. It often replaces prescription opioids due to
    availability and cost. Heroin can also be laced with a deadly drug call
    Fentanyl. Fentanyl can increase the overall potency that will often
    result in a stronger high.
        Fentanyl is a potent synthetic opioid pain reliever. It is
    impossible to measure the difference between a lethal or effective dose
    outside a laboratory, this drug is deadly. Fentanyl can be disguised as
    heroin to unsuspected individuals. Some individuals will gain access to
    Fentanyl and sell it as a very potent Heroin. This is where the
    majority of overdose deaths occur due to the unfamiliarity with the
    drug they are actually using.
       80 percent of all Heroin users have started with
            prescription opioids.
       70 percent of all those who have received treatment for
            Heroin addiction have relapsed.
       The age range most affected by Heroin overdoses is: 25 years
            of age to 54 years of age.
       There has been a 500 percent increase in overdose calls
            since 2014 for the Greensboro Police Department.
        In 2018, the Greensboro Police Department responded to 67 Heroin
    deaths and a total of 418 overdose calls for service. In 2019, the
    Greensboro Police Department has responded to 56 Heroin deaths and a
    total of 319 overdose calls for service.
        During my 28 years of service I have witness families being
    destroyed by this deadly drug often referred to as ``Opioids'' or
    ``Heroin'', due to overdose or criminal activity leading to
    incarceration or death.
        In 2018 the Vice Narcotics Division of the Greensboro Police
    Department has seized over 1,366.65 grams of Heroin and in 2019 from
    January through June there have been 8,478.80 grams of Heroin seized.
    Enforcement and Partnerships
        The Greensboro Police Department employs full-time, sworn police
    officers who are designated and assigned as Task Force Officers for
    short durations during their tenure. These Greensboro Police Officers
    are assigned to local, State, and Federal agencies for the purpose of
    providing coordinated investigative and enforcement functions and
    interoperability. This allows the Greensboro Police Department to
    maintain an on-going and effective relationship with Federal agencies
    operating within the same jurisdiction.
        Federal Law Enforcement Agencies tend to have a small number of
    Special Agents assigned to their field offices and rely on the
    assistance of local Law Enforcement Agencies and Task Force Officers to
    assist in accomplishing their agencies mission. Having Task Force
    Officers assigned to these agencies provides the ability to more
    effectively identify persons and businesses that conduct illegal
    activities that would otherwise go undetected.
        Officers have the ability to initiate Federal Investigations to
    include serving as an Affiant on a Federal Warrant, Federal
    Indictments, and Federal Court Orders. This allows the local government
    agency the ability to adopt local cases for Federal prosecution.
        Drug Enforcement Administration (DEA) and Homeland Security
    Investigations (HSI) coordinate with the Greensboro Police Department
    through the Vice/Narcotics Division. Federal Bureau of Investigations
    (FBI) Counter-Terrorism and United States Secret Service (USSS)
    coordinate with our agency through the Criminal Investigations
    Division.
        These partnerships allow investigations through the Vice/Narcotics
    Division with the United States Postal Inspection and with the NC State
    Bureau of Investigation (SBI). Most large-scale investigations in our
    agency involve the cooperation of one or all of the aforementioned
    agencies. These programs have proven to be beneficial to both the
    Greensboro Police Department and Federal agencies for years.
        Currently the Greensboro Police Department has 5 Vice-Narcotics
    Detectives that are designated as Federal Task Force Officers with
    Homeland Security. The primary nature of investigations initiated by
    Homeland Security and Task Force Officers include financial crimes,
    gangs, narcotics smuggling/trafficking, and weapons violations.
        The Detectives in the Vice/Narcotic Division utilize Fusion Centers
    such as the El Paso Information Center (EPIC) on a weekly basis,
    especially in the realm of interdiction. The information-sharing
    centers allow the detectives to quickly run information they are
    gathering and make a rapid determination if the subjects of the
    investigation are involved with large-scale investigations that are on-
    going by other agencies. This way the detectives can make contact with
    the agency currently investigating and maybe able to assist them with
    gathering information to further their investigation.
        The Greensboro Police Department utilizes a small group in the
    Vice/Narcotics Division with an Interdiction Initiative. This group is
    specifically designed to identify, infiltrate, disrupt, and dismantle
    narcotics trafficking and bulk currency smuggling (narcotics proceeds)
    organizations operating in the city of Greensboro that utilize
    legitimate businesses to illegally import and transport narcotics and
    the proceeds from this criminal activity into and out of Greensboro on
    both National and international levels.
        The Greensboro Police Department assisted the DEA with providing
    statistical data on arrests and seizures in our area which ultimately
    led to this area being classified as a High-Intensity Drug Trafficking
    Area initiative. Since being formed, the Investigative Interdiction
    Unit has been very successful in their approach to the detection and
    arrest of narcotics traffickers who utilize area hotels, motels,
    shipping corporations, and storage facilities.
        During the month of November 2018, the Interdiction group noticed a
    pattern of packages being shipped through the United States Postal
    Service. The interdiction group works closely with the Postal Inspector
    in the Greensboro area and began an investigation. Through
    investigative methods, the group developed sufficient information to
    initiate a Title III (Phone wire) case on a specific group of
    individuals trafficking heroin and cocaine into the area.
        The group utilized resources from the USPS, DEA, and NC SBI to
    conduct the investigation. After 6 months of investigation, the group
    was able to arrest 16 individuals and seize 4 kilograms of heroin, 1.5
    kilograms of cocaine, 1.5 pounds of marijuana, 8 firearms, and
    $128,250.00 cash. This is a significant outcome for our area especially
    in combating the opioid epidemic.
        In summation, this opioid crisis has left few untouched, with
    Americans dying every day from opioid overdose. Families are impacted
    from children being born with neonatal abstinence syndrome or children
    experiencing trauma as a result of a parent or family member's
    addiction.
        Families are being ripped apart because of the opioid's crisis
    resulting in higher criminal activity. Partnering law enforcement
    agencies are implementing solutions and addressing the problem through
    comprehensive approaches that include but are not limited to
    educational seminars.
        I thank you for this opportunity to testify before this
    subcommittee.

        Mr. Rose. Thank you for your testimony.
        I thank all the witnesses for their testimony.
        I will remind each Member that he or she will have 5
    minutes to question the panel.
        I will now recognize myself for questions.
        To begin, Ms. McCauley, you had mentioned that at Kennedy
    Airport specifically we are looking at 0.01 percent of mail
    being screened. Would it be, then--could we surmise that less
    than 1 percent of the fentanyl coming into that airport is
    seized?
        Ms. McCauley. I wouldn't be able to make that calculation,
    but I would say that they are not screening and identifying
    everything.
        Mr. Rose. OK.
        Ms. McCauley. I should indicate that the 0.01 percent, that
    is what is targeted, in terms of the amount of mail that they
    are looking at. CBP has an agreement with the Postal Service
    that they can also select other mail based on subjective
    assessment as well as risk-based assessments apart from ATS.
        Mr. Rose. Now, you made a series of recommendations. Have
    those been adopted in the roughly 6 months or more since your
    report came out?
        Ms. McCauley. No. Those recommendations are still open at
    this point. One recommendation is closed, but it was on
    unrelated issues involving some information technology servers
    and----
        Mr. Rose. So fentanyl is coming into our country through--
    50 percent of our international mail comes to Kennedy.
        Ms. McCauley. Yes.
        Mr. Rose. You made a series of recommendations. If adopted,
    they would have saved lives. Those recommendations are still
    open?
        Ms. McCauley. They are still open. We have a follow-up team
    out at JFK, and they are looking to see what more----
        Mr. Rose. We wonder why people hate government. A year.
    Recommendations still open. Canine teams, technology,
    resources.
        Ms. McCauley. Yes.
        Mr. Rose. They have not shown any sense of urgency to adopt
    these. Is that correct?
        Ms. McCauley. Our teams that are on the ground now are
    looking into these issues. They are seeing some improvement.
    They are going to be reporting out this fall in terms of----
        Mr. Rose. Some improvement. Are they adopting the
    recommendations, ma'am?
        Ms. McCauley. Some improvement, yes----
        Mr. Rose. I will make sure to pass on that next time I have
    to go to a funeral from someone who has overdosed from
    fentanyl-laced heroin.
        Ms. Brennan, I want to get an understanding of how fentanyl
    is coming into New York City. It is coming in through Kennedy.
    How else is it coming?
        Ms. Brennan. Well, there are two ways. Bulk fentanyl tends
    to come in overland from across the Southwest Border. Often it
    is mixed into loads of heroin. So if we seize a truck or a car
    that is carrying a very large load--100 pounds, 50 kilos,
    whatever--some of those kilos might be fentanyl, some might be
    heroin.
        Mr. Rose. OK. But how is the pure fentanyl getting to
    Mexico?
        Ms. Brennan. The pure fentanyl, as far as I know, there are
    two different methods. To a certain extent, the fentanyl itself
    is transported from China. Also the precursor chemicals are
    coming into Mexico, and then they are producing it there.
        Mr. Rose. OK. Thank you.
        Ms. McCauley, there was an interesting note that I saw in
    your report saying that our targeting system relies on getting
    advance data from foreign countries.
        Ms. McCauley. That is correct.
        Mr. Rose. But that means we need to have an agreement with
    foreign postal offices to do so. Do we right now have an
    agreement with China to get advance data on inbound mail?
        Ms. McCauley. It is my understanding that we don't have an
    agreement with China.
        Mr. Rose. Have we approached China to try to institute that
    agreement?
        Ms. McCauley. I don't know that----
        Mr. Rose. OK. You can count that we are going to track that
    down.
        Dr. Pardo, I want to look to the future a little bit here.
    Does China right now have a monopoly on the production of
    fentanyl?
        Mr. Pardo. In terms of the illicit production of fentanyl,
    according to law enforcement, the bulk majority that we are
    seizing is coming from China. That said, I mean, this stuff can
    be made very easily elsewhere.
        Mr. Rose. Has China done enough to crack down?
        Mr. Pardo. China has responded in some ways. They have
    controlled new chemicals at our behest. Most recently, they
    have adopted a generic ban on all fentanyl-related structures.
    We don't know what the impact of that will be. It will take
    time in order to ascertain how effective that is.
        But, nonetheless, fentanyl itself is still predominant in
    drug seizures and overdose deaths. Fentanyl is a medication.
    Fentanyl is produced legitimately in China as well.
        Mr. Rose. Is there the potential for fentanyl to also be
    weaponized? I know that we saw this in 2002 when the Russians
    attempted to overtake an area where hostages were held and they
    used a derivative of fentanyl.
        Mr. Pardo. Yes, that is one recent event in which fentanyl-
    related analogues were used in kind of a weaponized system. To
    my knowledge, I am not aware of anybody doing that, but that is
    not something I have researched.
        Mr. Rose. OK.
        What other countries should we look at as potential places
    where fentanyl could be produced on their own?
        Mr. Pardo. So, beyond Mexico and China right now, which are
    the largest exporters to the United States, according to law
    enforcement data, India is on the horizon. Late last year,
    there were two substantial seizures of fentanyl that were
    inbound, leaving India, inbound to North America, destination
    unknown. But that is the next place where it could go. India
    has a substantial pharmaceutical industry and lacks resources
    to police it.
        Mr. Rose. Thank you for your time and your answers.
        I now recognize Ranking Member Walker.
        Mr. Walker. Thank you, Mr. Chairman. Excellent questions
    there.
        Deputy Chief Hinson, the numbers you stated in your
    testimony, if I am reading this correctly, are very eye-opening
    to just how bad the crisis is throughout the country. I think
    the one number that stood out or popped to me was that, if I
    get this correctly, in the past 5 years, the Greensboro Police
    Department has seen a 500 percent increase in 9-1-1 calls
    related to overdoses related to opioids.
        Is that number accurate? Did I get that correctly?
        Mr. Hinson. Yes, sir. That is correct.
        Mr. Walker. My question, then, is, how does your department
    handle this increased workload when you are seeing those kinds
    of spikes?
        Mr. Hinson. Well, the first thing, we are going to make
    sure that we send out our officers with the appropriate
    staffing level. I would just also say this. We can't measure
    the dedication that our professionals have. They go out each
    and every day, and they answer the calls for service. They do
    that with a high level of just dedication to get that done.
        But, also, we look at their training component as well. We
    make sure that our officers are trained properly so that they
    can go out and respond to these calls on a daily basis.
        They do it very well. They do it in such a way that we are
    trying to save lives. In order to do that, we have to continue
    to try to educate our community about the dangers of opioids.
        Mr. Walker. Speaking of dedicated professionals, you are
    closing in on three decades. What trends have you noticed in
    drug trafficking, including types of drugs, volumes, the
    origins? Can you elaborate on that a little bit?
        Mr. Hinson. Well, I can talk about that just a little bit.
    But the trends are--we are seeing a lot of drugs coming from
    Mexico into our community, and other countries as well--
    Thailand, Turkey.
        What we are trying to do is to continue to work with the
    DEA, the FBI, and Homeland Security, because without those
    particular agencies, we would not be as successful as we are.
    Our task force officers are working with them daily, weekly,
    gathering intel, and this intel proves to be invaluable,
    because we are able to identify individuals, groups that are
    bringing these drugs into our community.
        As I stated before in my testimony, we arrested 16
    individuals as a result of a wire case. That initiated from
    packages being brought into the Postal Service system, and once
    those were detected, we were able to begin an investigation,
    and it was pretty far-reaching. As a result of that, we were
    able to take a large quantity of drugs off of the street.
        Again, it is all about accountability. We have to continue
    to be proactive, and we have to hold these individuals
    accountable that are bringing these dangerous drugs into our
    community. Not only--once we make those charges, we are looking
    for prosecution to the fullest extent of the law.
        Mr. Walker. OK. Well, then let me ask that. It leads to my
    next question. You guys are obviously on the front line. What
    Federal-level support do you need to go after these guys and
    the root systems?
        You mentioned several countries there, other foreign
    countries, that are arriving with these substances in
    Greensboro. What do you need from the Federal level?
        Mr. Hinson. I would say right now, sir, everything is going
    fine. Our communication is great. Anytime that we need anything
    from any one of those agencies, they are there to assist us. We
    are there to assist them. We have a great working relationship,
    a great partnership, and it has proven to be very productive.
        Mr. Walker. Unpack that a little bit for me. Talk about the
    relationships that you guys have with the DHS, the FBI, the
    DOJ. Can you paint us a little picture there?
        Mr. Hinson. Well, we have task force officers that are
    assigned to each one of those agencies, and they work very
    closely with those agencies. They take that information and
    they bring it back to our agency, and we kind of peel back that
    information, so to speak. Then we continue to work together by
    identifying those individuals that are bringing drugs into our
    community.
        The identification piece is very important, because without
    the exchange of communication with these particular agencies,
    we would not be able to identify these individuals. Once we
    identify those, then we put parameters and operations in place
    so we can make arrests.
        Mr. Walker. You are seeing some success in combating this.
    Talk to me----
        Mr. Hinson. Yes, sir.
        Mr. Walker [continuing]. About a program--and I have 40
    seconds left. Just talk to me a little bit about something
    specifically that you feel like is the reason that you guys
    are--you still have a long way to go, but are starting to get a
    handle on this.
        Mr. Hinson. Well, I will just say, one particular program
    that we have initiated to specifically try to save lives is our
    Vice/Narcotic detectives, they are making contact with overdose
    victims each and every day.
        We are not doing that to do that in such a way to belittle
    them. We are doing that in such a way to let them know that, if
    they need help, we are there to help them. We can refer them to
    various treatment centers. But we can also obtain information
    from them that could lead to further arrests.
        So that has proven to be very, very beneficial, and just
    working with the other agencies in our community. I believe
    that it is all about building a foundation. Continuing to build
    that strong foundation, we can definitely make some strides as
    it relates to the opioid crisis.
        Mr. Walker. Deputy Chief Hinson, your service is making
    this country better. I just want to say thank you.
        Mr. Hinson. Thank you.
        Mr. Walker. I yield back.
        Mr. Rose. Thank you, Ranking Member Walker.
        I now recognize Chairwoman Rice from the great State of New
    York.
        Miss Rice. Thank you, Mr. Chairman.
        Ms. Brennan, I would like to start with you. You mentioned
    the dark web. If we look back at the history of the dark web
    vis-a-vis drug sales, so it starts with the Silk Road, which
    was the original Darknet market which came on-line in 2011 and
    only sold, I think at that time, some psychedelic mushrooms and
    stuff like that.
        So when that was taken down in 2013, it was believed, after
    the takedown and the jailing of the founder, that that was
    going to serve as a deterrent to future imitators. But fast-
    forward to 2017, we had the takedown of two of the biggest
    successors of Silk Road, AlphaBay and Hansa market. At that
    time, there was 5 times as much traffic happening on the
    Darknet as there had been at the time of the takedown of the
    Silk Road at its peak. The Wall Street Market shut down in May
    of this year had, I believe, one-seventh as many vendors as
    AlphaBay. So we have seen kind-of this up, down, kind-of like
    that.
        Now, I know that in early 2018, when the FBI created the
    Joint Criminal Opioid Darknet Enforcement team, or J-CODE, this
    was specifically meant to address this kind of stuff from the
    Darknet. You also had the Justice Department focusing on
    techniques that create distrust on the dark web for buyers by
    convincing them that sellers are actually giving info to law
    enforcement.
        So kind-of with that backdrop, can you just talk about your
    experience dealing with this whole dark web, just expound on
    that a little bit more, and what your experiences working with
    the Federal authorities are, and any thoughts you have on how
    we can address? Because the web, the internet is not going
    away, so we have to figure out a way to stay on top of that.
        Ms. Brennan. I think you have hit on a key point.
        The dark web, what we see is a source usually of fentanyl
    analogues, which are little tweaks on the fentanyl molecule,
    often unregulated, that come in in very high concentrations.
    Those are the ones we see coming through JFK, through all kinds
    of different services that you can access on the dark web,
    offering such things as a free product in case the initial one
    becomes seized. Often the payment is in bitcoins.
        For all those reasons, it is very, very difficult to track.
    The entrepreneurs on the web are far more advanced, usually,
    than our investigative staff. It is hard to get the kind of
    expertise at the kind of salary that we are able to pay to
    really penetrate this web.
        I think you have hit on one of our key challenges,
    particularly with the onslaught of things coming in through
    these shipments through JFK. You can get an analogue that
    contains enough to kill many people in a greeting card. I mean,
    it is just a tiny package because it is a tiny, concentrated
    amount.
        So I think we need to continue our coordinated efforts in
    this regard. Any support that can be added to our efforts would
    be greatly appreciated. We need these combined task force,
    because there is a lot of knowledge in the various agencies,
    Federal agencies in particular. Working with local prosecutors
    or local police forces, I think it can really advance on this.
        Miss Rice. So in your opinion, who do you think, what
    agency, if one exists, has that kind of expertise that you are
    talking about that your specific agency is lacking because of
    whatever it is, the salary limits or----
        Ms. Brennan. Well, the FBI has been leading the way on many
    of these efforts. His has significant resources and significant
    intelligence.
        I don't think there is any one source. What I have seen
    is--actually, it is individual. There are unique individuals
    who are absolutely committed to enforcement and like doing this
    work. So I can't pinpoint any one agency, although I do believe
    the FBI is taking the lead.
        Miss Rice. So this committee is also focused on analyzing
    bitcoin, which is this kind-of new--we have to figure out what
    to do in that space as well.
        But I want to commend you, because you and I go back a long
    way from when I was DA in my home county, and you have always
    been such a fierce advocate for just aggressive techniques and
    cooperating with other agencies. I think that is in large part
    why you have been as effective as you have been.
        So I want to thank you. It is good to see you here in the
    District of Columbia.
        Ms. Brennan. Thank you very much.
        Miss Rice. I just have one additional quick question for
    Mr. Pardo.
        You talked about drug policy data collection. How can we do
    it better?
        Mr. Pardo. So right now we are limited in terms of
    understanding what or how these markets are transitioning away
    from heroin toward fentanyl. There are data lags in overdose
    deaths, in seizure data. We really don't know what is going on
    today given that what the CDC is putting out is 2 years later.
    We have data now in 2018. The lags are really kind-of what is
    bothering here.
        In addition to that, the other limitation is that we don't
    know what we are measuring given that these new analogues don't
    exist, there is no referent in order to test them.
        So using the mass spectrometry to actually understand what
    are in the seizures, we are doing the appropriate toxicological
    screens to determine whether or not that individual consumed
    carfentanyl or some sort of other analogue is important. That
    will allow us to better understand how these substances are
    moving from markets to markets.
        Miss Rice. We have to focus on that. I would like to
    continue this conversation with you after this, because that is
    the key. You have to have the data to understand where to go in
    the future.
        Thank you very much, Mr. Chairman.
        Thank you to everyone here.
        Mr. Rose. Thank you, Madam Chairwoman.
        I would also like to acknowledge on behalf of the committee
    your extensive work over the course of your career in this
    field as a prosecutor and also as a legislator.
        With that, we now recognize Ranking Member Higgins from the
    great State of Louisiana.
        Mr. Higgins. Thank you, Mr. Chairman.
        Mr. Chairman, according to the DEA, China is the main
    source of both illicit manufacturing of pure fentanyl as well
    as the precursors that are being shipped to other countries
    like Mexico for manufacturing of fentanyl.
        Fentanyl is illicitly manufactured in China and either
    shipped directly into the United States or processed at
    clandestine labs in Mexico primarily and smuggled by drug
    cartels into the United States.
        The STOP Act passed in the 115th Congress requires advanced
    electronic data for all international mail shipments entering
    the United States to help identify suspicious packages.
        Ms. McCauley, that is a phenomenal amount of mail to check
    electronically. Would you agree it is a tremendous task we are
    asking our professionals to accomplish?
        Ms. McCauley. Yes.
        Mr. Higgins. Dr. Pardo, let me ask you about technology
    that you, perhaps, know of, sir. To the best of your knowledge,
    is there a commercially available technology that exists right
    now that could move us closer to 100 percent scanning at our
    mail facilities?
        Mr. Pardo. One hundred percent? Probably not. There are
    enhanced mass spectrometry handheld machines, infrared
    spectrometry, that allow for kind-of quick detection, that
    allow for a line operator to scan a package and determine what
    powder is in that package.
        That said, the problem with the analogues is that it only
    tests against the known universe of chemicals. The chemical
    that is designed last week, we don't know about it yet. So that
    machine is not going to detect it. So that is a new challenge
    that we are facing, and there are really no solutions right
    now.
        Mr. Higgins. So slight changes in the formulation can
    prevent detection of the----
        Mr. Pardo. It makes it much harder to detect, yes.
        Mr. Higgins. Right. That makes sense.
        Well, medical studies concur that a lethal dosage of pure
    fentanyl can be as low as 250 micrograms. Just to put that in
    perspective for America, that is less than a grain of sand.
        Mr. Hinson, thank you for your service, my thin blue line
    brother.
        I would like to ask you. You had referred to an
    investigation that yielded results and made arrests and seized
    some drugs. Congratulations.
        Are you aware of international cooperative detective work
    that can help our Postal Service, our incoming inspection
    endeavors, to catch incoming shipments? Is there a cooperative
    effort internationally that you are aware of from the street
    level that exists or that can be enhanced?
        Mr. Hinson. Well, I would just speak what our agency is
    doing, sir.
        We do have an outstanding relationship with the Postal
    Service inspection. We frequently utilize our canine to go and
    visit----
        Mr. Higgins. Isn't fentanyl, in its purest form, dangerous
    for canines?
        Mr. Hinson. Sir?
        Mr. Higgins. Isn't fentanyl, it is dangerous for canines,
    is it not?
        Mr. Hinson. Yes, sir.
        Mr. Higgins. We are going to try and help America
    understand how dangerous this stuff is.
        Mr. Hinson. OK. All right.
        Mr. Higgins. To inhale a grain of sand is pretty easy, for
    anybody who has been to the beach.
        Mr. Hinson. Yes, sir.
        Mr. Higgins. So when a police officer finds a suspicious
    package that we suspect might be fentanyl, it is almost like
    discovering a bomb in the trunk of a car, is it not? You have
    got to be very careful with it.
        Mr. Hinson. You have to be very careful, sir, and use
    caution.
        Mr. Higgins. So large seizures of drugs, when America reads
    about that in the newspaper, so many tons of drugs seized in a
    truck on a highway or a boat coming into port, what America
    doesn't know generally is that is because of detective work.
    That is not blind luck. There is some work that was done that
    was tracking that vehicle or that boat.
        Mr. Hinson. Yes, sir.
        Mr. Higgins. Then the investigation, you had reasonable
    suspicion based upon the detective work, and, bam, you seize
    the drugs.
        Is there a cooperative effort like that for fentanyl, for
    any panelist, can you answer this, at the international level
    regarding tracking incoming fentanyl in its purest form into
    our country?
        Mr. Hinson. Well, I will say this. The work that we do, of
    course, is on a local level, and our partnerships with the
    various Federal agencies allow us to also look at other
    international components of this, drugs coming in from Mexico,
    Thailand, Turkey, or whatever the case way be. So oftentimes,
    once we make these arrests local, we will again get additional
    information of the source of the original----
        Mr. Higgins. You will feed that to your partners?
        Mr. Hinson. Sir?
        Mr. Higgins. You will feed that data to your partners?
        Mr. Hinson. Yes, sir. We will feed that.
        Mr. Higgins. In the interest of time, Mr. Chairman, Dr.
    Pardo perhaps can answer the question, and I will yield after.
        Mr. Rose. Of course.
        Mr. Pardo. In terms of the international law enforcement
    and supply reduction efforts, there are multilateral
    institutions. The International Narcotics Control Board is one
    of them. They do try to take in information in terms of
    seizures in order to allow other law enforcement agencies
    across the globe understand what is been seized where, in order
    to really help with the metrics, the risk metrics.
        The World Customs Organization may also be one additional
    multilateral organization that could be helpful in terms of
    sharing information about what is being seized where.
        Mr. Higgins. I thank you all for being here today.
        Mr. Chairman, I yield. My time has expired.
        Mr. Rose. Thank you, Ranking Member Higgins.
        The Chair now recognizes Mr. Correa from California.
        Mr. Correa. Thank you, Mr. Chairman.
        First of all, I want to thank all the witnesses for being
    here today and the good work you do for our citizens.
        Chief Hinson, I just want to say that I agree with you. I
    think all of us have been touched by this scourge in our
    society. My boy played Little League a number of years ago, and
    one of his good friends, a star pitcher, we thought was going
    to be the next major leaguer. You know what? He is very much
    addicted to the scourge.
        Tragedy after tragedy in our communities, and every day I
    pray that my kids are not victims. It touches all of us.
        As I listened to the discussion here, I am reminded of the
    history of addiction and the situation we have today.
    Prescription drugs right now in California, the No. 1 killer,
    overdoses in California. Of course, ever increasing, of course,
    is synthetic opioids.
        To think about the history, 30, 40 years ago most of the
    drugs coming into this country were through the Caribbean. A
    lot of drugs coming through the Caribbean. We were very
    successful in interdicting those drugs. The shift of trade went
    inland. So you had Central America and Mexico now being the
    main area of trade, destabilize those countries where there are
    drug dollars and a lot of scourge.
        We are very good now. We are kind-of clamping down on that.
    According to my Coast Guard information officers, now most of
    the trade is beginning to emerge in the eastern seaboard. Now
    you begin to have not 1 or 2 pounds, but thousands of pounds,
    thousands of pounds coming in through the eastern seaboard,
    cocaine laced with fentanyl.
        One of you just mentioned India is the next place that is
    emerging. Canada, I notice in this information.
        So I almost feel like we are fighting a fight that we
    continue. Every time we bottle something up, we have got the
    internet that pops up. You have bitcoin that pops up.
        So my question to all of you is, how do we work with Nancy
    Reagan, who said just say no? How do we as a Federal Government
    help you at the local level generate educate our kids so they
    just say no?
        Those kids out in the street, I don't think recognize the
    dangers, or adults, like Mr. Higgins said, where a culture that
    maybe is changing just too much too fast.
        How do we work with you in those local community groups,
    churches, schools, to begin to again emphasize we have to say
    no?
        Ms. Brennan. May I?
        Mr. Correa. Yes, please. It is a question to all of you.
        Ms. Brennan. What I would like to just point you to and
    suggest that you deeply explore is some of those communities
    where we are seeing progress. In Staten Island, Chair Rose was
    just in Staten Island a couple weeks ago where Staten Island
    was announcing a 40 percent decrease in overdose deaths and in
    naloxone use over the last 6 months, the past 6 months of this
    year. Long Island has reported significant decreases both in
    overdose and in naloxone use.
        There are pockets across the country where we are seeing
    success. The only thing that I have been able to see is a
    concerted effort kind-of throwing everything we have got at
    this problem.
        I suggest that if we can really drill down into those
    programs, the DAs in both Staten Island and Nassau County and
    Suffolk County have run very effective that is going on across
    the United States, Dayton, Ohio, has reported great success, if
    we can drill down and take a look at what is working and then
    try to match it up to other communities that are similar, we
    might see success.
        Mr. Correa. Chairman, I am running out of time. But I think
    that is what we need to do, is try to find those model programs
    that are working and duplicate them across the country.
    Because, again, these drugs pose such danger to our front-line
    officers, men and women, whether it is the airports, on the
    streets, when they come in contact with this scourge.
        I think we have just got to figure out how to double down,
    as you said, Ms. Brennan, and make sure kids know the dangers.
        Mr. Pardo.
        Mr. Hinson. I will be quick.
        I will just say this. I think we have to have those
    conversations with our kids at a very early age and to let them
    know the dangers of this and to continue to work with various
    programs, such as the Guilford County solution to the opioid
    problem, partnering with them. They have advocates that will go
    out and make contact with individuals who are suffering from
    the opioid crisis.
        Because many times many of these individuals feel as though
    they are alone and no one wants to walk with them down this
    road of recovery. But you have many agencies that are willing
    to do this.
        I think that it is very important that we continue to work
    with those agencies and support those agencies, because we
    definitely can't arrest our way out of this situation, but we
    can definitely work with the many partners to make a
    difference.
        Mr. Rose. Thank you, Mr. Correa.
        Ms. Brennan, thank you for noting the incredible success we
    have had on Staten Island. I believe what--I know what has been
    accomplished on Staten Island is that they have figured out how
    to build a structure whereby the key partners are regularly
    gathering around a table and it has become operationalized, law
    enforcement, hospitals, social service providers, district
    attorney, EMS, nonprofit sector, faith-based institutions. It
    is not just a one-off press opportunity. We are seeing the
    numbers.
        But I would also like to say that as these grant programs
    begin to still proliferate, and they rightfully should, and we
    are building up these systems, it only shines a light on how
    important fentanyl is. Because the issue with fentanyl is that
    people are not getting a second chance. We are not getting that
    opportunity to bring people into recovery. We are not getting
    that opportunity to integrate people into programs that we know
    work. It kills them right away.
        What we see right now, to put it into the plainest terms
    for the American people, is one nation, China, producing
    something that is killing over 30,000 Americans a year, 30,000
    Americans a year, produced by one country. If that doesn't
    shock our consciousness, I don't know what does.
        With that, I would like to recognize Mr. Guest from
    Missouri.
        Mr. Guest. Thank you, Mr. Chairman.
        To our witnesses----
        Mr. Rose. Mississippi. Mississippi. I am an ignorant New
    Yorker. My mistake.
        Mr. Guest. To our witnesses, I want to thank you for being
    here today. I want to thank you for playing such an important
    role in an epidemic that we see touch all corners of our
    country.
        Dr. Pardo, I want to ask you a couple questions. From your
    report, I see on page 4, you give some statistics there.
    Actually then continuing over on page 6 there is a table. But
    on page 4 of your report, that you note that the Customs and
    Border Protection agency in 2013 seized approximately 1
    kilogram of fentanyl. Then we see 5 years later, in 2018, we
    see that number has jumped to 1,000 kilograms. So within a 5-
    year window we see a 1,000 percent increase as far as seizures
    along our Southwest Border.
        Then in 2018, we see here on the table that you have
    included in your testimony, on page 6, that there was a total
    of roughly 994 kilograms that were seized. Of that, 85 percent,
    roughly, comes across our Southwest Border.
        Then you continue on, on page 8. You state in here, in
    recent years, there has been a noticeable increase in the
    amount of fentanyl seized at the U.S. border by law enforcement
    and Mexican authorities. Mexican drug trafficking organizations
    are importing fentanyl and precursors from China. Then you even
    go on later, and you talk about clandestine laboratories that
    have been seized in Mexico.
        So, in addition to China, which is where I understand a
    large amount of the fentanyl is produced or where the chemicals
    or precursors are produced, it seems like we are seeing a
    growing role in Mexico's importation, illegally, of course, of
    fentanyl.
        So my question to you, Dr. Pardo, is what can we do, in
    addition to working with law enforcement authorities in China,
    what can we do to work with our partners in Mexico to try to
    stem Mexico as being a distribution center of fentanyl where we
    know that that fentanyl, once it enters the United States, is
    then shipped across our country?
        Mr. Pardo. That is a good question.
        Mexico seems to be kind-of not as a big of a problem as
    China. But that said, we do have good working relationships
    with Mexico. We have had decades of collaborative drug
    interdiction efforts with joint--with the Marines down there,
    with DEA here.
        That said, this is novel. This is new. The challenge that
    is posed by fentanyl is such that a cartel really could cut a
    lot of the cost, operating cost, moving away from poppy, which
    takes 3 months to harvest, which requires labor, which you have
    to rely on enough sun and water to generate enough harvest. You
    can produce synthetic opioids pretty much anywhere in a couple
    of days in a lab in, say, Mexico City.
        So that really changes the way we need to think about this
    problem in terms of supply interdiction. It is going to take
    more intelligence gathering. It is going to take kind-of
    innovative thinking in terms of working with our partners down
    there and trying to understand how the sourcing works, how
    these distribution channels work, who is doing what.
        I think the long-term prospects of poppy declines in Mexico
    is a real potential. If the cartels see this as one way to
    really boost profits, which it definitely is, then Mexico might
    no longer be a poppy-producing country. It might be that you
    see more synthetic opioids coming from that country.
        Mr. Guest. Just as we have seen Mexican drug cartels many
    years ago began moving into the production of methamphetamine,
    do you see a model or a situation in which Mexico at some point
    could be really just as big a threat as China in the fact that
    they would be able to synthetically produce that, they would be
    able to produce it much closer to our communities, and then use
    the established drug cartels to then smuggle the fentanyl in,
    as they are doing now and as they have done with
    methamphetamine and cocaine and marijuana before that?
        Mr. Pardo. It is possible long-term. The difference,
    though, right now is that it doesn't seem that there are a lot
    of analogues coming out of Mexico. The analogue generation
    seems to be part of China, given that there is a large
    pharmaceutical industry, capable individuals with the knowledge
    to develop these new substances.
        It doesn't seem like Mexico has learned that yet. They are
    producing fentanyl, just classic old fentanyl.
        So that does change some of the kind-of risk problems.
    Since carfentanyl is much more potent then fentanyl, it can
    shipped by mail very easily. So the challenges from China are a
    little bit different.
        That said, the long-term prospects of Mexican cartels being
    able to learn the synthesis methods for carfentanyl or other
    opioids are there. I mean, it just makes enough research to do
    it.
        That said, it doesn't have as large of a pharmaceutical
    industry as China, so it might not ever really get to that
    point where it becomes as large. But the long-term prospects
    are something to consider.
        Mr. Guest. Dr. Pardo, I am over time, but I want to ask one
    quick question, and then I will yield back.
        What can we do to better secure our border to stop the
    flow, not just the fentanyl but other illegal drugs from coming
    into our country?
        Mr. Pardo. That is going to be a challenge. It always has
    been a challenge with cocaine and heroin.
        Efforts by CBP have been Herculean in many respects. They
    do see a lot of product, especially given that these are points
    of transit. A lot of trade happens through this border.
        It is going to be increasingly difficult given the potency
    of these substances. It just makes it easier to conceal a
    smaller amount of the same morphine milligram equivalent over
    the border.
        Mr. Guest. Mr. Chairman, I yield back. I apologize for
    going over my time.
        Mr. Rose. I apologize for messing up which State you are
    from, so I guess we are even.
        I now recognize Ms. Clarke from Brooklyn.
        Ms. Clarke. Thank you very much, Mr. Chairman. I thank our
    Chairpeople, our Ranking Members of this very important
    hearing. I want to thank our expert panelists today.
        We know that the opioid crisis is devastating our Nation,
    including our beloved New York City, where both the Chairman
    and I hail from. In 2017, there were 3,224 opioid overdose
    deaths in New York State. That is a rate of 16.1 deaths per
    100,000, higher than the National average of 14.6 deaths. That
    is why I fought hard for a comprehensive approach to this
    challenge.
        In the last Congress, I joined with my colleague
    Representative Adam Kinzinger of Illinois to introduce the
    Opioid Addiction Action Plan Act. My bill required the Center
    for Medicare and Medicaid Services to create a comprehensive
    strategy to combat the crisis, including a plan to reduce the
    cost of opioid overdose reversal drugs. Thanks to my role on
    the Energy and Commerce Committee, my bill was signed into law
    last October as part of the SUPPORT for Patients Communities
    Act.
        But DHS also has a critical role to play in tackling the
    crisis. At the end of the day, CBP is charged with stopping the
    flow of deadly fentanyl from China, which arrives by mail in
    airplanes. Meanwhile, our Coast Guard is tasked with preventing
    the illicit import of opioids by sea. DHS must give this crisis
    the priority it demands until the flow of opioids is ended.
        So my question is to you, first of all, Ms. Brennan. You
    said in your testimony that only the first wave of the crisis,
    the flood of addictive prescriptive drugs, involved drugs
    manufactured in the United States. The newest threats, from
    Chinese fentanyl to synthetics, often come from abroad.
        Given New York City's role as a hub of global commerce and
    international travel, we serve as a key entry point for many
    opioids. What Federal resources would help our city's
    facilities, such as the international mail terminal and JFK,
    better prevent opioid importation?
        I want to extend that to you as well, Ms. McCauley.
        Ms. Brennan. From our local perspective, we do work closely
    with CBP and with Homeland Security Investigations sometimes.
    Usually we are working the cases backward. We find the
    analogues on the street. We find out who is supplying them. We
    realize that the supply is coming in through the mail. Then we
    try to contact CBP to match up the person who is receiving with
    whatever package is coming in.
        These are teensy packages. It comes in in what purports to
    be a package of lingerie or a greeting card, because the
    concentrations are so high that the amount coming in can be
    very, very small.
        So literally for CBP, I do think it is like looking for a
    needle in a haystack. But they have had significant outreach
    efforts with us most recently. We have had several meetings
    with them and with Homeland Security Investigations to try to
    tighten up our partnership and for us to understand our access
    to them. That has been very helpful.
        The DEA is extraordinary. They, too, have been working very
    hard to penetrate the dark web, which is where this originates.
    So I think strengthening all those partnerships and supplying
    adequate resources.
        Each of these new fentanyl analogues has a new structure.
    Because they are in such higher concentrations, it takes a
    significant amount of time to identify them. So the CBP's
    guidelines don't fit with the amount of time it takes.
        So I think we can do some tweaking there. But many of our
    partnerships are very, very strong, and I commend the excellent
    work they do.
        Ms. Clarke. Ms. McCauley, your observations?
        Ms. McCauley. We haven't done any work in that area in
    terms of CBP outreach to local communities, so I couldn't speak
    to that.
        Ms. Clarke. What about your observations just in terms of
    the port of entry in terms of your interactions? Are there
    interactions with CBP?
        Ms. McCauley. I am not----
        Ms. Clarke. So the airports, are you seeing any
    collaboration there with respect to----
        Ms. McCauley. No, we did not look at that as part of our
    audits.
        Ms. Clarke. OK. Very well.
        Ms. Brennan, the opioid crisis is a homeland security
    challenge, but foremost it is a public health crisis. We must
    ensure our criminal justice system treats it as such as we have
    had some challenges in the past.
        As a prosecutor, could you discuss the historical mistake
    of treating users like criminals rather than victims in need of
    treatment, particularly when they hail from communities of
    color?
        Ms. Brennan. First of all, I could not agree with you more.
    You are absolutely right. I do think that law enforcement has
    certainly embraced that.
        Historically, you are completely accurate in that addiction
    was viewed as a failing, and people who were addicted to drugs
    were not viewed as having a disease but were viewed as
    criminal. That was a mistake with a cascade of consequences
    that we are still living with.
        But that having been said, I think if you look at--what I
    am familiar with is New York City. The change in strategy, we
    focus at the top of the supply chain. We try to take off the
    most dangerous drugs, those that are causing death. We work to
    rehabilitate those people whose crimes are caused by their
    addiction and to get out a very clear prevention message.
        So I think our strategies are different, but I certainly
    acknowledge the problem that you have recognized.
        Ms. Clarke. Thank you very much, Mr. Chairman. I yield
    back.
        I thank you for your testimony and your dedication and
    service.
        Mr. Rose. Thank you, Ms. Clarke.
        I would now like to recognize Mr. Langevin from the great
    State of Rhode Island.
        Mr. Langevin. Thank you, Mr. Chairman.
        I want to thank our panel of witnesses for being here
    today.
        Dealing with the opioid issue is obviously both a National
    security concern, it is a public health concern, it transcends
    many levels and can affect almost anyone from any type of
    background. It really knows no boundaries.
        It is certainly disturbing that this is something that we
    have seen in all of our communities. My home State of Rhode
    Island has been affected by the overdose issue. What is scary
    is that becoming addicted to opioids can, in fact, happen just
    through using regular opioids for legitimate purposes. Based on
    your chemical makeup, someone can get addicted very quickly,
    even after a very short time.
        It is even more disturbing, though, if these opioids being
    smuggled into the country are being done with a coordinated
    intent, if that is what it comes down to, of trying to get this
    into our communities and a number of people that affected and
    killed.
        If this is something, a targeted coordinated effort,
    whether it is smugglers or something that is nation-state-
    related, it is disturbing. It has all of our attention. We have
    to double down and make sure that we combat this with all the
    tools and resources we have at our disposal.
        So, Ms. McCauley, I want to start with you. I want to
    address a gap that I have seen and that the Joint Task Force to
    Combat Opioid Trafficking Act, which I introduced with Chairman
    Rose, Mr. King, and Mr. McCaul, is intended to address.
        So in your experience examining CBP mail screening
    operations, how is information from other law enforcement
    agencies fed into their processes? In other words, if Deputy
    Chief Hinson's department finds a pattern in mail that they
    have received, what processes exist to feed that information
    back into international mail screening guidelines?
        Ms. McCauley. I can say that CBP uses its Automated
    Targeting System to target high-risk mail coming into the
    country. The ATS is a--it is a decision support system that
    ingests data from foreign airports about the mail that is
    coming in inbound to the country and that data is matched
    against criminal as well as law enforcement and intelligence
    databases using risk-based scenarios to see where the highest
    risks are. So that is the main way in which that type of
    information is used.
        Mr. Langevin. But, again, if you see a pattern somewhere
    else, how is then that information fed back into the system so
    it is more widely dispersed? Is it a good two-way information
    sharing? It is one thing to be told what to look for, but when
    you see a pattern somewhere else, how do you make sure the left
    hand knows what the right hand is doing and that information is
    then fed back into the system?
        Ms. McCauley. I haven't heard of it being used in that way,
    no.
        Mr. Langevin. Well, it should be, but OK.
        Well, I encourage your colleagues in the Office of
    Inspector General to continue to examine these information-
    sharing efforts. I believe that the Joint Task Force to Combat
    Opioid Trafficking Act that we have introduced is an important
    step in improving linkages between disparate components of the
    Department and other Federal, State, and local entities.
        But I welcome any additional suggestions you may have. If
    there is anything you want to share with us, you can get back
    to us on that.
        Dr. Pardo if I could, staying on the topic of information
    for a minute. Based on your research, how would information
    gleaned from dark websites, either by law enforcement agencies
    or the intelligence community, regarding opioid trafficking
    make its way to DHS elements responsible for interdicting these
    illicit drugs? Can these links be strengthened?
        Mr. Pardo. That is a very good question.
        We don't quite know how the distribution works. In my mind,
    there could be several typologies of distribution. You could
    have an individual who is in Ohio who imports a kilogram of
    fentanyl over the Surface Web and then distributes it through
    the Darknet. That could happening. I think that might be
    happening. But we don't quite know. We need more research here.
        All that said, there had been indictments, unsealed
    indictments, of Chinese vendors on the Surface Web discussing
    the fact they might be warehousing product here. They send a
    bulk shipment of fentanyl through cargo, mislabeled as some
    sort of other chemical, and it arrives in a facility here. Then
    an order is put on-line to a user or to a buyer here
    domestically. That shipment is then sent from a warehousing
    facility here in the United States, not from China.
        So that poses an additional challenge because it is already
    past Customs. It has cleared CBP's remit, so now it is
    something of USPIS.
        So there needs to be kind-of greater awareness and
    strengthening across all levels of Federal and State law
    enforcement.
        In addition to that, you could use other kind-of metrics to
    inform this. You could use overdose deaths. If we could reduce
    the lag in overdose deaths and understand who is dying when and
    where in kind-of a point of time, an immediate point of time,
    you could then quickly kind-of determine, OK, which packages
    need to be screened to these ZIP Codes given that we are seeing
    elevated overdose deaths in the ZIP Codes.
        There are things that we need to do beyond this. Wastewater
    testing might be an additional tool that warrants
    investigation. Since individuals don't know what they are
    consuming, we just can look at what is being--every time
    someone flushes the toilet, we can determine what metabolites
    are in that water source in the sewer and then actually
    determine, OK, yes, we are seeing carfentanyl showing up in
    Dayton, Ohio, we need to then really be worried about it.
        Shortening that time span between what is reported publicly
    in the data and what is happening on the ground will save
    lives.
        Mr. Langevin. Well, I think it is important to have that
    holistic view of information sharing and get a better
    understanding of how this is getting into our country. Then
    also what we can do to make sure that we are strengthening the
    links in terms of information sharing.
        So thank you, and I yield back.
        Mr. Rose. Thank you, sir.
        I now recognize Mr. Payne from New Jersey.
        Mr. Payne. Thank you, Mr. Chairman.
        Just a general question, anyone on the panel can answer.
    What are the most common routes of trafficking fentanyl into
    the United States? How does the United States respond? I
    apologize if this has already been referenced, but I would
    really like to know that. Anyone can weigh in.
        Ms. Brennan. I will just talk about the roots that we see
    in New York City. We get very large shipments, and the very
    large shipments of fentanyl come in across the Southwest
    Border, typically over land routes into New York.
        The fentanyl analogues, which are more concentrated and
    more potent, there are just little changes on the fentanyl
    molecule, but those we see tend to be available often over the
    dark web. They come in in the major packaging centers, package
    centers at JFK, where there are hundreds of thousands of
    packages coming in each day, and they are in much smaller
    quantities.
        That is the kind-of overall arching picture that we see.
        Mr. Payne. Is it more difficult being able to identify it
    because of the smaller packages?
        Ms. Brennan. Absolutely. It really is. It is a smaller
    package, and there are hundreds of thousands of packages coming
    in.
        So it also gets into the supply chain, the distribution
    chain, in a much more diffuse way. So there are lots of
    different criminal organizations which may access it that way.
        If you have large amounts coming in, it is generally going
    to be delivered to criminal organizations that have the
    wherewithal to pay for it and then distribute it. So it is much
    more concentrated and much easier to cut off.
        Mr. Payne. You said that one of the major routes is the
    Southwest Border. Are the illicit synthetic opioids a major
    stream of revenue for the Mexican cartels?
        Ms. Brennan. Well, definitely. The drugs that we are
    seizing are coming from the Mexican cartels.
        Mr. Payne. OK.
        Well, Mr. Chairman, in the interest of time, I will yield
    back. Thank you very much for the panel's witnesses here today.
        Mr. Rose. Thank you, Mr. Payne.
        Dr. Pardo, just a quick thing. You had mentioned that there
    was--or in your testimony--that there was a previous influx of
    fentanyl in the early 21st Century, and we stopped that. Could
    you just speak to that very quickly?
        Mr. Pardo. Sure. So in our research, we have documented
    that we are aware of 4 previous outbreaks of fentanyl in the
    United States going back as early as 1979. The most recent was
    the 2005 to 2007 outbreak, lasted 2 years, coming from Mexico,
    one lab in Mexico.
        Federal response was very quick. Naloxone was provided to
    users on the street. DEA worked very aggressively to find the
    source, worked with Mexican counterparts to identify the lab
    and shut it down.
        The difference between all prior outbreaks and today's is
    that it was a single source, a single chemist. Today it is
    atomized. There are multiple sources in China, many firms. I
    mean, they have thousands of pharmaceutical firms, chemical
    firms. It is going to be very difficult to----
        Mr. Rose. You think that there are thousands of Chinese
    pharmaceutical firms that are taking part in this?
        Mr. Pardo. Legitimate pharmaceutical firms, yes. China
    recognizes about 5,000 active pharmaceutical ingredient
    manufacturers. Of those, we don't know how many are producing
    fentanyl either off book or illegitimately.
        Mr. Rose. OK. Thank you.
        With that, the Chair now recognizes Ms. Underwood from
    Illinois.
        Ms. Underwood. Thank you, Chairman Rose.
        In the United States, nearly 130 people die from opioid-
    related fatalities each day. In Illinois alone, from 2014 to
    2017, opioid related deaths rose from 127 to 1,187 per year. A
    majority of the opioid fatalities in our country are linked to
    synthetic opioids like fentanyl.
        These statistics are incredibly alarming. Confronting this
    epidemic means stopping the flow of synthetic opioids entering
    the United States from China and other countries. To do this,
    it is critical that the Department of Homeland Security is
    directing its resources strategically to the areas where most
    of these drugs are coming in.
        Ms. McCauley, according to the 2018 National Drug Threat
    Assessment, a majority of illicit opioids intercepted,
    including fentanyl and heroin, are seized by Customs and Border
    Protection at legal ports of entry.
        Can you give us more details on how exactly the opioids
    being seized are coming into our country? Because it seems that
    the majority are being mailed, is that through personal mail or
    commercial shipments?
        Ms. McCauley. We haven't focused on the drugs that are
    coming in over the ports of entry, over the land ports of
    entry. We have done our work focused on JFK mail, the
    international mail that is coming in there, and that is what we
    are seeing is the foremost problem now. We have some on-going
    work to look at the ports of entry at the land border.
        But, yes, the mail coming through JFK is a big problem. A
    lot more needs to be done in terms of applying the resources
    that are needed to interdict, to identify that mail, and then
    intercept it to keep it from getting into the mainstream.
        Ms. Underwood. In your experience, is it personal mail or
    is it commercial shipments?
        Ms. McCauley. We haven't looked at commercial shipments. We
    mainly looked at the mail that is coming through the U.S.
    Postal Service.
        Ms. Underwood. I see.
        Ms. McCauley. Yes.
        Ms. Underwood. Can anyone else speak to ports of entry on
    this panel?
        Mr. Pardo. So according to CBP seizure data, the bulk
    majority of fentanyl that arrives, by weight, comes over the
    Southwest Border. However, the purity of what is being seized
    there is very, very low versus the purity seized at ports of
    entry in the mail facilities or the express consignment
    facilities is very, very high, about 90 percent above. So after
    adjusting for purity, the bulk majority of fentanyl seized is
    coming by mail or express consignment.
        That said, as Ms. McCauley has noted, JFK is a large hub,
    and we do receive a lot of inbound packages from China. So it
    does seem to stand that it is coming--a large portion is coming
    from China by mail.
        Ms. Underwood. Right. So with the proportion of the
    seizures, does that same logic hold? The majority of the
    seizures are coming by mail and not from ports of entry?
        Mr. Pardo. That is the difficult thing using seizure data
    to really inform this. You don't know what you are not
    catching. But what we are catching is--that shows that China is
    a large supplier.
        Ms. Underwood. OK.
        What resources, Ms. McCauley, are needed to effectively
    apprehend the large share of illicit opioid being trafficked
    through the mail?
        Ms. McCauley. CBP uses a number of methods to screen for
    mail, to inspect for--I am sorry--to inspect for illegal drug
    shipments. It uses canine teams. We saw that at JFK Airport.
    They had a limited number of canine teams to help in terms of
    the inspections.
        They also had a limited number of outdated X-ray machines
    to do the screening. They typically had to do manual screening.
    That is piece by piece, to actually pick up the pieces of mail.
    If you see pictures of the volume of mail that is coming in,
    that is quite a task.
        They also do chemical analysis using the handheld
    screeners. Even those, we saw that they not always have the
    most up-to-date technology.
        So on all 4 scores, in technology, canine teams--and I
    forget to mention staffing as well. They didn't have adequate
    personnel there to help with the screening process. So they
    could do a whole lot in terms of improving in that area.
        Ms. Underwood. Right. As we understand from your report and
    your testimony here today, it is really a multifactorial
    process to do the screening of the mail effectively. So we need
    to make sure that CBP has enough resources to do that to
    protect the American people.
        In both the 2018 OIG report and in your testimony, Ms.
    McCauley, OIG has recommended that CBP conduct an analysis to
    determine what resources are needed to address deficiencies
    while inspecting the international mail.
        But it is really disconcerting to me that OIG has
    recommended that the CBP conduct this assessment twice in
    different reports. There have been two separate
    recommendations. Yet CBP has failed to follow through. So do
    you happen to know when CBP plans to conduct this analysis?
        Ms. McCauley. We are looking at CBP again in terms of the
    mail process up at JFK Airport, and we are following up on that
    information in terms of where they are in addressing our
    recommendations. We will be reporting out this fall.
        Ms. Underwood. Good. Well, we will look forward to seeing
    that.
        In your 2018 report, it recommended that CBP update the
    Mail Operations and Enforcement Handbook, and they haven't done
    that as well.
        So just from where we sit, right, it is very challenging
    recognizing this threat and an agency not following through. I
    am a member of the Freshmen Working Group on Addiction, you
    heard from Mr. Trone earlier today, and look forward to working
    with all our other colleagues to address this issue and advance
    legislation.
        With that, Mr. Chairman, I yield back. Thank you.
        Mr. Rose. Thank you.
        Just to close out, speaking of Mr. Trone, who has, I think,
    extraordinarily effectively led this freshman task force on
    addiction, I would like to just ask 2 questions on his behalf.
        Dr. Pardo, first of all, what are the dangers that we start
    to see domestic production of these synthetics such as
    fentanyl?
        Mr. Pardo. So domestic production of fentanyl was a
    problem. It was a problem up until 2005. I don't think you are
    going to see domestic production of fentanyl for a long time
    given its price. Nobody in the United States is going to stick
    their neck out for $5,000 a kilo. It is just too cheap coming
    from China.
        Mr. Rose. Great. Thank you.
        Ms. Brennan, as well as Dr. Pardo, what examples are we
    seeing as best practices from a law enforcement perspective? I
    know we touched on dealing with this as a health crisis. But
    from a law enforcement perspective, domestically as well as
    world-wide, surely the United States is not the only country
    having to deal with this crisis?
        Ms. Brennan. The crisis in the United States is more
    significant than anywhere else, much more significant. The
    consumption of opioids by the United States, even legal
    opioids, is tremendous compared--I believe the next largest
    consumer is Canada, and it is far lower.
        So the only other country that I am aware of that is
    suffering this kind of addiction issue would be Canada, and
    their source of supply and many of their issues kind-of mirror
    ours.
        So we are in a very challenging situation right now in
    terms of drugs coming in from many different sources, actually.
    We still have legal prescription drugs fueling some of our
    epidemic. It is just--it is a big challenge for us.
        In terms of best practices, I think law enforcement, at
    least I can speak in New York City, the approach is to focus on
    the top of the distribution chain, focus on those drugs that
    are killing people, and make that your top priority. It is
    about protecting lives. We also focus on those organizations
    that are involved in violence in terms of their drug
    trafficking.
        So those are our top priorities, because the main goal with
    regard to drug enforcement really is saving lives.
        Mr. Rose. Great.
        Mr. Pardo. In terms of best practices, we need to start
    thinking outside the box. As prosecutor Brennan noted, Canada
    is kind of the next case study. It is the most approximate in
    terms of what we are seeing, especially in British Columbia and
    Vancouver.
        There are some Nordic countries who are suffering this.
    Estonia has had a fentanyl market for almost 20 years. We think
    that that will be the case here in the United States. New
    Hampshire is far along in the transition to fentanyl. We do not
    foresee heroin coming back. We think that fentanyl will be
    around to stay. So we need to really start----
        Mr. Rose. Pure or----
        Mr. Pardo. Well, I mean, what is offered on the streets is
    generally not pure fentanyl. It is usually pressed with some
    other power or some other filler, because it is just too small
    to handle. You need something else.
        But thinking about kind-of the future, we really need to
    start thinking outside the box. I mean, yes, more of the same
    might help with some things. But we really need to start
    thinking about investigations more on-line, trying to intel--
    using intelligence to really understand how these networks
    work, trying to understand how dealers are making the decision
    to import fentanyl or what analogue they are deciding to input,
    how do they determine how to cut it, with what, how do they
    press it into tablets, what machinery are they using.
        I mean, a lot of the machinery that is coming from China--a
    lot of the pill press machines that are being used to
    manufacturer tablets here are coming from China as well.
        So kind-of going back to your earlier question, we don't
    see synthesis here. We do see manufactured tablets here. The
    illicit, the counterfeit tablets. So that is something we need
    greater research and investigation on, working with
    collaborative efforts in Europe, working with law enforcement
    agencies and customs agencies there who have seen this stuff
    before, who are working--you know, doing the same--fighting the
    same problem. We need more efforts internationally to
    collaborate with this problem.
        Mr. Rose. Great.
        All right. Well, thank you again.
        With that, I thank the witnesses for their valuable
    testimony and the Members for their questions.
        The Members of the committee may have additional questions
    for the witnesses, and we ask that you respond expeditiously in
    writing to those questions.
        Pursuant to committee rule VII(D), the hearing record will
    be open for 10 days.
        Without objection, the subcommittees stand adjourned.
        [Whereupon, at 11:51 a.m., the subcommittees were
    adjourned.]

                                A P P E N D I X

                                  ----------

              Questions From Chairman Thompson for Sondra McCauley
        Question 1. Each new phase of the opioid epidemic has caught the
    country unprepared: If fentanyl analogues do indeed represent a
    ``Fourth Wave'' of the crisis, what do you expect to be the most
    glaring weakness of our current interdiction capability?
        Answer. The Department of Homeland Security Office of Inspector
    General has focused our oversight work on the interdiction capabilities
    at John F. Kennedy (JFK) airport, the Nation's largest international
    mail hub. U.S. Customs and Border Protection's (CBP) limited mail
    screening practices at JFK airport is the most glaring weakness
    identified in our office's work in the 2018 audit, ``CBP's
    International Mail Inspection Processes Need Improvement at JFK
    International Airport''.
        OIG will continue to provide effective oversight in this critical
    area. In addition to our on-going follow-up audit related to CBP air
    mail inspection processes at JFK, our office is also considering work
    to determine the status of inspections at Express Consignment Centers,
    such as those run by FedEx, DHL, and United Parcel Service.
        Question 2. Have the re-assignments of Office of Field Operations
    Officers to Border Patrol duties degraded the ability of ports of entry
    to identify and seize fentanyl and other narcotics?
        Answer. The Office of Inspector General has not completed any audit
    work related to re-assignments of Office of Field Operations Officers
    to Border Patrol duties so I am unable to offer an opinion on whether
    it affects drug interdiction efforts at the ports of entry. CBP
    informed us there has only been one re-assignment from the JFK
    International Mail Facility (IMF); however, we have not determined the
    impact of this re-assignment.
             Question From Chairman Thompson for Bridget G. Brennan
        Question. Each new phase of the opioid epidemic has caught the
    country unprepared: If fentanyl analogues do indeed represent a
    ``Fourth Wave'' of the crisis, what do you expect to be the most
    glaring weakness of our current interdiction capability?
        Answer. Response was not received at the time of publication.
           Questions From Chairman Bennie G. Thompson for Bryce Pardo
        Question 1. Have you seen any indication of other emerging opioid
    threats aside from fentanyl's? For example, chemical producers may
    shift synthesis to non-fentanyl-based opioids to avoid scheduling.\1\
    Additionally, what recommendations would you propose to combat this?
    What are you currently doing to combat these new novel opioids?
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        \1\ Karen Steward, Identifying Novel Opioid Agonists From
    Metabolites, TECHNOLOGY NETWORKS, August 2, 2019, https://
    www.technologynetworks.com/applied-sciences/blog/identifying-novel-
    opioid-agonists-from-metabolites-322453.
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        Answer. An examination of Federal and State law enforcement drug
    seizures suggests that the nature of the supply of synthetic opioids
    changes from year to year. Although fentanyl dominates these seizure
    counts, the emergence (and sometimes decline) of other fentanyl analogs
    (e.g., acrylfentanyl, carfentanil, 4-fluoroisobutyryl fentanyl) and
    non-fentanyl synthetic opioids (e.g., U-4770, AH-7921) is documented.
    Similarly, on-line vendor websites offer variations of nonfentanyl
    synthetic opioids, such as the U-series or AH-series, and their various
    analogs.
        While a generic control (i.e., a blanket ban on all fentanyl-
    related structures) might help to future-proof drug control efforts
    aimed at fentanyl, it might also encourage chemists to move to non-
    fentanyl synthetic opioids. Although employed in parts of Europe,
    generic controls are relatively new and untested in the United States.
    That said, reducing the number of chemicals that are introduced to U.S.
    drug markets could help reduce product variability that increases risks
    that result in overdose.
        Apart from generic controls, which focus on the chemical
    composition of the substance in question, alternative approaches may be
    warranted. Other countries have attempted, with mixed results,\2\ to
    control emerging substances based on their intended pharmacological
    effect. In some cases, a substance is subject to control if it has an
    effect or binds to a certain receptor in the central nervous system.
    This approach, circumscribed to a handful of structural classes, was
    introduced in the United States under the Synthetic Drug Abuse
    Prevention Act of 2012. The law added ``cannabimimetic agents'' to
    Schedule I of the Controlled Substances Act and defined them as any
    substance that is a ``cannabinoid receptor type 1 (CB1) agonist as
    demonstrated by binding studies and functional assays within five
    structural classes.''
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        \2\ Although blanket controls recently adopted in the United
    Kingdom were used to bring a wide range of new psychoactives under
    scheduling, the country faced substantial problems operationalizing
    enforcement and bringing cases to trial. Early assessments by the
    government point to mixed results (see U.K. Home Office, Review of the
    Psychoactive Substances Act 2016, London, November 2018).
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        Question 2. Have the re-assignments of Office of Field Operations
    Officers to Border Patrol duties degraded the ability of ports of entry
    to identify and seize fentanyl and other narcotics?
        Answer. I cannot speak to personnel decisions made by Customs and
    Border Protection, and my research has not examined the specific
    impacts of such decisions. But, in the abstract, any decision to
    reallocate resources comes with a trade-off. Good policy making
    recognizes and is explicit about such trade-offs.
        In general, reassigning personnel from one port of entry to another
    may affect the number or quantity of fentanyl or other narcotics
    seized. In my written testimony, I present Customs and Border
    Protection seizure data for fentanyl for fiscal year 2018, noting the
    amounts and estimated purity across various types of ports of entry.
    Based on these data--which may not be representative of supply routes
    \3\--the majority of pure fentanyl seized (i.e., adjusted for purity)
    comes by air to mail and express consignment carrier facilities.
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        \3\ Peter Reuter, ``Seizures of Drugs,'' in Jane Smith and Bob
    Johnson, eds., Encyclopedia of Drugs and Alcohol, New York: MacMillan,
    1995.
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