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The 2019 National Drug Threat Assessment (NDTA)a is a comprehensive strategic assessment of the threat posed to the United States by domestic and international drug trafficking and the abuse of both licit and illicit drugs. The report combines federal, state, local, and tribal law enforcement reporting; public health data; open source reporting; and intelligence from other government agencies to determine which substances and criminal organizations represent the greatest threat to the United States. Illicit drugs, and the transnational and domestic criminal organizations that traffic them, continue to represent significant threats to public health, law enforcement, and national security in the United States. The opioid threat (controlled prescription drugs, synthetic opioids, and heroin) continues at ever-increasing epidemic levels, affecting large portions of the United States. Meanwhile, the stimulant threat (methamphetamine and cocaine) is worsening and becoming more widespread as traffickers continue to sell increasing amounts outside of each drugs’ traditional markets. New psychoactive substances (NPS) remain challenging and the domestic marijuana situation is evolving as state-level medical and recreational legalization continues. Drug poisoning deaths are the leading cause of injury death in the United States. In 2017b , drug poisoning deaths reached their highest recorded level and, every year since 2011, have outnumbered deaths by firearms, motor vehicle crashes, suicide, and homicide. In 2017, approximately 192 people died every day from drug poisoning.

Fentanyl and Other Synthetic Opioids

Fentanyl and other highly potent synthetic opioids— primarily sourced from China and Mexico—continue to be the most lethal category of illicit substances misused in the United States. Fentanyl continues to be sold as counterfeit prescriptions pills as traffickers—wittingly or unwittingly—are increasingly selling fentanyl to users both alone and as an adulterant, leading to rising fentanyl-involved deaths. Fentanyl suppliers will continue to experiment with other new synthetic opioids in an attempt to circumvent new regulations imposed by the United States and China.


Heroin-related overdose deaths remain at high levels in the United States, due to continued use and availability, while fentanyl is increasingly prevalent in highly profitable white powder heroin markets. Mexico remains the primary source of heroin available in the United States according to all available sources of intelligence, including law enforcement investigations and scientific data. Further, high-levels of sustained opium poppy cultivation and heroin production in Mexico allow Mexican Transnational Criminal Organizations (TCOs) to continue to supply high-purity, low-cost heroin.

Controlled Prescription Drugs (CPDs)

CPDs are still responsible for the most drug-involved overdose deaths and are the second most commonly abused substances in the United States. Traffickers continue to manufacture and distribute counterfeit CPDs often-containing fentanyl and other opioids along with non-opioid illicit drugs in attempts to expand their customer base and increase profits. Overall diversion incidents continue to decline; however, CPDs lost in transit or diverted by medical professionals remains a prevalent threat across the United States.


Methamphetamine remains widely available, with traffickers attempting to create new customers by expanding into new, non-traditional methamphetamine markets such as the Northeast, or other user bases with new product forms. Most of the methamphetamine available in the United States is produced in Mexico and smuggled across the Southwest Border (SWB). Domestic production occurs at much lower levels than in Mexico and seizures of domestic methamphetamine laboratories have declined steadily for many years while overall supply has increased.


Cocaine is a resurgent threat in the United States as domestic indicators—such as seizures, availability, and overdose deaths—remain at elevated levels. Cocaine-involved overdose c. Unless explicitly stated, the term “fentanyl,” when used in this report, refers to clandestinely manufactured and illegally distributed fentanyl and not to pharmaceutical or “licit” fentanyl. d. In this document, the phrase “synthetic opioid” refers to only those substances, which are classified as opioids and have no plant-based material in their production (i.e. fentanyl, fentanyl-related substances, and other novel opioids) and therefore does not include heroin.  Deaths continue to exceed established benchmarks, primarily due to the continued spread of fentanyl into the cocaine supply. In addition, coca cultivation and cocaine production in Colombia, the primary source of supply for cocaine in the United States, remain at high levels.


Marijuana remains the most commonly used illicit drug in the United States. The nature of the marijuana threat continues to evolve, as more states vote on referendums and initiatives as well as pass legislation regarding the possession, use, and cultivation of marijuana. Most states that have legalized marijuana have placed no limits on Tetrahydrocannabinol (THC) potency of marijuana or its associated concentrate products. Consequently, THC potency continues to increase, as does demand. Mexico remains the most significant foreign source for marijuana available in the United States, but domestic marijuana production and availability continues to rise. Black market marijuana production by local, national, and transnational criminal trafficking organizations continues to increase, predominantly in states that have legalized marijuana.

New Psychoactive Substances (NPS)

The number of NPS varieties continues to increase worldwide, but remains a limited threat in the United States compared to other widely available illicit drugs. China remains the primary source for the synthetic cannabinoids and synthetic cathinones trafficked into the United States. The availability, popularity, and the public health threat of specific NPS varieties in the United States changes every year, as traffickers experiment to circumvent legal restrictions and discover more potent, and therefore popular, substances.

Mexican TCOs

Mexican TCOs remain the greatest criminal drug threat to the United States; no other groups are currently positioned to challenge them. The Sinaloa Cartel maintains the most expansive footprint in the United States, while the Jalisco New Generation Cartel (Cartel Jalisco Nueva Generación or CJNG) has become the second-most dominant domestic presence over the past few years. Although drug-related murders in Mexico continue to reach epidemic proportions, U.S.-based Mexican TCO members still generally refrain from domestic inter-cartel conflicts, resulting in minimal spillover violence in the United States.

Colombian TCOs

Colombian TCOs’ control over the production and supply of cocaine to Mexican TCOs allows Colombian TCOs to maintain an indirect influence on U.S. drug markets. Meanwhile, ongoing disputes between the Government of Colombia and the remnants of the Revolutionary Armed Forces of Colombia (FARC) and other Armed Criminal Groups continue to, at times, exacerbate the problem of sustained high-levels of illicit coca cultivation in Colombia. Smaller Colombian TCOs still directly supply wholesale quantities of cocaine and heroin to Northeast and East Coast drug markets.

Dominican TCOs

Dominican TCOs dominate the mid-level distribution of cocaine and white powder heroin in major drug markets throughout the Northeast while also engaging in some street-level sales in the region. Dominican TCOs work in collaboration with foreign suppliers to ship cocaine and heroin directly to the United States from Mexico, Colombia, and the Dominican Republic. Family members  and friends of Dominican nationality or American citizens of Dominican descent comprise the majority of Dominican TCOs, insulating them from outside threats.

Asian TCOs

Due to China’s currency control restrictionse , Asian TCOs have taken advantage of the availability of U.S. dollars belonging to Mexican and Colombian TCOs in the United States by acquiring the U.S. dollars in exchange for the payment of Colombian/Mexican pesos in the respective drug source country. TCOs launder drug proceeds through a variety of means, the primary being a hybrid of trade-based money laundering (TBML) and the black market peso exchange (BMPE). Asian TCOs continue to operate indoor marijuana grow houses in states with legal personal-use or medical marijuana laws. Asian TCOs also remain the primary 3,4-Methylenedioxymethamphetamine (MDMA) source of supply in U.S. markets, trafficking MDMA from China or clandestine laboratories in Canada into the United States.

Outside Continental United States (OCONUS) and Tribal Threats

Cocaine is the principal drug threat in the Caribbean followed by marijuana, with Puerto Rico and the U.S. Virgin Islands (USVI) serving as major transshipment points for both drugs. Methamphetamine and marijuana remain the top two drugs of choice in Guam, with cocaine being a rising threat as an alternative to methamphetamine due to changing prices. The drug threat in Indian Country varies by region and is influenced by the illicit drugs available in major cities near the reservations. Methamphetamine and marijuana remain the most widely abused substances in Indian Country.

Illicit Finance

U.S. drug sales continue to account for tens of billions of dollars in illicit proceeds annually. These proceeds change hands multiple times across various levels of the illegal drug market. Bulk cash smuggling seizure amounts remain at lower levels than in previous years, indicating that TCOs may be employing different methods of moving monetary value through the financial system. While traditional methods of laundering money are still the most widely used, the advent of 21st century methods may increase the complexity of anti-money laundering enforcement activities in the future.


National and neighborhood-based street gangs and prison gangs remain the dominant distributors of illicit drugs through street-sales in their respective territories throughout the country. Struggle for control of lucrative drug trafficking territories continues to fuel the majority of the streetgang violence facing local communities. Meanwhile, some street gangs are working with rival gangs to increase both gangs’ drug revenues, while individual members of assorted street gangs have profited by forming relationships with friends and family associated with Mexican cartels.

For the full Drug Threat Assessment, visit:  https://www.dea.gov/sites/default/files/2020-01/2019-NDTA-final-01-14-2020_Low_Web-DIR-007-20_2019.pdf

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