Important Update for Families from the 2019 Drug Threat Assessment

Drug Enforcement Administration
Drug Enforcement Administration in Washington DC, USA

Every year the Drug Enforcement Administration (DEA) evaluates changes in the threats to our peace of mind and safety resulting from the trafficking and use of illicit drugs. While this might seem to be the sole province of law enforcement, in fact, families can utilize this information to better protect their members. Let’s take a look at what data from the most recent report might serve our needs.


Not surprisingly, the country’s gravest threat comes from fentanyl. One of the reasons this drug is so deadly is that many people don’t know they are consuming fentanyl, a drug far more powerful than heroin. They could have bought pills from a drug dealer that they thought had been diverted from a pharmacy. In fact, the drug dealer got some fentanyl from a drug trafficking organization. He then bought a pill press, some powder and coloring and is making his own “OxyContin” dosed with fentanyl. If he gets the dosage of fentanyl wrong, he’s going to kill some of his customers.

Counterfeit pills
Photo courtesy of the DEA.

These counterfeit oxycodone pills actually contained fentanyl.

Fentanyl has been found mixed into cocaine or methamphetamine without a buyer’s knowledge. While this has led to some unexpected fentanyl overdoses, it’s a way that drug dealers can get a person craving opioids, so they come back for more purchases.

There are now so many overseas and foreign source points for fentanyl, and so many people trafficking it that it’s going to be very hard to eliminate this substance from our landscape. Anyone buying heroin, cocaine, meth or any powder or pill on the illicit market should expect the possibility of fentanyl in their purchase. Among injecting drug users, it’s common to “taste” a small amount of a purchase from an untrusted source to prevent a possible overdose.

How much has this threat grown recently? This chart from the 2019 Threat Analysis represents the number of samples of fentanyl that have been turned in to forensic labs for analysis.

Threat assessment on fentanyl

The states seeing the highest number of these samples? (In descending order.)

  • Ohio
  • Pennsylvania
  • New York
  • New Jersey
  • Massachusetts
  • Maryland
  • Virginia
  • Kentucky
  • New Hampshire
  • Illinois
  • Missouri
  • Delaware
  • Florida


Unfortunately, heroin is not going anywhere any time soon. While supplies are down slightly, this really isn’t good news because many people are either asking for fentanyl or receiving fentanyl when they thought they were getting heroin.

Here, you can see how many people are losing their lives to heroin alone and how many to a combination to heroin and fentanyl. The yellow line shows how many people overdosed on heroin WITH fentanyl in it.

Heroin grath

Drug purchases containing both drugs can be so powerful that even those accustomed to using opioids are inadvertently overdosing.

The highest rates of heroin overdose deaths occurred in West Virginia, Washington, D.C., Connecticut, New Jersey, and New Mexico.

Cocaine and Methamphetamine

These two extremely strong stimulants starting seeing increased supply and popularity a few years ago. Both drugs have the ability to wreak havoc on a user’s body, especially the cardiovascular system. Heart attacks, cardiac arrests, shredding of the aorta and other kinds of deadly reactions are possible from either drug.

Methamphetamine started out being a problem on the West Coast. It then moved to the Midwest and Great Lakes region but never penetrated the East Coast. The East Coast was controlled by different drug gangs and opioids were the popular drugs along the Atlantic Seaboard. That’s changed. Now, while methamphetamine is still in heavy supply along the Southwest Border and West Coast, availability is increasing in major East Coast metropolitan areas.

Meth has also been found in pills purported to be MDMA (ecstasy) and counterfeit Adderall. Counterfeit Adderall has been found, so far, in Michigan and Florida.

Nearly all of America’s cocaine comes from Colombia. Producers hand the drug off to drug trafficking organizations who bring it across the border with their other shipments.

Costs for cocaine are declining and purity is increasing, which could be part of the plan of the traffickers to build its popularity. What are the effects of their marketing efforts? In San Diego, DEA field agents report that cocaine use by minors has become mainstream and “normalized.” In St. Louis, cocaine is making inroads into the party and club scene.

Cocaine supplies are the most dominant in the South and Northeast, with increasing seizures in selected West and Midwest regions. Cocaine is now starting to be found in counterfeit prescription drugs as well.

Cocaine overdose deaths mostly occur east of the Mississippi River.


Two states that were among those with the highest number of cocaine seizures were also the top states for heroin seizures. You have to have empathy for families in these states trying to raise drug-free kids.

  • Ohio
  • Illinois

Other states that ranked high for heroin and cocaine or all three drugs were:

  • Virginia
  • Massachusetts
  • New York
  • New Jersey
  • Pennsylvania
  • Maryland
  • Texas
  • California

Prescription Drugs

Overall, the diversion and consumption of authentic prescription drugs has been falling. In West Virginia, Maryland, Kentucky, and Utah, however, overdose deaths from prescription drugs were still high.

While many states have invested heavily in systems to prevent overprescribing or diversion of these drugs, they are still readily available. Hydrocodone and oxycodone pills are still lavishly prescribed by doctors and dispensed by pharmacies. There were enough opioid pills dispensed in 2018 to provide every American of any age with 33 pills. In some states like Alabama and Arkansas, there were more prescriptions handed out than there were residents.

Much more needs to be done in every state to re-educate doctors on proper prescribing and prosecute those reaping the financial rewards of overprescribing.

Also being overprescribed are methylphenidate (Ritalin), amphetamine and buprenorphine, an opioid used to prevent withdrawal sickness in drug treatment programs.

Psychostimulants Can Kill, Too

Psychostimulants include methamphetamine, MDMA (C, caffeine, ecstacy) amphetamine and cathinones, stimulants often called “bath salts.”

As you can see in this chart, the number of deaths from psychostimulants is soaring, largely because of the increased distribution of methamphetamine across the country.

Psychostimulants graph

Deaths from these drugs are focused on West Virginia, Colorado, Nevada, New Mexico, Arizona, Oklahoma, Kentucky, Hawaii and Alaska.


Perhaps marijuana is legal for medical use in your state. Or recreational use. In the eyes of the federal government, it is still an illegal, illicit drug and is treated as such in their reports.

A significant quote from this report: “Black market marijuana production by local, national, and transnational criminal trafficking organizations continues to increase, predominantly in states that have legalized marijuana.” If you accepted the promise that the black market in your state would be eliminated by a legal market in marijuana, you were misled.

Three hundred thousand kilograms of marijuana were seized at the Southwest border. Illicit grows are increasing in California, Colorado, Oregon, Washington, with tons of this product moving out of state. More than 5,000 illegal grow sites were destroyed in 2018. The average potency of leaf marijuana and concentrates continues to increase. In other words, this is an industry that is out of control.

How Can You Use this Information?

All this information paints a vivid picture of the tens of thousands of manufacturers, growers, traffickers and dealers who care nothing about the welfare of you, your children or your extended family. If you haven’t given much thought to the presence of drugs in your community, perhaps this report can serve as a wake-up call.

There’s no community completely free from drugs. Your children should know the threats that exist in your town and how they risk their very lives if they believe anything a drug dealer tells them. They could buy drugs from a good friend but that person could have been completely misled about the drugs they bought and what their real ingredients were.

Who has a better chance of avoiding these risks? Young people who are educated about the risks, who have some insight into the lies being told by sellers and users, who have goals they are pursuing, who have the support of a family, who make it home to family dinners frequently, whose parents know where they are and who their friends are—these young people have a better chance of avoiding the life-threatening effects of these drugs.

Please use this information to inform yourself and then educate your children. It could save their lives.


Reviewed by Claire Pinelli, ICAADC, CCS, LADC, MCAP, RAS


Karen Hadley

For more than a decade, Karen has been researching and writing about drug trafficking, drug abuse, addiction and recovery. She has also studied and written about policy issues related to drug treatment.