National Office for Drug Policy Use, abuse and trafficking of opioids in Mexico: The importance of international collaboration October, 2018 HIGH SPECIALIZATION IN DRUGS Collaborate with PHASE Production Routes Seizures Sampling Public policies Authorities Chemical and Crop Destruction of International Physical Strategic Specialized ACTIVITY Interception Focus actions Identification Crops Agencies Characterization Intelligence Program of substances Federal Level Pen Online PICS National Drug SPECIALIZED PRISM Observatory MEXW-34 AREA MEXK-54 National Control of COHESION Effort Synthetic Drugs SECURITY CABINET Monitoring System of Air and Maritime Traffic Prequim Impulse to integral improvement in Regulation of authorized List of Surveillance, Cooperation and production zones through the companies of controlled Use of statistical tools Early Warning System, coordination with promotion of actions oriented to the substances. to focus and prioritize consumption international agencies Sustainable Development of the Identify routes of illicit trafficking institutional efforts indicators and of substances to strengthen on drugs communities regulations PROMINENT surveillance in customs and ports State Level ACTIONS Internacional Global ONU Regional Grupos Binacionales STATISTICAL COORDINATION AMONG COORDINATION AND JUSTICE AND LAW ENFORCEMENT INTERNATIONAL PREVENTION SCOPE INDICATORS INSTITUTIONS INTEGRAL DRIVING DIMENSION Attention to Supply and Demand Comprehensive Policies and Strategies OVERVIEW GLOBAL OVERVIEW People worldwide used drugs at least once in 2016 Deaths indirectly attributable to 275 million drug Opioids implicated People who their drug use is 24% harmful to the point where they may need treatment Deaths associated with 31 million overdoses in Deaths related with drug use in 2015 2015 167, 750 450 000 76% It is estimated that in 2016, 34.3 million people used opioids and opiates for non-medical purposes Source: World Drug Report 2018 (United Nations publication, Sales No. E.18.XI.9). OPIOID USE IN MEXICO LEGAL FRAMEWORK International: Single Convention on Narcotic Drugs of 1961; Yellow List, List 1. National: General Health Law (LGS) Art. 234 (Narcotics). Its use is permitted for medical and scientific purposes LGS Art. 235; Medical Prescription (prescription) LGS Art.226, frac. I AGREEMENT: The compulsory nature of the comprehensive management of palliative care schemes is declared, as well as the processes indicated in the Guide. Source: National High Level Drug Policy Group. PHARMACEUTICAL OPIOIDS IN MEXICO Methadone Fentanyl LGS, Art.226, frac. I Morphine Codeine Hydromorphone Oxycodone Oxycodone / Paracetamol Sufentanil Remifentanyl The electronic special prescription is mandatory to get these narcotics for medical use. Source: National High Level Drug Policy Group. ABUSE OF PRESCRIPTION DRUGS IN MEXICO 1.3% of the population aged 12 to 65 has used medical drugs at some time (1.7% men, 0.9% women); 0.5% consumed them in the last year (0.6% men, 0.4% women). Consumption once: 406 235 Consumption once: 690 986 Consumption in the last year: 163 166 Consumption in the last year : 248 292 Medical drugs: Opiates, tranquilizers, sedatives, barbiturates or amphetamines, the use must be out of prescription or for a longer time or amount than indicated by the doctor. Source: National Survey ENCODAT 2016-2017. 2011: 178, 680 users 2016: 145, 382 users The downward trend is 18%. 0.2% of the population aged 12 to 65 has ever consumed 4, 812 140, 570 Source: National Survey ENCODAT 2016-2017. HEROIN SEIZURES RELATED WITH HEROIN Opium Poppy Erradication Clandestine Heroin Crops gum laboratories 1,015,904 Ui. 132,524.5 Has. 4,580.44 Kg. 23* 2,641.96 Kg. Poppy eradication hectares Source: Criminal Investigation Agency. National Effort. Preliminary figures HEROIN SEIZURES Source: Criminal Investigation Agency. National Effort. Preliminary figures HEROIN TRAFFICKING ROUTES TO THE UNITED STATES OF AMERICA WASHINGTON NUEVA YORK Illinois Connecticut COLORADO CALIFORNIA ARIZONA TEXAS GEORGIA D TERRAIN OPERATION Q AERIAL OPERATION HEROÍNA MÉXICO: DESTINO EEUU DESDE HEROÍNA EEUU: DESTINO EEUU DESDE MÉXICO MÉXICO December 1, 2012 to August 15, 2017 4 a 4 (2) 5 a 5 (1) 2 a 4 (1) 3 a 5 (3) NOTE: 3 natural ranges were considered (excluding zero). The natural ranges allow to generate 1 a 2 (9) 1 a 3 (5) ranges or intervals with values that are similar to each other but with significant difference with 0 a 0 (20) 0 a 0 (42) respect to the following range. The tip of the arrow indicates the direction of the route; the destination where heroin was seized. HEROÍNA Source: Criminal Investigation Agency. National Effort. Preliminary figures FENTANYL FENTANYL OVERVIEW 2017 Source: Criminal Investigation Agency. National Effort. Preliminary figures FENTANYL OVERVIEW 2018 Powder Tablets Ampoules (kg) (units) (units) 90 fentanyl related cases nationwide, since 2006. Source: Criminal Investigation Agency. National Effort. Preliminary figures EFFORTS OF THE MEXICAN GOVERNMENT SPECIAL PRESCRIPTIONS Paper Electronic Both forms in TRIPLICATE (Pharmacy, Patient, Doctor) Firma autógrafa del médico The electronic form can be generated through the website of the Ministry of Health. The electronic validation of the prescriptions through the alphanumeric reference of the two-dimensional code and the folio number, allow the validation by the pharmacies before being dispensed. Source:General Health Law. SPECIAL PRESCRIPTIONS Who can prescribe? Dispensing special prescriptions Medical surgeons SPECIAL PRESCRIPTIONS Medical Prescription (prescription) LGS Art.226, frac. I Dental surgeons • Medication for 30 days from prescription. • Validity of 30 days from the prescription. Veterinary doctors: • It is supplied and For use in animals retired. Source: National High Level Drug Policy Group. ACHIEVEMENTS OBJECTIVES OF REGULATING THE WHOLE SUPPLY CHAIN OF NARCOTICS AND PSYCHOTROPIC SUBSTANCES 1. Allow and promote use for therapeutic and scientific purposes. 2. Minimize the risk of abuse. 3. Reduce the risk of their illicit production, demand and traffic. Source: National High Level Drug Policy Group. LIMITED AVAILABILITY OF NARCOTICS AND PSYCOTROPIC SUSBSTANCES FOR MEDICAL AND SCIENTIFIC PURPOSES México´s average per capita consumption of morphine for 2013: 1.07 mg 54% lower than average 10 7.30 8 6 4.54 4.32 4.29 3.62 3.33 4 2.49 1.99 1.63 1.56 1.50 2 1.07 0.68 0.66 mg per capita por país 0.34 0.31 0.24 0.22 0.07 0.06 0.04 0.03 0 Source: International Narcotics Control Board; World Health Organization (2013). REGULATIONS PUBLISHED IN 2014 Became mandatory for all Health institutions to have operational and overall policy schemes for palliative care. COFEPRIS had to develop the operational guidelines for special prescription books for controlled substances. As a result, COFEPRIS created the electronic prescription books for opioids. COFEPRIS had to establish guidelines to facilitate the access and assure the supply of opioids. Source: Federal Comission for the Protection against Sanitary Risks (COFEPRIS) RESULTS IN ELECTRONIC PRESCRIPTION BOOKS Pain reduction and Palliative care Characteristics of Prescription Results* books Doctor data is protected 4,643 doctors with electronic prescription books Authorization via internet ( 300% increase). 200 prescriptions per application 1 day response. Prescription validation in pharmacies. Traceability of medicines. Source: National High Level Drug Policy Group. ACTIONS FOR DRUG CONTROL ILLICIT CROP MONITORING SYSTEM IN THE MEXICAN TERRITORY “MEXK54 PROGRAM” Objectives Technical capabilities Comprehensive public policies. Detection of illicit crops. Combat the supply and demand of drugs. 1 Sown area 2 Obtain Yield Kg/Ha statistical data on the planted 3 area where poppy and Chemical analysis marijuana are grown. Study of illicit crops through field work, to obtain the yield Generation Obtaining the of the same. Publication morphine of evidence- "Poppy Crop concentration Monitoring based 2014-2015". of the samples collected in the policies field. Source: MEXK54 Program Documento de uso cerrado ILLICIT CROP MONITORING SYSTEM IN THE MEXICAN TERRITORY “MEXK54 PROGRAM” For the period July 2014 - June 2015, the information was evaluated by the UNODC-Vienna to obtain the estimate of the area sown with poppy crops. Results 2014 - 20151 The results were published in June 2016 in Minimum Medium Maximum a national report and in Poppy sown Surface (Ha) 21,800 26,100 30,400 the 2016 World Drug Report. 2 For the period July 2015- Results 2015 - 2016 June 2016, the estimate of Minimum Medium Maximum poppy crops has been calculated. Poppy sown Surface (Ha) 20,400 25,200 30,000 Source: MEXK54 Project 1 Las cifras correspondientes a 2015 publicadas en la página 51 del Informe Mundial sobre las Drogas 2016 (publicación de las Naciones Unidas, número de venta: S. 16. XI. 7), se han revisado debido a un ajuste estadístico procesado por la UNODC. Estas Cifras corresponden al periodo de estimación de julio de 2014 a junio de 2015. Documento de uso cerrado https://www.unodc.ord/wdr2017/field/Booklet_2_HEALTH.pdf DRUG POLICIES BASED ON SCIENTIFIC EVIDENCE Procedure used to collect field data Source: MEXK54 Project 2. STRENGTHENING THE PROCESS OF COLLECTING DATA OF ERADICATION ACTIVITIES MEXW34 Data transmission via 3 satellite Compile Information in Institutional 2 Databases Generate file in 4 application (Information and 1 images) Monitor, collect and report information on erradication activities of illicit crops nationwide. Compile