Fighting the Opioid Scourge

The numbers are shocking. In 2016, more than 42,000 people in the U.S. died from opioid overdoses – more than any other year on record, according the Centers for Disease Control and Prevention. The toll continues to rise today, claiming, on average, the lives of 91 Americans every single day. President Donald Trump declared the opioid crisis a national health emergency, pledging the full support of the federal government in this fight. Part of that support starts right at America’s borders and ports of entry.

"Like those who distribute and sell drugs on the streets, the criminals who import and distribute narcotics into this country are relentless in their quest for profits and power," said CBP’s Commissioner Kevin McAleenan. "As America’s frontline border security agency, CBP is uniquely responsible – and uniquely positioned – for disrupting the influx of narcotics."

"Customs and Border Protection has a large role in battling the opioid emergency, because we’re at the front lines, at the border," said Amy Schapiro, who’s involved in the agency’s response and is acting branch chief in the Integrated Planning Division of the Operations Support Office for CBP in Washington, D.C. "Illicit fentanyl is produced outside the continental United States, so every time it’s being used, it’s somehow crossing our borders to get into this country. We’re fully committed to disrupting the illicit opioid supply chain and are actively working with our interagency partners."

CBP officials created a broad strategy to combat opioids with four primary goals:

• Enhance collaboration and information sharing
• Produce actionable intelligence
• Target the opioid supply chain
• Protect CBP personnel from exposure to opioids

Improving collaboration and information sharing

The border-crossing nature of the illegal opioid smuggling market makes it essential that CBP also partners with other law enforcement entities charged with helping stop this scourge.

"We interact with national and regional organizations that represent the various levels of law enforcement, such as the International Association of Chiefs of Police and the National Sheriffs’ Association, as well as major cities’ and counties’ police and sheriff’s departments," said Tim Quinn, executive director of intergovernmental public liaison at CBP. "We tell them we recognize this is a big issue, and CBP has an important role to play in it. When you look at how the drugs are coming in through the ports or the mail and express consignments, that is CBP’s responsibility to stop it at those points."

Since so many of the opioids originate overseas, part of the work requires embassies and foreign attachés to develop high-level agreements and working groups to stop the flow of the drugs. That includes working with the U.S. Department of State’s Bureau of International Narcotics and Law Enforcement Affairs, which approaches the illegal drug trade from a security and public health perspective. Through international partnerships, the program, in part, helps break up cross-border narcotics trafficking, using American expertise from the State Department’s 110 partner law enforcement organizations across the U.S.

A good working partnership with some of the United States’ closest neighbors is also key to success fighting the opioid problem.

"Sharing of knowledge between the various agencies is essential so law enforcement can stay on top of current trends and concealments. The more information everyone has, the better chance we have of identifying, interdicting and disrupting," said Chelsea Stark with the Canada Border Services Agency. "For example, there may be a new concealment method that U.S. law enforcement has seen that my agency hasn’t encountered. Sharing it will allow our officers to recognize it should they encounter it."

Another part, closer to home, starts literally where the rubber meets the road: America’s highways. The Domestic Highway Enforcement, or DHE, program links local, state and federal law enforcement officials, in addition to North American international partners, such as Canada Border Services Agency, to catch drugs, currency, counterfeit money, and other contraband, and to break up human trafficking rings. DHE is part of the larger High Intensity Drug Trafficking Areas, better known as HIDTA, a program created by the Anti-Drug Abuse Act of 1988 and run through the Office of National Drug Control Policy. The White House-led effort looks to reduce drug use and stress its devastating consequences by leading the development, implementation, and assessment of U.S. drug policy. HIDTA assists federal, state, local, and tribal law enforcement agencies working these U.S. drug-trafficking regions.

"CBP, as part of the DHE program, shares the latest intelligence about the smugglers through monthly calls and an information-sharing system benefitting law enforcement agencies across the country," said Stephen McConachie, a chief CBP officer and the agency’s liaison to the Office of National Drug Control Policy. "If something should get past CBP’s officers and Border Patrol agents, the next layer of enforcement is the state troopers and local law enforcement agencies."

Those in the High Intensity Drug Trafficking Areas appreciate the information CBP shares through the DHE network to stop opioid smugglers in their tracks.

"We [law enforcement and CBP] are disrupting these drug-trafficking organizations’ method of operations by and through our partnerships," said Tony Garcia, director of the South Texas HIDTA, which includes the border with Mexico and is one of the nation’s highest drug trafficking areas. He said dealers consider the American drug user as a "lab rat." Drug lords try to find different drugs, including synthetic opioids, which can be harder to detect, as well the amount of the drugs users can tolerate. "We have to stay proactive, ahead of the game. DHE is an integral part of information sharing."

Stark said there are formal international treaties and agreements with U.S. agencies, such as CBP and the FBI, to make sure information sharing complies with Canadian law while catching the smugglers.

"The DHE program provides a lot of timely information on smuggling trends, concealments, officer safety issues and interdiction information that we are able to share with our frontline officers to assist them with intercepting narcotics at Canadian land borders," Stark said. "We are interested in identifying the Canadian links and networks in order to disrupt future smuggling attempts. I have been able to connect our agency’s intelligence officers with U.S. partners in relation to other modes, such as small marine vessels. So it opens the doors for the exchange of information that helps us all do our jobs."

McConachie said it comes down to a goal all law enforcement officers have: reduce the supply of illicit drugs in America. "DHE is a good example of working together for a common cause," McConachie said.
 

Producing workable intelligence and cutting the opioid supply chain

CBP also is working on producing the right intelligence to catch more of the deadly cargos as smugglers try to bring them in.

"When you look at drugs as disruptive and deadly as opioids, especially fentanyl, which can kill you, it’s scary," said Steven Stavinoha, director of field operations for CBP’s New Orleans field office. His area includes all of the ports of entry in Alabama, Arkansas, Louisiana, Mississippi and Tennessee. "Our goal is to stop the illicit drugs."

While agents and officers at the border and ports of entry check as many shipments as possible, it’s simply not practical to check every shipment. Helping to narrow down which containers and packages to search, CBP’s National Targeting Center uses a program where advance data and access to law enforcement and intelligence records together target travelers and cargo that pose the highest risk to U.S. security.

"We create advanced, predictable targets and let agents and officers at these ports know to be on the lookout for particular types of shipments," said Robert Gross, chief watch commander at the center’s cargo headquarters in Sterling, Virginia. "After we transmit these various targets to the ports of entry, they’ll inspect those particular shipments, packages or vehicles."

Some of the places taking most advantage of this advanced targeting information are the CBP offices at express carrier hubs, such as the one in Memphis, Tennessee, where shipping giant FedEx processes hundreds of thousands of international packages each day, many of them from overseas locations where opioids are initially produced. Stavinoha said it’s not practical to check every package coming through because express carrier companies deliver time-sensitive packages, such as lifesaving medical supplies. So his people rely on good intel from the National Targeting Center.

"When you’re trying to whittle through that haystack of targets, that’s where you need that additional support at the national level," said Stavinoha, who once served as director of the National Targeting Center’s cargo division. "The center has the capabilities to really do a deep dive on the smuggling organizations, on new trends in smuggling. They look at previous shipments and destinations to link together, as well as other targets to look at, and that is fed back to ports of entry, so we can look for specific targets."

If a suspicious substance is first found and confirmed at the port, it’s then validated by a lab as a banned item. Then the case is turned over to the appropriate law enforcement agencies, including the U.S. Drug Enforcement Administration, for prosecution. The targeting center also adds information from those seizures into its database to better understand what to look for in future targets.
 

Photo illustration of 2 milligrams of fentanyl, a lethal dose in most people. Drug Enforcement Administration photo

Overall, CBP seized nearly 1,500 pounds of fentanyl during fiscal year 2017, partly due to the efforts of CBP’s National Targeting Center. Gross listed some of the latest opioid seizures the center helped with during 2016 and 2017:

• 10 heroin seizures totaling nearly 18 pounds
• Six seizures of opium weighing almost 33 pounds
• 26 seizures of fentanyl weighing nearly 33 pounds

While the amounts might seem small in comparison to the hundreds of pounds of marijuana that CBP often catches in a single bust, Gross said you have to consider how a small amount of an opioid such as fentanyl can end up being literally millions of fatal doses.

"A dose of fentanyl is only 1 milligram (.000035 ounces)," said Gross. "So a kilo of fentanyl has one million doses in it. And it only takes about 2 milligrams (.000070 ounces) for a fatal dose. So the numbers don’t sound big, but they’re actually huge."

Gross said the low purity of the opioids smuggled across the border – usually around 7 percent – makes for overall larger seizures. But shipments through international mail and package delivery services are closer to 100 percent pure fentanyl, meaning smaller, but more deadly quantities come through the mail and package deliveries.

Gross said CBP’s work with the U.S. Postal Service, express carriers and foreign governments helps identify more packages that could be carrying the illicit opioids. The efforts are also paying off as more smugglers are being caught. Recently, the U.S. Department of Justice handed down its first ever indictments against several Chinese makers of fentanyl and other opioids, as well as their American and Canadian. Gross said during the past year, CBP helped support investigations and prosecutions by other law enforcement agencies.

"We’re supporting prosecution in 31 current U.S. Drug Enforcement Administration and 109 Homeland Security Investigations cases," he said. "We’ve been conducting a series of operations with the U.S. Postal Service, Homeland Security and DEA targeting various types of drugs."

Besides the shipments and packages identified by the targeting center, all international mail coming into the U.S. is X-rayed. But even with that close scrutiny, it’s hard to find something measured in milligrams in the tons of mail that come through every day. At the CBP’s international mail processing center in Miami, 60,000 parcels weighing about a quarter of a million pounds are examined each day. That’s a lot to go through to catch drugs handed out in milligrams.
 

An officer in CBP’s Office of Field Operations conducts global observations of air traffic and trade activities at the National Targeting Center, a key component in CBP’s response to the national opioid crisis. Photo by Glenn Fawcett
 

A CBP officer uses protective gloves while searching a packet of wafers and finding illicit drugs. Photo by Keith Smith
 

"We have officers looking at everything and pulling targets [suspected packages] off as they go along the conveyor belt," said Philip Spataro, supervisory CBP officer at the Miami facility who oversees about 30 officers. "It’s a lot of manual labor, and our officers should be commended for their efforts."

"I think we’re making a difference," Spataro said. "We’re committed to keeping these drugs off the streets. If you look at the national statistics of the amount of people dying from opioid overdoses, it’s a serious epidemic."

Gross was also quick to point out CBP didn’t wait to get moving in the fight against opioids.

"We’ve been full speed for a couple of years now," he said.

Gross said while the targeting center has been crucial in helping stem the tide of illegal opioids, they can’t rest on their laurels.

"We need to continue what we’re doing and step up our game," he said, adding that getting more help from CBP’s foreign counterparts and other U.S. agencies is important. "As we develop new targets, it leads to more targets and new investigations."

Stavinoha’s bottom line is pretty direct, considering how deadly the opioid crisis nationwide has become with this latest crop of drugs: Make it tougher for the bad guys to deal in dope.

"I know we’re having an impact, because what we’re doing is forcing them to try deeper concealment methods or ship through other facilities," Stavinoha said. "Whether you are at a seaport, airport, land border, or express or international mail facility, we have an obligation to the citizens of the U.S. to protect them. We are the guardians of our borders."
 

Protecting the frontline from opioids

The potential danger opioids, especially fentanyl and its equivalents, pose to abusers is also apparent to the CBP officers and Border Patrol agents, as well as their K-9 colleagues.

"In the past, that risk was lower when dealing with opioids, such as heroin or morphine," said Dr. David Tarantino, senior medical adviser for CBP and coordinator of the protection part of CBP’s response to the opioid crisis. "But with some of the synthetic opioids, such as fentanyl, the risk has changed."

Tarantino said while the dangers are increasingly clear, part of what they are teaching officers and agents includes debunking some myths. For instance, getting a few grains of fentanyl on unbroken skin will not kill someone; simply brushing it off and thoroughly washing the area with soap and water will prevent adverse effects. In addition, properly worn protective equipment gives significant protection against opioid exposure in most situations.

"We don’t want to stop them from doing their job. We want to keep them safe while they do it," Tarantino said. "The risk is real but manageable."

Tarantino said his office is educating officers and agents and offers these precautions to stay safe:

• Personnel should have a heightened awareness of the potential presence of opioids, including fentanyl
• Avoid exposure to cuts, scrapes, broken skin, or mucus membranes (eyes, nose, mouth). If exposed, wash the area with soap and water. Most important, avoid turning the opioid into an air-born danger and breathing it in, as inhalation increases the risk
• Wear the proper protective equipment: gloves, respirator masks and eye protection. Gloves that cover entire arms can also be part of the package
• Know the signs of opioid exposure in yourself and coworkers: slow or no breathing, drowsiness, pinpoint pupils, and/or an altered mental state
• Make naloxone, a short-term antidote, available to all personnel, and make sure everyone knows how to administer the lifesaving drug

"The increased presence of fentanyl has raised employee’s concerns," Tarantino said. "We’re working to address those concerns and give people the tools and education they need to carry out their mission."

Nicholas Hanke is a CBP officer program manager in the agency’s Office of Field Operations incident management division. He also is the national emergency medical services coordinator for CBP’s Office of Field Operations, Emergency Medical Service program. He said those in the field are trained to a standard used by medical responders for years: Treat every person and every object in the same way, using the proper protections and procedures.

"So you get into the habit of every time wearing your gloves, your eye protection and masks if there’s going to be stuff flying around. It’s trying to get that same mindset if handling contraband," said Hanke. "Plan for the worst-case scenario."

In addition, glove boxes – a place where packages can be breached to extract a small sample for testing – have become the norm.

"We’ve gotten officers out of the mindset of pulling out their knives and cutting into the package. Now, we use small styluses in the glove boxes to make small holes," Hanke said. "No longer are we dropping samples of any white powder into chemical drug test kits at the point of discovery. More care in how and where we field test contraband is now required."

Even K-9 colleagues with the agents and officers are being considered. While you would think drug-sniffing dogs would be at more risk because they literally have their noses right down in the danger zone, the way smugglers wrap up these dangerous narcotics to conceal them from the dogs actually keeps the drugs from escaping the package, preventing exposure.

"We went to a passive dog (one that sits when they find a drug, instead of biting into a package) years ago, well before this danger popped up," said Christopher Houseman, CBP’s Office of Field Operations K-9 program manager. Should an accidental exposure occur, dog handlers also carry naloxone to treat their four-legged companions – something those handlers have actually been carrying for 20 years or more.

Whether four-legged or two, Tarantino said keeping all CBP assets safe from opioids is the goal.
 

All in

There are two important common threads for all four of CBP’s approach (improving collaboration and sharing information; producing workable intelligence; cutting the opioid supply chain; and protecting the frontline from opioids) to fighting opioids: collaboration and an urgent desire to make sure the fight is successful.

"Our part in this national fight against opioids focuses on the supply chain – where and when these drugs are coming into the country," Schapiro said. "We have to keep the most deadly of these illicit opioids, especially fentanyl and its analogues, out of the U.S."

Tim Quinn, executive director of intergovernmental public liaison, explained CBP’s renewed and focused effort to deal with the crisis.

"If we’re going to get on top of this, we’ve got to be working simultaneously in all these different areas, whether it’s abroad or at our ports or taking down international criminals or keeping our CBP officers and Border Patrol agents safe," said Quinn. "Not just one of these things can be done and expect success. All of them have to be done with a real focus given the enormity of the issue."

Schapiro said senior leaders at CBP are making fighting the opioid crisis a priority, as demonstrated in the all-encompassing strategy being executed by the men and women of the agency every day.

"Because of the skyrocketing loss of lives due to drug overdoses, the country as a whole has a responsibility," Schapiro said. "We have to keep illicit opioids out of the hands of family, friends and loved ones."

"Tackling this complex threat involves a united, comprehensive strategy and an aggressive approach by multiple entities across all levels of government," Commissioner McAleenan said. "CBP pledges to work to disrupt and ultimately eliminate these ongoing threats against our communities."
 

CBP canine teams put real teeth into opioid fight

By John Davis

The rise of fentanyl means CBP canines need to be ready to safely sniff out the deadly opioid. The first classes of handlers and dogs trained to detect fentanyl – along with the other drugs they have been trained to detect in the past – graduated in December 2017 from CBP’s canine training centers in Front Royal, Virginia, and El Paso, Texas. Started as a two-week pilot program in June 2017, the training was incorporated into the 12- week, Concealed Human and Narcotics Detection Course. Now, the centers became the very first nationwide to certify canine teams to detect the odor of fentanyl. Going forward, all Office of Field Operations canines will be trained to detect fentanyl.

"In response to the national opioid crisis, we began researching the feasibility of adding this capability to Office of Field Operations canine teams and our training program," said Mark Bazill, acting director of the CBP Canine Program in the Office of Training and Development. "Through our research and collaboration with CBP’s Laboratory and Scientific Services Directorate, as well as other CBP and Department of Homeland Security components, we put together a very rigorous and safety conscious training program."

The newly trained teams of handlers and dogs are already in the field, working to detect fentanyl and other drugs that smugglers might try to bring into the country. More teams are being trained and sent to where they can do the most good, safely.

"All the substances we train with can be deadly to dogs and humans, but fentanyl adds another layer of concern," said Adrian Guerrero, the acting assistant director in Front Royal. "The staff did exceptional work here to implement the additional safety precautions with this substance."