Heroin

Introduction and Trends

While the demand for heroin is significantly lower than for other drugs such as cocaine, methamphetamine, and marijuana, the consequences of heroin abuse are such that its abuse poses a significant drug threat. Less than 9.0 percent of state and local law enforcement agencies nationwide describe heroin as their greatest threat, lower than those who identify crack cocaine (26.5%), methamphetamine (39.6%), and marijuana (12.0%). Moreover, slightly more than 314,000 persons aged 12 or older report past year heroin use in 2003, considerably lower than the number of individuals who report past year use of marijuana (25.2 million), cocaine (5.9 million), and methamphetamine (1.3 million). However, national-level studies indicate that the consequences of heroin abuse such as ED mentions, treatment admissions, and overdose deaths compare to and, in some cases, exceed those associated with drugs with much higher rates of use such as cocaine, marijuana, and methamphetamine.

Heroin is readily available in most major metropolitan areas in the United States, and availability remains relatively stable. Nonetheless, law enforcement reporting indicates that heroin availability continues to increase in rural and suburban areas, albeit at a much slower pace than in the past several years. The increase is most notable in the Northeast Region of the United States. Law enforcement reporting from that region indicates that increasing rates of heroin abuse have put a strain on law enforcement resources, requiring small, local police departments to deal with a problem that historically has been confined to large metropolitan areas. Moreover, many rural and suburban communities lack the extensive drug treatment facilities to accommodate the increasing number of individuals seeking treatment.

Abuse of heroin, a highly addictive drug, can result in serious health consequences including fatal overdose, spontaneous abortion, collapsed veins, and infectious diseases including HIV (human immunodeficiency virus) and hepatitis. Moreover, heroin may have additives that do not readily dissolve and can clog blood vessels that lead to the lungs, liver, kidneys, or brain and cause infection or death of small patches of cells in vital organs. Results from a 33-year study conducted by the University of California, Los Angeles (UCLA) Drug Abuse Research Center highlight the pervasive public health and public safety consequences of heroin use. Of 581 heroin addicts who participated in the study, nearly half had died by the completion of the study when they would have been between 50 and 60 years of age. The most common cause of death was drug overdose, followed by chronic liver disease. The study also found that nearly half of those who survived continued to use heroin, evidence of the significant addictive nature of heroin. Initially, tolerance develops with regular heroin use. As a result, users must use more heroin to achieve the same effect. Tolerance eventually leads to physical dependence and addiction. Once an individual is physically dependent on heroin, he or she will experience withdrawal symptoms if use is reduced or stopped.

Heroin abuse generally is associated with property or nonviolent crime. Heroin abusers frequently resort to crimes such as shoplifting, petty theft, burglary, and prostitution to support their overwhelming need for the drug. Law enforcement reporting indicates, however, that heroin distribution is increasingly associated with violent crime. Heroin distributors--particularly members of street gangs--often engage in violent crimes such as assaults and homicides to establish or maintain control of distribution in a certain area. According to the NDTS 2004, 12.3 percent of state and local law enforcement agencies nationwide identify heroin as the drug that most contributes to property crime in their areas, up from 10.9 percent in 2003. The data also show that 5.8 percent of state and local law enforcement agencies nationwide identify heroin as the drug that most contributes to violent crime in their areas, up from 4.6 percent in 2003.

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Availability

The availability of Southwest Asian heroin in the United States appears to have increased slightly in 2003. According to EPIC, wholesale Southwest Asian heroin seizures in the U.S. Arrival Zone in FY2003 exceeded the amount of Mexican heroin seizures, making Southwest Asian heroin second only to South American heroin in the amount seized within the U.S. Arrival Zone--an indication of the increased availability of Southwest Asian heroin. However, although anecdotal law enforcement reporting indicates that, nationally, Mexican heroin remains much more widely available. Moreover, the amount of heroin identified as Southwest Asian by the DEA Heroin Signature Program (HSP)¹⁵ increased from 7 percent of the total heroin analyzed by weight in 2001 to 10 percent of the total heroin analyzed by weight in 2002. Finally, reporting from DEA Field Divisions in Chicago, St. Louis, and New York indicates that the availability of Southwest Asian heroin has increased in their jurisdictions.

NDIC Comment: Law enforcement reporting indicates that the increased availability of Southwest Asian heroin in 2003 was attributable partly to participation by certain groups in heroin transportation and wholesale distribution. For example, West African traffickers, primarily Nigerians, are responsible for resurgence in the availability of Southwest Asian heroin in Chicago. According to DEA, arrests and seizures over the past few years have significantly interrupted Nigerian and other West African traffickers' ability to transport Southeast Asian heroin to Chicago. As a result, these traffickers more frequently obtain heroin in Pakistan, increasing the availability of Southwest Asian heroin. According to the DEA St. Louis Field Division, at least some of the Southwest Asian heroin available in its jurisdiction is transported to the area from Chicago. The DEA New York Division reports that the increasing availability of Southwest Asian heroin in its jurisdiction is due partly to Russian and East European trafficking organizations. These organizations are able to obtain Southwest Asian heroin at a price lower than that at which their counterparts can obtain South American heroin, and they can rely on an increasingly dependable network of distributors in some areas of New York City.

Despite the data and anecdotal reporting that show increased availability of Southwest Asian heroin in the United States during 2003, preliminary 2004 data indicate that availability of Southwest Asian heroin may be receding to pre-2003 levels.

Demand

National-level drug prevalence studies indicate that the overall demand for heroin in the United States is relatively stable; however, the number of primary heroin treatment admissions continues to increase. According to TEDS data, the number of primary heroin treatment admissions increased steadily each year since 1992 and increased from 277,911 in 2001 to 285,677 in 2002.

NDIC Comment: The increase in treatment admissions for heroin despite stabilizing demand may be due to the fact that heroin abusers typically abuse the drug for several years before seeking treatment. Thus, many individuals currently seeking treatment likely began abusing the drug in the mid- to late 1990s when the demand for heroin increased significantly in the United States. According to TEDS data, the average number of years of heroin use for clients entering treatment for the first time in 2000 and 2001 was 12.9 and 12.3 years, respectively, for abusers whose primary route of administration was injection and 11.1 and 11.6 years for users whose primary route of administration was inhalation.

Production

After decreasing significantly from 2000 to 2001, worldwide illicit opium production increased in 2002 and 2003; the production in 2003 (3,757 mt) was nearly double that in 2002 (2,237 mt). Likewise, potential heroin production decreased from 522.2 metric tons in 2000 to 132.6 metric tons in 2001 before increasing to 244.7 metric tons in 2002 and 426.9 metric tons in 2003. Moreover, 2004 estimates indicate a significant increase in illicit opium production and potential heroin production.

NDIC Comment: The significant increases in potential worldwide opium and heroin production estimates for 2002, 2003, and 2004 are attributable overwhelmingly to increases in production in Afghanistan. Potential opium production in Afghanistan increased from 63 metric tons in 2001, to 1,278 metric tons in 2002, to 2,865 metric tons in 2003, and 4,950 metric tons in 2004. Potential heroin production estimates for Afghanistan increased from 7 metric tons in 2001, to 150 metric tons in 2002, to 337 metric tons in 2003, and 582 in 2004. Conversely, potential opium and heroin production estimates for Burma--the primary source of Southeast Asian heroin--have decreased each year since 2000. As a result of these changes, the predominant source of Asian heroin in the United States appears to be shifting from Southeast Asia to Southwest Asia. However, the market for white powder heroin will likely continue to be dominated by heroin from South America. In fact, the increased heroin production in Afghanistan is not likely to result in increased heroin availability in the United States because only a small amount of Southwest Asian heroin is transported to the United States for subsequent distribution

Transportation

The amount of South American heroin seized in the U.S. Arrival Zone along the Southwest Border--particularly Texas--increased significantly in 2003. According to EPIC, the amount of South American heroin seized in the U.S. Arrival Zone in Texas surpassed the amount seized in New Jersey, historically the state reporting the third highest amount of South American heroin seized, after New York and Florida.

NDIC Comment: South American heroin typically is smuggled into the United States by couriers aboard commercial flights to international airports in New York and Miami. However, law enforcement reporting indicates that traffickers are transporting increasing amounts of South American heroin across the Southwest Border. Law enforcement reporting indicates that Colombian DTOs are increasingly relying on Mexican DTOs and criminal groups to transport South American heroin to the United States much as they rely on Mexican DTOs to transport cocaine. Most of the South American heroin transported across the Southwest Border likely is destined for markets in the eastern United States including Chicago and New York.

Distribution

Heroin distribution in Chicago, a Primary Market Area for multiple types of heroin, has expanded to many outlying communities, resulting in an increase in the consequences of heroin abuse in the Chicago area. In fact, national-level consequence data indicate that rates of heroin-related treatment admissions, ED mentions, and deaths in Chicago are among the highest in the nation and continue to increase.

NDIC Comment: A primary factor contributing to increasing consequences of heroin abuse in Chicago is the increase in the number of suburban users, particularly those under age 25, who are experimenting with and becoming addicted to heroin. The number of suburban users began to increase in the early 1990s when high purity South American heroin became available in Chicago. Because of the high purity, new users were able to snort the drug, avoiding the stigma and health consequences associated with injection drug use. However, TEDS data show that injection drug use increased significantly in the Chicago Metropolitan Statistical Area from 1997 through 2000, possibly the result of these suburban users transitioning to injection. Although the majority of injection drug users were over age 35, the largest increase in the rate of injection drug use was for those aged 24 and younger. Injection drug use results in serious health consequences that have contributed and will continue to contribute to the increasing number of heroin-related treatment admissions, ED mentions, and deaths in the Chicago area.

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Availability

There are no conclusive estimates of the total amount of heroin available in the United States largely because of unsubstantiated or unknown laboratory capacity and yield estimates in source areas and limitations in seizure data. However, in attempting to quantify the amount of heroin available in the United States, the interagency Heroin Availability Working Group established a preliminary estimate in 2002 of 16.1 metric tons of pure heroin; the estimate falls within the estimated range for 2001 of 13 to 18 metric tons of pure heroin.

Heroin is readily available in most major metropolitan areas in the United States, and availability appears to be relatively stable. Nearly all DEA Field Divisions and HIDTA offices report that heroin is readily available: only two HIDTAs--North Texas and Rocky Mountain--report that heroin is not readily available throughout the HIDTA area. In addition, the New England HIDTA reports that heroin availability is increasing, and the Hawaii HIDTA reports that heroin availability is decreasing. Over the past several years, heroin has become increasingly available, particularly in the Northeast Region of the United States. This likely is not an indication that the amount of heroin available in the United States is increasing but rather an indication that heroin is available in more areas, particularly rural and suburban areas. Law enforcement reporting indicates that heroin availability continues to increase in rural and suburban areas, albeit at a much slower pace than in the past several years.

NDTS 2004 data indicate that heroin availability has increased since 2002. The percentage of state and local law enforcement agencies nationwide reporting that heroin availability was high or moderate in their areas increased from 33.0 percent in 2002, to 38.0 percent in 2003, and 41.3 percent in 2004. In 2004 more agencies in the Northeast Region (74.2%) reported heroin availability as high or moderate than agencies in the Pacific (55.8%), Midwest (37.6%), Southwest (32.8%), West (19.5%), or Southeast Regions (17%). NDTS 2004 data show that the percentage of state and local law enforcement agencies nationwide reporting that heroin availability was low in their areas decreased from 52.3 percent in 2002, to 50.5 percent in 2003, and 47.1 percent in 2004. The percentage of agencies reporting that heroin was not available in their areas increased from 8.1 percent in 2003 to 9.0 percent in 2004.

FDSS data show that after 4 consecutive years of increases, the amount of heroin seized through incidents in which federal agencies participated decreased in 2003 (see Figure 31). The decrease in federal heroin seizures appears to be due primarily to a decrease in the amount of heroin seized in New York from 2002 (1,064.3 kg) to 2003 (628.8 kg). Despite the decrease, over half the total amount of heroin seized in 2003 was seized in New York or Florida (608.1 kg). Large quantities of heroin also were seized in Texas (281.5 kg) and California (150.8 kg)

Figure 31. Federal-wide drug seizures, heroin, in kilograms, 1999-2003.

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Source: Federal-Wide Drug Seizure System.

South American and Mexican heroin are the most prevalent types of heroin available in the country, and availability of these types varies regionally. According to DEA, heroin produced in South America dominates the white powder heroin market east of the Mississippi River, and black tar heroin and brown powder heroin produced in Mexico dominate the market west of the Mississippi River. According to the DEA Domestic Monitor Program (DMP), nearly 95 percent of all qualified heroin samples--those for which price, purity, and geographic source data were available--were classified as South American or Mexican heroin in 2002.¹⁶ Of 614 qualified samples, 341 were classified as South American heroin, and 241 were classified as Mexican heroin.

Southeast and Southwest Asian heroin also are available in the United States, albeit to a lesser extent than Latin American (South American and Mexican) heroin. According to DMP, only 32 retail-quantity qualified heroin samples were classified as either Southwest or, to a lesser extent, Southeast Asian heroin in 2002. Over twice as many retail-quantity samples were classified as Southwest Asian heroin (22) than Southeast Asian heroin (10). In 2002 Southeast Asian heroin was purchased in Atlanta, Chicago, Dallas, and Washington, D.C. Southwest Asian heroin was purchased in Atlanta, Baltimore, Chicago, Detroit, New Orleans, New York City, and Washington, D.C.

In 2002, for the eighth consecutive year, the majority (80%) of the heroin analyzed by weight under the HSP was identified as South American heroin. During that same year, 10 percent of the heroin analyzed by weight was identified as Southwest Asian heroin, 9 percent as Mexican heroin, and 1 percent as Southeast Asian heroin. In 2001, 56 percent of the heroin analyzed by weight was South American, 30 percent was Mexican, 7 percent was Southwest Asian, and 7 percent was Southeast Asian. The decrease in the percentage of Mexican heroin by weight in 2002 is due to a decrease in the weight of individual seizures. In 2001 eight seizures of Mexican heroin ranged from 12 to 74 kilograms each; however, in 2002 single-seizure amounts generally ranged from just 1 to 5 kilograms. The total number of Mexican heroin samples analyzed was the same (101) in both years.

The number and rate of DEA arrests involving heroin decreased steadily over the last 3 years; however, this decrease is not an indication of decreasing availability of the drug but rather a reflection of a change in DEA investigation strategy to target fewer but higher priority targets. The number of DEA arrests involving heroin decreased from 3,220 in 2001, to 2,613 in 2002, and 2,069 in 2003; the rate of heroin arrests also decreased from 13.1, to 12.2, to 10.7 percent of all arrests during that same period.

Heroin purity levels vary considerably based on several factors including the type of heroin, the location of the market, and the quantity purchased. According to DMP data, the average retail-level purity of South American heroin purchased in 13 metropolitan areas in 2002 was 46.0 percent, considerably higher than that of Mexican, Southeast Asian, or Southwest Asian heroin. Mexican heroin purchased in 10 metropolitan areas averaged 27.3 percent pure, while Southeast and Southwest Asian heroin purchased in four and seven metropolitan areas, respectively, averaged 23.9 percent and 29.8 percent pure. The highest individual purity levels were recorded in New York City (South American 96.0%), San Diego (Mexican 71.2%), Atlanta (Southeast Asian 61.4%), and Detroit (Southwest Asian 72.5%).

The price of heroin also varies considerably throughout the country and is dependent on a number of factors including the type of heroin, location of the market, buyer-seller relationships, quantity purchased, and purity. DEA illicit drug price data--reported as a national price range for heroin--indicate that heroin prices generally have decreased from 2001 through 2003 with some fluctuations. According to DEA, the national price range in 2003 was $52,000 to $90,000 per kilogram, $2,000 to $3,100 per ounce, and $60 to $200 per gram for South American heroin; $18,000 to $50,000 per kilogram, $700 to $2,000 per ounce, and $90 to $110 per gram for Mexican heroin; $40,000 to $80,000 per kilogram, $2,700 to $3,000 per ounce, and $60 to $200 per gram for Southeast Asian heroin; and $60,000 to $70,000 per kilogram, $2,000 to $4,000 per ounce, and $200 to $400 per gram for Southwest Asian heroin.

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Demand

The overall demand for heroin in the United States is relatively stable at levels lower than those for other major drugs of abuse such as cocaine, marijuana, methamphetamine, and MDMA. According to 2003 NSDUH data, 314,000 persons aged 12 or older used heroin in the past year, considerably lower than the number of individuals who used cocaine (5,908,000), marijuana (25,231,000), methamphetamine (1,315,000), or MDMA (2,119,000).

Predominant User Groups

National drug prevalence data indicate that rates of heroin use are relatively low among all user groups. Nonetheless, NSDUH 2003 data indicate that rates of past year heroin use were higher among persons aged 18 to 25 (0.3%) than any other age group including those aged 12 to 17 (0.1%) and 26 or older (0.1%). According to 2003 MTF data, rates of past year use were highest among eighth graders (0.9%), followed by twelfth (0.8%) and tenth graders (0.7%); rates of past year use were lowest among college students aged 19 to 22 (0.2%) and young adults aged 19 to 28 (0.4%).

Overall, males are more likely to use heroin than females, although female rates of use are higher for some age groups. According to NSDUH 2003 data, twice as many males (0.2%) report using heroin in the past year than females (0.1%). However, among persons aged 12 to 17, rates of use were higher among females (0.2%) than males (0.1%). Among persons aged 18 to 25, rates of use were higher among males (0.4%) than females (0.2%). MTF 2003 data show that past year rates of heroin use among eighth grade females (0.9%) were higher than rates among eighth grade males (0.8%), while rates of use among tenth and twelfth grade males (0.8% for both grades) were higher than rates among tenth and twelfth grade females (0.7% and 0.5%, respectively). MTF data also show that rates of past year heroin use among males aged 19 to 30 (0.5%) were higher than rates among females (0.3%).

Drug prevalence data regarding rates of heroin use among different ethnic groups are limited; however, available data indicate no significant differences in the rates among different ethnic groups. MTF 2003 ethnicity data--available only for eighth, tenth, and twelfth graders--show that rates of past year heroin use were higher among Hispanics for eighth graders (2.7%) than among Whites (1.5%) and Blacks (1.0%). For tenth graders, rates among Hispanics and Whites (even at 1.8%) were higher than among Blacks (0.5%), and for twelfth graders, rates of use were higher among Whites (1.6%) than among Hispanics (1.8%) and Blacks (1.0%).

Drug prevalence data regarding the proportion of individuals in large metropolitan areas who use heroin compared with the proportion of users in rural areas suggest that there are no significant differences in the rates. According to 2003 MTF data, the rate of past year use for heroin among persons aged 19 to 30 was 0.5 percent for those in Very Large Cities and 0.4 percent for those in Farm/Country areas. Among adolescents, rates were slightly higher for those living in Non-MSAs than Large MSAs. MTF 2003 data show that in Non-MSAs 1.2, 0.9, and 0.9 percent of eighth, tenth, and twelfth graders, respectively, report past year heroin use compared with 0.8, 0.6, and 0.7 percent in Large MSAs.

Trends in Use

Rates of heroin abuse among adults increased slightly after trending downward over the past few years. According to MTF data, past year use rates among college students declined each year from 2000 to 2002 before increasing slightly in 2003. Use rates among young adults increased in 2003 after declining significantly from 2001 to 2002. Only 2 years of NSDUH data are available, and therefore the data are not sufficient to show definitive trends. Nevertheless, NSDUH data indicate that rates of past year heroin use were relatively stable from 2002 to 2003 for adults aged 18 to 25 and 26 or older (see Figure 32).

Figure 32. Adult trends in percentage of past year use of heroin, 2000-2003.

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Source: Monitoring the Future; National Survey on Drug Use and Health.

Among adolescents, MTF data show that past year rates of heroin use declined overall--with some fluctuations--since 1999 for eighth, tenth, and twelfth graders. From 2002 to 2003, the rate of use for tenth graders declined significantly but then trended upward in 2004. During that same period, past year use rates remained stable for eighth graders and twelfth graders. According to NSDUH, data also show very low and declining rates of past year heroin use among adolescents from 2002 to 2003, the only years for which such data are available (see Figure 33).

Figure 33. Adolescent trends in percentage of past year use of heroin, 2000-2004.

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Source: Monitoring the Future; National Survey on Drug Use and Health.

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Perceptions of Use

National prevalence data show that adolescents generally perceive heroin use as risky behavior. According to MTF data, the rates at which eighth, tenth, and twelfth graders perceive great risk in people using heroin once or twice without a needle have remained relatively stable at high levels since 1995, while perceptions of risk among younger and older adults have trended upward over the last 10 years (see Figure 34). MTF data also indicate that most adolescents and younger and older adults disapprove of people using heroin (see Figure 35). PATS data indicate that while teenagers generally perceive heroin use as risky behavior, those perceptions have lessened slightly over the past few years. In 2003, 76 percent of teenagers agreed that "heroin was a dangerously addictive drug" compared with 77 percent in 2002 and 79 percent in 2001. In addition, the number of teenagers who agreed that "heroin can wreck your life" decreased from 86 percent in 2001 to 84 percent in 2002 to 83 percent in 2003.

Figure 34. Trend in percentage of perceived harmfulness of heroin, selected groups, 1995-2004.

Percentage saying there is "great risk" in 
people trying heroin once or twice.

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Source: Monitoring the Future.

Figure 35. Trends in disapproval of heroin use, 1995-2004.

Percentage who "disapprove" or "strongly disapprove" of
people trying heroin once or twice.

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Source: Monitoring the Future.

Trends in Consequences of Use

Data regarding the consequences of heroin use are mixed. After a considerable increase in the number of ED mentions for heroin between 1996 and 2000, the total number of ED mentions for heroin remained relatively stable in 2001 and 2002 (see Figure 36). DAWN cities with the highest rates in 2002 were Chicago (220 per 100,000 population), Newark (214 per 100,000), and  Baltimore (203 per 100,000), while the DAWN cities with the lowest rates were Dallas (10 per 100,000), Minneapolis (16 per 100,000), and Atlanta (20 per 100,000).

Figure 36. Heroin-related emergency department mentions, estimated number, 1996-2002.

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Source: Drug Abuse Warning Network.

TEDS data show that heroin accounted for 15.2 percent of all treatment admissions in 2002, exceeding the proportion of admissions for primary cocaine abuse for the fourth consecutive year. The number of admissions for which heroin was identified as the primary substance of abuse increased steadily since 1992 and increased from 277,911 in 2001 to 285,667 in 2002 (see Figure 37). Approximately two-thirds (68.5%) of all admissions were male and nearly half (47.9%) were Caucasian. Most (71.9%) primary heroin admissions were aged 30 years or older, and the average age at admission for primary heroin admissions was 36. Most (61.9%) primary heroin admissions reported injection as their primary method of administration, followed by inhalation (32.9%) and smoking (2.5%). Slightly more than 80 percent of primary heroin abusers report using heroin daily.

Figure 37. Heroin-related admissions to publicly funded treatment facilities, number, 1992-2002.

TEDS: Heroin Admissions to Publicly Funded Treatment 
Facilities, 1992-2002

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Source: Treatment Episode Data Set.

ADAM data show that the median percentage of adult male arrestees who tested positive for opiate use (usually heroin) in 2003 was 5.8. More males tested positive in Rio Arriba (NM) (28.4%) than in any other ADAM site. Other sites where positive rates were high include Chicago (24.9%), Boston (17.3%), New York City (15.0%) and Portland (OR) (15.0%). Sites with the lowest rate of males testing positive for opiate abuse in 2003 were Woodbury (IA) (1.6%), Charlotte (NC) (2.0%), and Los Angeles (2.0%). Overall, only a small number of male arrestees report using heroin in the past year. Of those arrestees who report they had used the drug in the past year, the median average number of days that they report using heroin in the past 30 days was 9.6.

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Production

Heroin is produced from opium cultivated in Latin America (Mexico and South America, primarily Colombia), Southeast Asia (primarily Burma), and Southwest Asia (primarily Afghanistan). In 2003 potential worldwide opium production and heroin production increased significantly. Potential worldwide illicit opium production in 2003 was estimated at 3,757 metric tons compared with 2,237 metric tons in 2002. Worldwide heroin production was estimated at 426.9 metric tons in 2003 compared with 244.7 metric tons in 2002 (see Table 20).

Table 20. Potential Worldwide Heroin Production, in Metric Tons, 1999-2004

Source: Crime and Narcotics Center.
* Estimates for 2004 are not completed

Latin America. Potential opium production in Latin America increased from 126 metric tons in 2002 to 164 metric tons in 2003, accounting for less than 5 percent of worldwide production. However, nearly all the Latin American opium produced is refined into heroin destined for the U.S. market. The increase from 2002 to 2003 primarily is due to an increase in poppy cultivation in Mexico. According to the Crime and Narcotics Center (CNC), there were an estimated 4,800 hectares under cultivation in Mexico in 2003 that potentially could have produced 101 metric tons of opium compared with 2,700 hectares under cultivation in 2002 that potentially could have produced 58 metric tons of opium. Potential heroin production in 2003 is estimated at 11.9 metric tons, an increase from 6.8 metric tons in 2002. Most of the heroin produced in Mexico is black tar and, to a lesser extent, brown powder heroin. Limited law enforcement and intelligence reporting indicate that white heroin is being produced in Mexico, although the extent of that production is largely unknown. Poppy cultivation in Colombia decreased slightly in 2003 likely due to a continued aerial-spraying eradication campaign. According to CNC, there were an estimated 4,400 hectares under cultivation in 2003 that potentially could have produced 63 metric tons of opium compared to 4,900 hectares under cultivation in 2002 that potentially could have produced 68 metric tons of opium. Potential heroin production in 2003 is estimated at 7.8 metric tons, a slight decrease from 8.5 metric tons in 2002.

Southeast Asia. Poppy cultivation in Burma decreased for the fifth consecutive year but, unlike previous years, weather was not a major factor affecting the decline in cultivation levels. According to CNC, a major factor contributing to the decline was Rangoon's enforcement of opium poppy-growing bans. In 2004 there were an estimated 30,900 hectares under cultivation in Burma that potentially could have produced 292 metric tons of opium compared with 47,130 hectares under cultivation in 2003 that potentially could have produced 484 metric tons of opium. Potential heroin production in Burma was estimated at 28 metric tons in 2004 compared with 46 metric tons in 2003. Opium cultivation and heroin production occur to a much lesser extent in Laos. In 2004 an estimated 10,000 hectares were under cultivation in Laos that potentially could have produced 49 metric tons of opium compared with 18,900 hectares under cultivation in 2003 that potentially could have produced 200 metric tons of opium. Potential heroin production in 2004 is estimated at 5 metric tons compared with 19 metric tons in 2003. Heroin produced in Burma and Laos primarily is destined for markets in China, Southeast Asia, and the Asian Pacific Rim (including Australia); limited quantities are available in the United States.

Southwest Asia. Afghanistan remained the world's largest producer of opium in 2004. According to CNC, poppy cultivation in Afghanistan increased from 61,000 hectares in 2003 to 206,700 hectares in 2004. Likewise, potential opium and heroin production increased from 2,865 metric tons and 337 metric tons, respectively, in 2003 to 4,950 metric tons and 582 metric tons, respectively, in 2004. Opium poppy cultivation also increased in Pakistan in 2003, the latest year for which such data are available, albeit to very low levels after being all but eliminated in 2001. In 2003 an estimated 1,714 hectares were under cultivation that potentially could have produced 44 metric tons of opium compared with 213 hectares under cultivation in 2002 that potentially could have produced 4.3 metric tons of opium. Potential heroin production is estimated at 5.2 metric tons in 2003 compared with 0.5 metric ton in 2002. Heroin produced in Afghanistan and Pakistan primarily is destined for European, Eurasian, and West Asian markets. As with Southeast Asian heroin, limited quantities are available in the United States.

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Transportation

Heroin is smuggled into the United States primarily from South America and Mexico but also from Southeast and Southwest Asia. Law enforcement reporting indicates that heroin typically is smuggled into the United States by couriers on commercial flights from source or transit countries or concealed in private and commercial vehicles driven across the Southwest Border and, to a lesser extent, the Northern Border. Heroin also is smuggled into the United States via maritime conveyances and mail services. Once inside the United States, heroin is transported primarily overland in private and commercial vehicles often equipped with hidden compartments but also by couriers traveling on commercial flights and via mail services.

According to EPIC seizure data for 2001, 2002, and 2003, seizures of heroin arriving from foreign source areas have occurred overwhelmingly from commercial air followed by land and maritime conveyances. In 2003, 1,312 kilograms of heroin were seized from commercial air compared to 1,589 kilograms in 2001 and 1,766 kilograms in 2002. Significantly less heroin was seized at POEs, between POEs, at checkpoints, or resulting from traffic stops or investigations along the Southwest and Northern Borders. In 2003, 291.5 kilograms of heroin were seized along the Southwest Border compared with 372.0 kilograms in 2001 and 252.7 kilograms in 2002. In 2003 nearly half (47%) of the heroin seized along the Southwest Border was seized at checkpoints or as the result of traffic stops compared with 2001 when nearly three-quarters (74%) of the heroin was seized at POEs. The Southwest Border POE recording the largest amount of heroin seized in 2003 was El Paso (TX) (70.7 kg). Small quantities of heroin also were seized at the Calexico, Otay Mesa, and San Ysidro POEs in California; the Nogales and San Luis POEs in Arizona; and the Brownsville, Del Rio, El Paso, Hidalgo, and Laredo POEs in Texas. Along the Northern Border, a total of 4.8 kilograms of heroin was seized in 2001 at POEs in Detroit and Niagara Falls (NY), and less than 1 kilogram of heroin was seized in 2002 through an investigation in Washington State. No heroin was seized along the Northern Border in 2003. In 2003, 111 kilograms of heroin were seized from commercial maritime vessels compared with 222 kilograms in 2001 and 102 kilograms in 2002. In 2003 commercial maritime seizures were made in California, Delaware, Florida, Louisiana, New Jersey, Puerto Rico, South Carolina, Texas, and the U.S. Virgin Islands.

Mexico. Mexican DTOs and criminal groups with ties to Mexico and the United States smuggle Mexican heroin--primarily black tar but also brown powder--into the United States overland across the Southwest Border. Law enforcement reporting indicates that Mexican heroin seized along the Southwest Border primarily is seized from private vehicles often equipped with hidden compartments. Mexican heroin also is smuggled into the United States in commercial vehicles and by couriers who walk across the Southwest Border at or between POEs. Couriers typically conceal heroin taped to their bodies or hidden in their shoes or in carried baggage.

Seizure data indicate that the amount of Mexican heroin seized along the Southwest Border decreased significantly from 2002 to 2003. According to EPIC data, only 55 kilograms of heroin seized in the Southwest Border Arrival Zone (in the United States up to approximately 150 miles from Mexico) in FY2003 was reported to be or was analyzed as Mexican black tar or brown powder heroin. This represents a significant decrease from FY2002 when 338 kilograms of heroin reported to be or analyzed as Mexican heroin were seized in the Southwest Border Arrival Zone; however, the high seizures in FY2002 were primarily the result of one law enforcement operation during that period. Most of the Mexican heroin seized in the Southwest Border Arrival Zone in FY2003 was seized at POEs in California (29 kg) followed by POEs in Texas (20 kg).

The Primary Market Area for Mexican heroin is Los Angeles. Mexican heroin is transported in private and commercial vehicles from the Southwest Border to Los Angeles via interstate highways. Some Mexican heroin also is transported to Chicago, a Primary Market Area for heroin. Traffickers transport Mexican heroin from the Southwest Border to Chicago in commercial and private vehicles.

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South America. Colombian DTOs and criminal groups control the transportation of South American heroin to the United States. South American heroin typically is smuggled into the United States by couriers aboard commercial flights to international airports in New York and Florida. Couriers take direct or indirect flights from international airports in Colombia to John F. Kennedy or La Guardia International Airports or Miami International Airport. Indirect flights involve a stopover at a transit country prior to arriving in the United States. Transit countries include those in Central America, the Caribbean, or South America such as Argentina or Chile. Single flights, direct or indirect, may involve several couriers. Couriers employ a variety of concealment methods that include swallowing latex-wrapped heroin pellets, taping packages of heroin to their bodies, or secreting heroin in clothing in luggage. In addition, couriers continue to smuggle heroin-saturated clothing into the United States. The amount of heroin smuggled by individual couriers aboard commercial flights has increased over the past few years, now ranging between 5 to 8 kilograms per trip.

Seizure data indicate that South American heroin is increasingly smuggled overland through and between POEs along the Southwest Border. In fact, in FY2003 the amount of heroin seized in the Southwest Border Arrival Zone that was reported to be or was analyzed as South American heroin exceeded the amount of heroin seized that was reported to be or was analyzed as Mexican heroin. According to EPIC data, most of the South American heroin was seized at the El Paso POE and at the U.S. Highway 281 Border Patrol checkpoint located near Falfurrias (TX). In FY2003 Texas was ranked third behind New York and Florida for the largest amount of heroin reported to be or analyzed as South American, a rank historically held by New Jersey. According to EPIC, the most common concealment method for South American heroin seized along the Southwest Border was sewing the heroin into jacket linings.

South American heroin also is smuggled into the United States aboard commercial vessels. The heroin typically is smuggled by passengers or crew members aboard cruise ships that arrive in Florida or Puerto Rico. South American heroin also is smuggled by crew members on cargo vessels--direct from Colombia or through transshipment areas in Central America, primarily Panama--arriving at East Coast and, occasionally, West Coast ports as well as U.S. ports in the Gulf of Mexico. South American heroin is increasingly smuggled into the United States commingled with cocaine in commercial shipping containers. In 2003, 109.9 kilograms of heroin, most of it South American, were seized aboard commercial vessels in the U.S. Arrival Zone, an increase from 94.1 kilograms in 2002. As of March 2004 more than 100 kilograms of South American heroin had been seized aboard commercial vessels.

The Primary Market Areas for South American heroin are New York and Chicago. Although a significant amount of South American heroin is transported directly to New York by couriers aboard commercial flights, some is transported first to Miami via couriers aboard commercial flights or aboard commercial maritime vessels, then transported from Miami to New York in private and commercial vehicles. South American heroin is transported in private and commercial vehicles to Chicago from the Southwest Border or from New York.

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Southeast Asia. Ethnic Chinese criminal groups, principally the Fukinese, and West African criminal groups, principally Nigerians, are the primary transporters of Southeast Asian heroin to the United States. Limited amounts of Southeast Asian heroin are smuggled into the United States via couriers on commercial flights, containerized maritime cargo, and express mail services.

Couriers on commercial flights primarily transport Southeast Asian heroin to international airports in New York as well as to other international airports in cities such as Atlanta and Chicago. Law enforcement reporting indicates that Southeast Asian heroin also is transported via commercial air to Montreal, Québec and subsequently is transported by Middle Eastern DTOs and criminal groups in private and commercial vehicles to a limited number of United States drug markets.

Seizure data indicate that Southeast Asian heroin is rarely seized from commercial maritime vessels--the last significant seizure (62 kg) occurred in January 2001. However, law enforcement reporting indicates that traffickers continue to transport Southeast Asian heroin to the United States using this mode. According to DEA, Southeast Asian heroin is transported from Southeast Asia through Asian countries or Pacific islands to the United States via containerized cargo, typically across the Pacific Ocean to maritime POEs in Vancouver, British Columbia, or California. Although intelligence is limited regarding the smuggling of Southeast Asian heroin from Canada into the United States, two scenarios are likely. First, Southeast Asian heroin may be smuggled from Vancouver through POEs in the western United States before being further transported east across the United States to domestic drug markets, primarily New York. Second, Southeast Asian heroin smuggled into Vancouver initially may be transported east across Canada before being smuggled into the United States through POEs in New York.

The Primary Market Areas for Southeast Asian heroin are New York and Chicago. Southeast Asian heroin is transported either directly to New York or indirectly from the West Coast and Canada as described above. Southeast Asian heroin is transported to Chicago also by couriers on commercial aircraft directly to Chicago or via Canada and by package delivery services. Southeast Asian heroin also is transported to Chicago from New York and Los Angeles in private and commercial vehicles and by couriers on buses and trains.
  

Southwest Asia. Pakistani traffickers are the primary transporters of Southwest Asian heroin to the United States; however, East European, Middle Eastern, Russian, and West African criminal groups also transport Southwest Asian heroin to the United States. Southwest Asian heroin is transported to the United States primarily by couriers on commercial aircraft but also via air cargo and express mail services. It often is smuggled through Central Asia and Europe. The primary POE for Southwest Asian heroin is New York City. Southwest Asian heroin also is transported via commercial air to other U.S. cities including Atlanta, Chicago, Detroit, and Washington, D.C. Nigerian criminal groups transport small quantities of Southwest Asian heroin to and through Atlanta. Nigerian criminal groups also transport Southwest Asian heroin to Chicago using couriers aboard commercial flights. Middle Eastern criminal groups transport some Southwest Asian heroin into Canada via commercial air before transporting it in private and commercial vehicles to Detroit. According to the DEA Washington Field Division, West African traffickers obtain Southwest Asian heroin from Pakistani sources that use couriers of Asian descent to transport Southwest Asian heroin to the Washington-Baltimore area.

The Primary Market Areas for Southwest Asian heroin are New York and Chicago. Southwest Asian heroin is transported directly to New York and Chicago as described previously. Southwest Asian heroin also is transported to Chicago via Canada and from New York and Los Angeles in private and commercial vehicles.

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Distribution

The distribution of heroin occurs throughout the country primarily in major metropolitan areas and increasingly in rural and suburban areas--the rate of increase in rural and suburban areas is lower than in the past several years. Distribution in rural and suburban areas, particularly in the eastern United States, is facilitated by drug traffickers based in major metropolitan areas who supply distributors and abusers located in rural and suburban markets. In some cases, abusers from suburban and rural areas travel to major metropolitan areas to purchase retail quantities of heroin for personal use or for low-level retail distribution. Conversely, distributors from major metropolitan areas relocate from inner-city neighborhoods into outlying smaller cities and rural areas to attract new customers and increase profits.

Colombian DTOs are the primary wholesale distributors of heroin in the eastern United States where South American heroin is the predominant type available. Dominican criminal groups also are predominant wholesale heroin distributors of South American heroin, particularly in the New England states. Several other trafficking groups distribute wholesale quantities of heroin in the eastern United States, although to a lesser extent than Colombian and Dominican traffickers. Puerto Rican and African American traffickers distribute wholesale quantities of South American heroin; Chinese and Nigerian traffickers distribute Southeast Asian heroin; and Nigerian, Pakistani, Lebanese, and Russian traffickers distribute Southwest Asian heroin.

In the western United States where Mexican heroin is the predominant type available, Mexican DTOs and criminal groups are the primary wholesale heroin distributors. Members of Mexican DTOs and criminal groups are either U.S. citizens with familial ties to the United States or Mexico or Mexican nationals who have illegally entered the United States. Mexican DTOs and criminal groups that distribute wholesale quantities of Mexican heroin often are polydrug organizations that distribute any of a number of other drugs including cocaine, methamphetamine, and marijuana. Law enforcement reporting indicates that Mexican DTOs and criminal groups also distribute wholesale quantities of South American heroin in locations such as Michigan and New York.

A wide range of criminal groups, gangs, and independent dealers distribute heroin at the retail level, dependent largely on the type of heroin and the location of the market. In the Northeast Region of the United States, Dominican criminal groups are the predominant retail distributors of South American heroin, particularly in cities such as New York, Boston, and Philadelphia. Other retail-level heroin distributors in the Northeast include African American, Caucasian, Colombian, and Puerto Rican criminal groups in Boston; African American dealers who are usually members of "crews" in Washington, D.C.; and Puerto Rican and African American criminal groups in Philadelphia. In the Southeast Region of the United States, retail heroin distributors include Dominican and Puerto Rican criminal groups in Puerto Rico; African American, Dominican, Haitian, and Puerto Rican criminal groups in Florida; and Colombian, Dominican, and Mexican criminal groups in Atlanta. In the Midwest Region of the United States, retail heroin distributors include Hispanic and African American criminal groups in Ohio and African American criminal groups in Michigan. In the Pacific, Southwest, and West Regions of the United States, criminal groups that distribute retail quantities of heroin include African American, Guatemalan, Honduran, and Mexican criminal groups.

Law enforcement reporting indicates that local independent dealers and street gang members--primarily from African American and Hispanic gangs but also Asian gangs--distribute retail quantities of heroin to varying degrees in every region of the country. According to NDTS 2004 data, 11.2 percent of state and local law enforcement officials nationwide report that street gang involvement in heroin distribution is high or moderate in their areas. Law enforcement reporting indicates that members of OMGs distribute heroin at the retail level as do members of prison gangs, particularly prison gangs in states along the Southwest Border.

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Primary Market Areas

Chicago, Los Angeles, and New York are the three Primary Market Areas for heroin distributed throughout the United States because abuse levels are high in these cities, and wholesale quantities of heroin are distributed from these cities to heroin markets throughout the country. Other cities that are not Primary Market Areas but are significant markets in terms of abuse or distribution include Baltimore, Detroit, Miami, Newark, Philadelphia, San Francisco, Seattle, and Washington, D.C. Boston also is a very significant heroin market and previously was designated a Primary Market Area for the drug; however, Boston does not appear to be a heroin distribution center equal to Chicago, Los Angeles, and New York. In fact, law enforcement reporting indicates that most wholesale and midlevel heroin distributors in New England states are supplied directly by New York City-based wholesale distributors rather than Boston-based wholesalers.

Chicago. The consequences of heroin abuse in Chicago and the surrounding area are reflected in high rates of ED mentions, heroin-related overdose deaths, treatment admissions, and arrestees testing positive for opiates. The total number of ED mentions in Chicago also increased, although not significantly, from 11,902 in 2001 to 12,982 in 2002. DAWN mortality data show that heroin/morphine was involved in 352 of 854 drug deaths in Chicago in 2001 and 376 of 861 drug deaths in 2002. Heroin/morphine was involved in 78 of 303 single-drug deaths in 2001 and 83 of 312 single drug deaths in 2002. The number of treatment admissions for heroin in Chicago increased 23 percent from 21,755 in 2002 to 26,739 in 2003. ADAM data show that 24.9 percent of male arrestees tested positive for opiates--usually heroin--in Chicago in 2003, second only to the rate in Rio Arriba (NM) (28.4%).

Chicago serves as a Primary Market Area for heroin distributed throughout cities in the Midwest Region. South American heroin is the primary type available; however, Asian heroin--Southeast and Southwest--and, to an even lesser extent, Mexican heroin also are available. Colombian DTOs and criminal groups are the primary transporters and wholesale distributors of South American heroin in Chicago, although they increasingly rely on Mexican DTOs and criminal groups to transport and distribute wholesale quantities of the drug. Nigerian criminal groups are the primary transporters and wholesale distributors of Southeast Asian and, increasingly, Southwest Asian heroin.

Colombian and Mexican DTOs and criminal groups and Nigerian criminal groups distribute heroin to Hispanic and African American street gang members who are the dominant retail heroin distributors in Chicago. Members of street gangs, including Gangster Disciples, Vice Lords, Almighty Latin King Nation, Black Peace Stone Nation, and Black Disciples, distribute retail quantities of heroin at numerous open-air drug markets in West Side and South Side neighborhoods. Users travel from as far as southern Wisconsin or northwestern Indiana to purchase heroin in these neighborhoods. Chicago also serves as a distribution point for heroin that is transported to other cities throughout Illinois such as Springfield and to other states including Indiana, Iowa, Ohio, Michigan, Minnesota, Missouri, New York, Tennessee, and Wisconsin. In addition, law enforcement officials in Cleveland, Dayton, Pittsburgh, and St. Louis report that Chicago is a source for heroin available in their jurisdictions.

Los Angeles. Although Los Angeles historically has demonstrated high levels of heroin abuse, some data indicate that the effects of heroin abuse have lessened over the past several years. After increasing from 1999 (2,923) to 2000 (3,177), the total number of ED mentions decreased in 2001 (2,878) and 2002 (2,525). DAWN mortality data show that heroin was involved in 644 of 1,887 drug deaths in Los Angeles in 1999 and 473 of 1,192 drug deaths in 2000, the latest year for which data are available. Heroin/morphine was involved in 76 of the 295 single-drug deaths in 2000. ADAM data show that 2.0 percent of male arrestees tested positive for opiates--usually heroin--in Los Angeles in 2003 compared with 5.9 percent in 2002.

Los Angeles is a Primary Market Area for Mexican black tar and, to a lesser extent, brown powder heroin. Mexican heroin is transported via land routes across the Southwest Border to Los Angeles from where it is transshipped to locations in the Pacific, Southwest, and West Regions of the United States. Mexican DTOs and criminal groups are the primary transporters and wholesale distributors of Mexican heroin in Los Angeles as well as throughout the Pacific, Southwest, and West Regions. Independent Hispanic groups are the primary retail distributors of Mexican heroin in Los Angeles; however, members of African American and Hispanic street gangs such as Crips, Bloods, Mara Salvatrucha, and F Troop also purchase Mexican heroin from Mexican criminal groups and distribute the drug at the retail level.

EPIC Pipeline, Convoy, and Jetway drug seizure data indicate that Los Angeles is a primary distribution point for heroin destined for locations primarily in the western United States. Combined EPIC data for 2002 and 2003 show that shipments of heroin seized that originated in Los Angeles were destined for locations including Chicago, Compton (CA), El Paso, Eugene (OR), Honolulu, Las Vegas, New York, Portland (OR), and Salem (OR). Law enforcement reporting also indicates that Los Angeles is a source city for heroin destined for Denver, New Orleans, Seattle, St. Louis, and Salt Lake City.

New York. The negative effects of heroin abuse are significant in New York as evidenced by emergency department, mortality, treatment, and arrest data. The total number of ED mentions remained relatively unchanged from 2001 (10,644) to 2002 (10,397). DAWN mortality data indicate that heroin/morphine was involved in 224 of 894 drug deaths in New York in 2002 (2001 data are not available) and was involved in 3 of 202 single-drug deaths. According to the New York Office of Alcohol and Substance Abuse Services (OASAS), there were 21,773 primary heroin admissions in New York City in 2002, considerably higher than the number of primary treatment admissions for cocaine (14,697) and marijuana (13,400). ADAM data show that 15.0 percent of male arrestees tested positive for opiates--usually heroin--in New York in 2003. Only four other sites reported rates equal to or higher than New York.

New York is a Primary Market Area for South American and Southeast and Southwest Asian heroin, and the city serves as a distribution center for heroin available throughout the eastern United States. Colombian DTOs and criminal groups are the primary transporters and wholesale distributors of South American heroin in New York. Dominican DTOs and criminal groups and, increasingly, Mexican criminal groups also are significant transporters and wholesale distributors of South American heroin. Ethnic Chinese and West African criminal groups are the primary transporters and wholesale distributors of Southeast Asian heroin, and Pakistani criminal groups are the primary transporters and wholesale distributors of Southwest Asian heroin in New York.

A wide range of criminal groups, gangs, and independent dealers distribute heroin at the retail level in New York. Dominicans are the primary retail-level heroin distributors, particularly of South American heroin. Other retail-level distributors include members of African American, Jamaican, Puerto Rican, and Caucasian criminal groups as well as independent dealers and members of street gangs such as Ñeta, Latin Kings, Five Percenters, and Bloods.

EPIC Pipeline, Convoy, and Jetway drug seizure data indicate that New York is a primary distribution center for heroin distributed throughout the Midwest, Northeast, and Southeast Regions of the United States. Combined EPIC data for 2002 and 2003 show that shipments of heroin seized that originated in New York were destined for locations throughout these regions including Chicago, Durham (NC), Orlando, Wilmington (NC), and Washington, D.C. Law enforcement reporting indicates that New York also is a source city for heroin distributed in Atlanta, Baltimore, Boston, Newark, New Orleans, Philadelphia, Michigan, and Ohio.

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Outlook

The demand for heroin, currently stabilized, will remain lower than the demand for other major drugs of abuse such as cocaine, marijuana, and methamphetamine. An overall high perception of risk associated with heroin use is an indication that rates of heroin use, particularly among adolescents and young adults, will remain stable. However, the consequences of heroin abuse will remain comparable to or exceed the consequences of other major drugs of abuse as those individuals already addicted to heroin experience the negative health effects that result from their addictions.

The 73.3 percent increase in potential worldwide heroin production from 2002 to 2003, though cause for concern, will not likely result in a significant increase in heroin availability in U.S. drug markets. The net increase in potential worldwide heroin production from 2002 to 2003 (181.6 mt) is attributable to an increase of 187 metric tons in Afghanistan and 5.1 metric tons in Mexico--increases offset somewhat by a 13.9 metric ton decrease in Southeast Asian heroin production and a 1.1 metric ton decrease in Colombia. Moreover, sharp increases in Southwest Asian heroin production will likely have little effect on U.S. drug markets because relatively little Southwest Asian heroin is intended for U.S. drug markets but rather primarily for Asian and European drug markets. Nevertheless, sustained increases in Mexican heroin production could lead to increases in domestic heroin availability because nearly all heroin produced in Mexico is intended for distribution in U.S. drug markets. However, there is no indication that production in Mexico has increased to levels sufficient to substantially affect availability of the drug in the United States or that the current level of production is sustainable. In fact, heroin production estimates for Mexico have fluctuated greatly since 1999 and currently are only slightly higher than 2001 estimates (see Table 20).

End Notes

15. Under the HSP, the DEA Special Testing and Research Laboratory analyzes heroin samples from POE seizures, as well as a random sample of other seizures and purchases submitted to DEA laboratories, to determine source areas. Although HSP results do not directly correspond to an assessment of the market share in the United States, they provide indicators of market trends.
16. The DMP is a heroin purchase program designed to identify the purity, price, and source of origin of retail-level heroin available in drug markets in 23 major U.S. metropolitan areas.

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