Illicit drugs, and the transnational and domestic criminal organizations that traffic them, continue to represent significant threats to public health, law enforcement, and national security in the United States. The opioid threat (controlled prescription drugs, synthetic opioids, and heroin) continues at ever-increasing epidemic levels, affecting large portions of the United States. Meanwhile, the stimulant threat (methamphetamine and cocaine) is worsening and becoming more widespread as traffickers continue to sell increasing amounts outside of each drugs’ traditional markets. New psychoactive substances (NPS) remain challenging and the domestic marijuana situation is evolving as state-level medical and recreational legalization continues. Drug poisoning deaths are the leading cause of injury death in the United States. In 2017, drug poisoning deaths reached their highest recorded level and, every year since 2011, have outnumbered deaths by firearms, motor vehicle crashes, suicide, and homicide. In 2017, approximately 192 people died every day from drug poisoning. Fentanyl and other highly potent synthetic opioids— primarily sourced from China and Mexico—continue to be the most lethal category of illicit substances misused in the United States. Read the full report here.