INTERVIEW: UNODC’s Asma Fakhri on the Opioid Crisis and the International Response

In August 2021, we spoke to Asma Fakhri, Coordinator of the UNODC Opioid Strategy, about the scale and impact of the global opioid crisis and United Nations efforts to tackle it. Read the full interview below.

What do we mean when we talk about an “opioid epidemic,” and how is it impacting people’s lives?

The opioid epidemic is a far-reaching drug and public health policy issue stemming from the non-medical use of opioids. The potentially deadly consequences of this have been known ever since science discovered their huge medical potential. Over the past 150 years, humanity has experienced several opioid crises but none as devastating as the present one.

Since its appearance, efforts have been made both at the national and international level to develop integrated policy responses to address the crisis, yet despite some progress, the crisis continues both to expand geographically and to deepen in complexity with the emergence of a new generation of synthetic opioids or new psychoactive substances (NPS) with opioid effects.

Overdose deaths contribute to between roughly a third and a half of all drug-related deaths, with most of these cases being attributable to opioids.

What’s the scale of the problem?

The current phase of the opioids crisis is principally defined by significant global increases in the non-medical use of opioids and opioid-related overdoses in recent years. This has affected North America mainly with fentanyl and its analogues, and parts of Africa, Asia and the Middle East with tramadol.

Under the conditions of a globalized drug market, the risk that it may spread to many other regions has never been greater.

The rapidly emerging crisis which has resulted in significant loss of lives calls for a coordinated, comprehensive and multidisciplinary response. Additionally, the COVID-19 pandemic has further complicated existing trends in the ongoing crisis.

What’s the unique role that the United Nations can play in fighting the opioid epidemic?

UNODC is the United Nations Secretariat entity responsible for supporting Member States in their efforts against drugs and crime. Together, ongoing programs in the areas of synthetic drugs monitoring, early warning and trend analysis, national forensic and counternarcotic capacity building, law enforcement operational work, and prevention and treatment provide a unique platform for contributing to the reduction of the non-medical use of synthetic opioids.

UNODC’s active collaboration with international organizations such as the International Narcotics Control Board (INCB), the World Health Organization (WHO), the World Customs Organization (WCO) and Interpol; regional organizations like the Organization of American States (OAS), the European Monitoring Centre for Drug Dependence and Addiction (EMCDDA), and the Organization for Security and Co-operation in Europe (OSCE); and Member States provides opportunities for leveraging the requisite expertise to address the current crisis.

You head up the UNODC Opioid Strategy – can you tell us when and why that was launched and what it does?

The Opioid Strategy was launched in June 2018 to coordinate the international response to the ongoing opioid crisis with the aim of reducing the supply of opioids for non-medical use through changes in the scope of control of substances, supporting the implementation of scheduling decisions of the Commission on Narcotic Drugs (CND), as well as capacity building in support of national law enforcement interventions; promoting rational use of, and access to, opioids for medical and scientific purposes; and promoting effective prevention strategies and treatment options for substance-use disorders.

The strategic response brings together existing UNODC expertise and programs under one umbrella for a timely organization-wide response that leverages a unique set of complementary activities and resources as well as coordinating inter-agency collaboration with key partners like the WHO and the INCB.

The Strategy’s five pillars are:

1. Early warning and trend analysis to generate evidence in support of policy decisions and operational responses.

2. Promoting rational prescribing and access to opioids for medical and scientific use and interagency cooperation in addressing the non-medical use of opioids.

3. Strengthening effective prevention and treatment programs.

4. Enhancing international law enforcement operations to disrupt trafficking and prevent the diversion of synthetic opioids.

5. Strengthening national and international counternarcotic capacity by raising awareness, sharing best practices and promoting international cooperation.

What are the Opioid Strategy’s success stories, and what do you hope to achieve in the coming months?

The Opioid Strategy launched the United Nations Toolkit on Synthetic Drugs, an innovative platform to help countries to address the international threats posed by the non-medical use of synthetic drugs.

The Toolkit is a one-stop shop which brings together a wide range of guidance and resources from a variety of specialized agencies across the UN system tailored to experts, practitioners, and policymakers in the fields of health, law enforcement, forensics and research. It contains over 260 practical resources and tools on different topics such as forensics, postal security, access to medicines, legal approaches, treatment and precursor control.

The development of the Toolkit was coordinated by the UNODC Opioid Strategy in collaboration with the World Health Organization, the International Narcotics Control Board, the Universal Postal Union and the World Customs Organization.

In the coming months we will be expanding the Toolkit by adding new topics such as cybercrime and prevention strategies and air cargo security. We also plan to make the content available in all UN official languages to help make its multidisciplinary tools and resources more accessible around the world.

In addition, within the framework of the Opioid Strategy, new substances are identified through the UNODC forensic Early Warning Advisory (EWA) which are then analysed and reported on with the aim of preventing the next crisis before it happens by flagging the most prevalent, persistent and harmful emerging substances for action.

Furthermore, the Strategy has:

· Informed scheduling decisions of the most harmful prevalent and persistent substances threating the global community

· Developed guidelines on safe handling and disposal of toxic chemicals

· Developed guidelines for the profiling and targeting of mail parcels used in the trafficking of synthetic drugs, including synthetic opioids.

· Enhanced capacity of Judiciary to prosecute synthetic opioid cases.

· Built capacity of law enforcement and customs officers in SEAP and LAC to identify, interdict, safely handle and report synthetic drugs, including synthetic opioids and their precursors

· Supported the establishment of national early warning systems in LAC and SEAP

· Built capacity and promoted regional cooperation around precursor control in SEAP

· Analysis report on the global synthetic drug problem

· Built capacity of forensic laboratories on drug identification and analysis

· Built capacity around crime scene investigation, evidence collection, handling, etc.

· Built capacity of cyber investigative units to identify, intercept, disrupt online trafficking of synthetic opioids and seize related cryptocurrencies.

In the coming months, we will:

· Provide regional trainings in Africa and LAC on drug identification, crime scene investigation, safe handling of toxic substances, profiling of mail parcels and prosecution of cases related to trafficking of synthetic opioids.

· Provide training for SEAP on investigating online trafficking of synthetic opioids.

· Launch the UNODC Synthetic Drug Strategy.

Please also see our three-part “Impact in Nigeria” series of videos.

What more can UN Member States do to help tackle this problem?

Member States can ensure that the synthetic drug problem, including the opioid crisis, remains at the top of the political agenda. International cooperation for early warning is critical as well as continued support to building sustainable capacity around the world for balanced, comprehensive response.

Note: The views expressed in this interview do not necessarily reflect those of the United States Government.