1. Combatting the Opioid Epidemic
Pittsburgh Division
Combatting the Opioid Epidemic
SSA Shawn A. Brokos
Unclassified

2. Understanding the Epidemic What is being done by FBI
Overview
Topics
Understanding the Epidemic
What is being done by FBI
Current trends and cases

3. Age-adjusted drug overdose death rates
20 per 100,000

4. Age-adjusted drug overdose death rates
1,2 and 4
Highest observed age-adjusted drug overdose death rates:
West Virginia (52.0)
Ohio (39.1)
New Hampshire (39.0)
Pennsylvania (37.9)

5. Overdose deaths 2016 Overdose deaths 2017 Western PA (10) – 1,232
Statistics Cont.
Overdose deaths 2016
Western PA (10) – 1,232
Allegheny County – 650
Overdose deaths 2017
Western PA (10) – 1,378
Allegheny County – 737

6. “Four out of five (heroin) addicts say they came to the drug from prescription pain killers.”
M. Calabresi
Time Magazine, June 2015
The Price of Relief, Why America Can’t Kick Its Painkiller Problem
State of events, but why are we where we are? Some speculate that this is a result of the proliferation of prescription pills. How did we get here?
Unclassified

7. Top Overdose Drugs
i.e. Fentanyl, Fentanyl analogs, and Tramadol
i.e. Morphine, Codeine, Hydrocodone, and Oxycodone
Rise in synthetics – fentanyl synthesis. No matter how we got here, these are the drugs that are killing people.

8. Fentanyl Schedule II controlled substance Synthetic opioid
Legally prescribed
Binds to opioid receptors in the brain
White powder, pill, patch, lollipop
You will hear a lot about fentanyl
Source: “Heroin Fact Sheet” DEA.gov; “Why is Fentanyl so much more deadly than Heroin?” Walton, A.G., Forbes.com;

9. Fatal Dose of Heroin versus Fentanyl
Source:Allegheny County Medical Examiner Office

10. Supply: Tackling the Epidemic Health Care Fraud TF/OFADU
Drug Diversion
Pill Mills
Forged Script Rings
Drug Seekers
Opiate Overdose Task Force
Title 18 Section 841C
DarkNet
Fentanyl, Oxy, Crystal Meth, Pill Presses, Carfentanyl, synthetic derivatives
Regardless of how we got here, here were are. Now how do we tackle this?

11. Healthcare Fraud Task Force
How we do it?
Healthcare Fraud Task Force
Combat the growing HCF threat:
HHS-OIG
DEA Drug Diversion Investigators
Pennsylvania Attorney Generals Office –Medicaid Fraud Department
Unites States Postal Inspectors
IRS-CID
USAO
Since Jan 2016 – 18 Doctors charged
Since Jan Doctors surrendered DEA Registration
Drug Diversion – diversion of pharmaceutical drugs for financial gain
Unclassified

12. No Physical Examination
Prescriptions are written in exchange for:
Cash, Sexual Favors or Bill medicaid

13. Opiate Overdose Task Force
How we do it?
Opiate Overdose Task Force
Combines personnel and resource to identify supply chain of heroin/fentanyl:
FBI
USAO
Munhall Police Department
West Mifflin Police Department
Port Authority Police Department
ACSO
ACPD
PAOAG
Pittsburgh Bureau of Police
Unclassified

14. Accomplishments to date (07/02/18)
36 federal Indictments
26 Pending Indictments
80 guns seized
>$600k cash seized
>8 kilos of fentanyl seized
>3 kilos of cocaine seized
95 Federal Search Warrants
Multiple vehicle/asset seizures
Pill Press

15. Recent Heroin/Fentanyl Seizure

16. Stamp Bags Linked to Overdoses

17. Traditional Drug Trafficking Routes
Traditional v. non traditional such as the Darknet

18. The overall classification of this presentation is: UNCLASSIFIED//LES
Darknet Fentanyl Vendor Initiative
The overall classification of this presentation is: UNCLASSIFIED//LES

19. Dream Market
Spector of anonymity, done out of your own home

20. J-CODE Video

21. Recent Law Enforcement Activity

23. Narcoboss
Used to display where information is located across the Internet
Clear web is estimated to contain 1-10% of information online (Not to be confused with all information on Internet. This is only information indexed by traditional search engines.)
Deep Net is estimated to contain 90-99% of information online*
The darknet is a subset of the deep net.**
*The deep net can be indexed by traditional search engines, but they generally choose not to in order to maintain the integrity of their product. There are products that are being developed to search the Deep Net, but they are currently not available or widely available.

24. FBI PG Community Outreach and Training
DEMAND
Inelastic
Heroin Outreach Prevention and Education (HOPE)
Law Enforcement Training
(12 counties)

25. Most recent
Unclassified