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Excerpt from UN “World Drug Report 2019“:
Complex global smuggling networks underpin heroin and cocaine markets

The Balkan route remains the world’s busiest heroin trafficking channel

The world’s single largest heroin trafficking pathway continues to be the Balkan route, which sees drugs smuggled from Afghanistan through the Islamic Republic of Iran, Turkey and the Balkan countries and on to various destinations in Western and Central Europe. Seizures made by countries along the Balkan route accounted for 47 per cent of global quantities of heroin and morphine seized outside Afghanistan in 2017.

Other routes take heroin out of Afghanistan via Pakistan to South Asia or Africa (the southern route), or through Central Asia to markets in the Russian Federation (the northern route). However, those routes seem to be less important, and that importance is declining further, as in the case of the northern route. For example, in 2008, 10 per cent of global heroin and morphine interceptions were made in countries along the northern route; by 2017, this had fallen to 1 per cent.

Most of the heroin trafficked in the Americas originates within the region

The amount of heroin seized in the Americas has shown a clear upward trend over the last decade. Most of this trafficking takes place within North America, usually from Mexico to the United States, although the heroin found in Canada originates in Afghanistan. Analysis of wholesale seizures of heroin in the United States has shown the increasing predominance of heroin originating in Mexico. Some 80 per cent of the heroin samples analysed in 2016 came from Mexico.

Cocaine trafficking has expanded into a global phenomenon since the 1980s

Some 143 countries across all regions reported cocaine seizures over the period 2013–2017, up from 99 countries over the period 1983–1987. Most of the cocaine trafficked from the Andean countries of South America is destined for the main consumer markets in North America and Western and Central Europe. Seizures in North America have more than doubled in recent years, from 94 tons in 2013 to 238 tons in 2017. The second most important cocaine trafficking flow worldwide is from the Andean countries to Western Europe. The quantity of cocaine seized in Western and Central Europe has also more than doubled in the past five years, from 65 tons in 2013 to 141 tons in 2017.

Relationship between licit production and illicit markets remains sometimes unclear

Fentanyl and tramadol markets are likely underpinned by illicit supply

Data that can help explain whether pharmaceutical opioids are diverted from the licit to the illicit market or are illicitly produced at source are limited, although the situation varies depending on the substance and region.

In the case of fentanyl, for example, the bulk of the substance found on the illicit market comes from illicit manufacture, although some small diversions of fentanyl have been reported in the United States. The large market for tramadol for non-medical use in North Africa and the Near and Middle East also seems to be supplied by tramadol specifically manufactured and trafficked for the illegal market, but information remains limited. The illicit market for other pharmaceutical opioids is likely sourced from licit channels, although illicit manufacture also occurs

Outside North America, where the diversion of pharmaceutical opioids such as codeine and oxycodone from the licit to the illicit market is evident, such diversions are not reported in large quantities. This could be the result of underreporting or the limited capacity of law enforcement authorities to detect diversions. There is a gap in knowledge about the supply chain of codeine, a substance used non-medically in many subregions. The fact that most seized codeine is licitly manufactured and the lack of evidence of illicit laboratories manufacturing codeine suggest that non-medical use of codeine is largely fuelled by the legal supply chain. However, it is unclear how and at what stage the supply of codeine for medical use is diverted for non-medical use. There may be a combination of scenarios: some codeine preparations may be easy to access through pharmacies or other types of outlets, and some diversion may take place before the drug reaches the retail market, resulting in the licit supply being diverted to the illicit market.
World Drug Report 2019 (United Nations publication, Sales No. E.19.XI.8