- 2 years ago
Anne Milgram, Administrator, U.S. Drug Enforcement Administration Interviewer: Maria Aspan, FORTUNE
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00:00 The United States is experiencing a crisis
00:02 with deadly results.
00:04 According to the CDC, more than 10,000 people in the US
00:07 died of drug overdoses last year,
00:09 and nearly 70% of those deaths involved fentanyl
00:12 and other synthetic opioids.
00:14 Just last month, a horrific situation.
00:17 A child died and three were hurt at a daycare center
00:20 in New York City after exposure to fentanyl.
00:23 Our next guest says fentanyl is the single deadliest
00:26 drug threat our nation has ever encountered,
00:28 and no community is immune from its dangers.
00:31 Anne Milgram is head of the US Drug Enforcement
00:33 Administration.
00:34 She leads nearly 10,000 people in the DEA's 334 offices
00:39 around the world as they work to combat the illegal
00:42 drug trade in the United States.
00:44 Anne joins Fortune senior writer and NPW co-chair
00:47 Maria Aspin to talk about leading the agency,
00:50 the role of international cartels,
00:52 what's fueling and what's fueling the so-called fourth wave
00:55 of the devastating opioid crisis.
00:57 Please welcome them to the stage.
00:59 (audience applauding)
01:02 - Almost going to the other stage for a minute.
01:11 Anne, thank you so much for being here to discuss
01:14 this important and really overwhelming topic,
01:17 at least I find, when considering the statistics
01:21 and the stories like the horrific Bronx daycare story.
01:25 I believe in 2010 there were 40,000 deaths of drug overdoses
01:30 in the US, and last year there were more than 100,000,
01:33 almost 70% of which came from fentanyl.
01:36 How, in your role, how do you wrap your head around
01:39 the size of the crisis and identify priorities to respond?
01:43 - It's a great question, and thank you so much
01:45 for having me.
01:46 It was such a privilege to sit yesterday and listen
01:48 to so many of you talking about your work.
01:50 I find it truly inspiring.
01:53 The information I often use is that in 2019
01:56 there were 71,000 US deaths.
01:59 In 2022 we just experienced 110,757 American lives lost.
02:04 Those numbers don't include the people who've been given
02:08 the antidote, naloxone, Narcan, and have survived.
02:11 And so we talk about this as it is the deadliest drug threat
02:15 we've ever seen.
02:16 It is also totally different than any other drug threat
02:19 the United States has ever known.
02:21 This is all chemicals.
02:23 It is literally chemicals that come from China
02:25 that are going to two criminal organizations in Mexico
02:28 that are mass producing fentanyl,
02:30 and then it's coming into the US and killing Americans.
02:33 And it's being hidden in other drugs.
02:36 It's being hidden in pills that look like
02:39 they're real oxycodone or real Percocets,
02:42 and in fact it's fentanyl.
02:43 And just the amount of fentanyl,
02:46 enough to fit on the tip of a pencil, can kill someone.
02:49 And so it is devastating communities from coast to coast
02:53 and everywhere in between, and many people are dying
02:55 that don't know they're taking it.
02:57 They think they're taking a real Percocet.
02:59 They think they're taking a real oxycodone or Adderall
03:02 that they bought on social media.
03:04 Or they think they're taking cocaine or heroin
03:07 or methamphetamine that's all laced with fentanyl
03:11 because it is so highly addictive.
03:13 If people become addictive, they buy more
03:15 and the cartels make more money.
03:17 - You have really identified the cartels and also China
03:20 as responsible for this crisis,
03:22 and you have said in the past that the governments there
03:24 haven't taken enough action or cooperated enough.
03:27 And I believe just last week, the Biden administration
03:30 took action against Chinese entities and individuals.
03:34 How do you, well, a couple of questions.
03:37 Our relationship with China is super tense, as you know.
03:42 At a time when the Biden administration
03:44 is trying to navigate that relationship,
03:48 how do you think about what actions DEA and Justice
03:51 are taking, how that plays into
03:52 the greater geopolitical situation?
03:55 - It's such an important question.
03:56 And I would say, just going back a little bit
03:58 to the priority question, our top priority is to save lives,
04:01 to stop people from dying.
04:03 It is not a war on drugs, it is a fight to save lives.
04:06 And our top operational priority
04:08 is to defeat these two networks.
04:10 Again, it starts in China with chemical companies
04:13 that are making these chemicals that cost pennies
04:17 to make a dose of fentanyl.
04:19 That is then sold for 10 to $30 in the US.
04:22 They're then being mass produced in Mexico
04:25 by two criminal organizations.
04:27 I was reflecting yesterday,
04:28 one of the incredible angel investors was saying
04:31 she likes to invest in people who lose sleep at night,
04:34 thinking about how to build companies.
04:36 I lose sleep at night thinking about how to destroy
04:39 and take down multinational, global,
04:43 billion dollar criminal networks that operate
04:46 like diversified corporations in the world, right?
04:48 And that are essentially peddling death
04:51 and making a lot of money for it.
04:53 So this is a largely international supply chain issue
04:57 that ends in the US.
04:58 When I came into DEA, I felt very strongly
05:01 we had to transform the way we were working.
05:03 We could not just go after the top individuals.
05:06 So DEA did successful investigations into El Chapo.
05:10 He's now in a US prison for the rest of his life.
05:13 His sons, the Chapitos, came up
05:15 and took over his organization.
05:18 So we are now working across the globe
05:20 on entire criminal networks,
05:23 starting with the chemicals in China.
05:24 So we just announced cases we've brought
05:27 for the first time against Chinese chemical companies
05:29 that are mass producing these chemicals
05:31 that can be used to make fentanyl.
05:33 We did a series of case, a huge case against the Chapitos,
05:37 El Chapo's sons, and their entire criminal network,
05:41 from the precursor chemical suppliers in China
05:43 to the manufacturers in Mexico,
05:45 to the security apparatus in Mexico,
05:47 to the people who bring it into the US.
05:49 We did a series of cases about the traffickers in the US
05:53 that are responsible for those sales
05:54 on social media and in our communities.
05:56 And so what we're trying to do
05:58 is really work across the supply chain
06:00 as a whole of government.
06:01 And so the State Department has formed
06:04 an international coalition against fentanyl, for example.
06:07 But we work with any country
06:10 that will work with us right now, we will work with.
06:12 We also, again, my commitment is to save lives,
06:15 we'll take action wherever we need to take it.
06:18 - You came in in 2021, unanimous confirmation by the Senate,
06:22 but at that point, the DEA had been criticized
06:25 for responding slowly to the fentanyl crisis.
06:28 How are you catching up?
06:31 - So we've had to transform ourselves.
06:33 And I would say a couple of points,
06:35 which is first, the entire space of drug trafficking,
06:39 fentanyl is unlike any other substance we've ever seen.
06:42 My own view is we will never go back
06:44 to just plant-based drugs like cocaine.
06:47 Chemicals are cheap, they're easy to make synthetic
06:50 or man-made drugs from, and they allow so much profit
06:54 that no one is ever gonna turn back.
06:56 We had to turn, and they've transformed,
06:58 the cartels have transformed with chemicals,
07:01 using social media to recruit people
07:04 who will take the drugs into the US,
07:06 to sell to young people
07:08 who think they're buying a Percocet.
07:09 So we had to transform ourselves.
07:12 And we've done it in a couple of ways.
07:14 One is by going across the entire supply chain.
07:17 Two is by building a strategic layer over everything we do.
07:21 We have 334 offices around the globe.
07:24 We had our data and our information in 334 separate places.
07:29 So what we've done is form these two counter-threat teams,
07:32 three now, one devoted to Sinaloa,
07:34 one devoted to Jalisco,
07:36 the two main threats that we face, the two cartels,
07:39 and now one devoted to illicit finance
07:41 because we're tracking billions of dollars
07:43 across the globe on a regular basis.
07:46 So we're now pulling together all the information we have.
07:49 We're analyzing who are the members of the cartels,
07:52 who are the people we're mapping and we're targeting.
07:55 And that's what's letting us do the first cases
07:57 against the Chinese chemical companies,
07:59 do the entire Chapito's network.
08:01 And there's a lot more work to come
08:03 in the coming months that you'll see.
08:05 - You know, you mentioned that the cartels
08:08 operate like for-profit multinational corporations,
08:11 but it has to be said that legitimate
08:13 for-profit multinational corporations
08:15 have also been held accountable for their role
08:17 in creating the opioid crisis in the first place.
08:19 What are you and the DEA doing
08:21 to continue taking action on that front?
08:25 - It's a great question and a great point.
08:27 As the quick recap is that the opioid epidemic
08:30 really did start with the over-prescribing
08:33 of legitimate prescription medicine, oxycodone,
08:37 Purdue Pharmaceuticals has now been convicted of fraud
08:40 and a number of actions have been taken.
08:44 What happened is that when the supply
08:46 of legitimate oxycodone, when everyone realized
08:50 what was happening in the United States,
08:51 and this is many years ago, that supply was pulled back.
08:55 Many people who had substance use disorder
08:57 went, turned to heroin, which the Mexican cartels
09:00 pushed into the United States.
09:02 From there, we've transformed into fentanyl,
09:05 into fentanyl which is cheaper, it's deadlier,
09:08 and it is much more addictive.
09:10 And I would stop here and say the question
09:12 people ask me the most, and you may be about
09:14 to ask me this, but it's just why would
09:17 the cartels kill their customers?
09:19 And thinking about, it's so different
09:21 than the original opioid epidemic
09:22 where people were seeking pain medicine.
09:25 What we see happening now is that
09:27 the cartels wanna make money,
09:29 and they make money by selling more.
09:31 Fentanyl is 50 times more addictive than heroin.
09:34 So that's why they put it in cocaine,
09:36 that's why they put it in these fake pills.
09:38 It's far more addictive than oxy.
09:40 And so anyone who takes it, if they survive,
09:43 may come back and buy again and again.
09:45 And it's the price of doing business for the cartels
09:48 because think about our modern world,
09:50 more than 200 million Americans are on social media.
09:53 And the cartels are on Snapchat, they're on Facebook,
09:56 they're on TikTok, they're on Instagram.
09:58 And so if one of, someone dies,
10:00 they believe there's always somebody
10:02 behind them to buy the next pill.
10:05 - I wanna open it up to questions in a minute,
10:07 but I also wanna ask, you're a prosecutor,
10:09 former state attorney general,
10:11 enforcement is in your agency's name.
10:14 The narrative about treatment and response
10:17 to drug addiction has really changed
10:19 since the DEA was formed 50 years ago.
10:22 How do you think about harm reduction
10:24 versus prosecuting and punishing victims?
10:27 - I think it's a great question.
10:29 Our work right now is at the intersection
10:31 of national security, public safety, and public health.
10:34 As I said earlier, this to me is a fight to save lives.
10:37 We have to do everything we can to save lives.
10:40 And that means treatment, it means prevention,
10:43 it really means awareness.
10:45 So being here with all of you who are influencers
10:48 in your communities, in your jobs,
10:51 having the opportunity to talk to you
10:52 about how dangerous this threat is,
10:55 when we spread the word and we spend a lot of time
10:57 with families who've lost loved ones,
10:59 we believe we save lives.
11:00 And so we are committed to making, sorry,
11:04 we're committed to making treatment accessible
11:07 to any American who wants it.
11:09 And I think it's a core part of who we are at DEA,
11:13 helping those who are harmed and targeting,
11:15 going after the people causing the harm.
11:18 - Are there questions in the audience?
11:19 We have one in the back.
11:21 - Kate Woolley from IBM.
11:23 We've had a lot of conversations over the last couple
11:26 of days and technology and AI has come up in all of them.
11:29 Are you using technology and AI in the fight?
11:34 And, but are the cartels using it faster
11:37 or how are they using it?
11:39 - So that's an amazing question.
11:41 The cartels have harnessed technology.
11:43 So they have people who are in charge of social media,
11:46 for example, they are incredibly sophisticated at this.
11:50 We have to be more sophisticated.
11:52 We have to be proactive.
11:54 We have to be able to be ahead of it.
11:56 We are now, and I was reflecting on this yesterday,
11:59 we are now at a point where we have pulled our data
12:02 together where we can start thinking about
12:04 what are the sophisticated analytics that we could use.
12:08 We've pulled together our financial data across the globe
12:11 from our 334 offices and within one week,
12:14 we found a major money launderer for one of the cartels,
12:18 tracking at billions of dollars
12:20 over three cryptocurrency exchanges.
12:22 So I really welcome the opportunity to learn from you
12:25 and to think about how we should be thinking
12:28 about our next 50 years.
12:30 I believe if government doesn't innovate,
12:32 if we don't figure out how to use the tools
12:35 of the modern world, we will not be able to proactively
12:38 counteract these threats and save lives.
12:39 So would love to learn more from all of you
12:42 about how to think about this.
12:44 - We have another question here.
12:47 - Hi, Julie Howard.
12:49 I have deep, deep respect for the work that you do.
12:51 It's just Yeoman's work.
12:53 Is this a US issue?
12:56 And if so, why?
12:57 Because it feels like all we talk about
12:59 is fentanyl in the US.
13:01 - That's an incredible question.
13:03 Right now, it is a primarily North American issue.
13:07 Part of it is starting with the opioid epidemic
13:10 with the pills that move to heroin
13:13 that then move to fentanyl.
13:14 So some of it is that in the US,
13:16 we had the opioid epidemic that came
13:18 from the over-prescribing of oxycodone here.
13:21 As many of you may know, the US is one of only two countries
13:24 that also allows direct to consumer marketing
13:26 of pharmaceutical drugs.
13:28 And so we are unique in certain ways.
13:31 What I would say is I was just with 138 countries
13:35 that we brought together across the globe.
13:37 And our message is that fentanyl is either there
13:40 or it is coming because it is the cheapest product to make
13:44 and the most highly addictive.
13:46 And so it has been, these two cartels are operating
13:49 in more than 50 countries around the world.
13:51 Fentanyl has been seized in many other countries.
13:54 And the cartels have the piping globally to be able
13:58 to push fentanyl into countries.
14:00 And so the one thing I would say that one of my core messages
14:03 to them is you have to start testing for it.
14:06 In the US for a long time, we were testing for heroin
14:09 because that is what we expected to see.
14:11 And heroin all of a sudden started going down.
14:14 And we realized, we have an incredible lab, if we test
14:17 for every substance, fentanyl was in so many of them.
14:21 So our message around the world is you are just testing
14:24 for cocaine or you are just testing for heroin,
14:26 you may find it, but fentanyl is hidden in those substances.
14:30 And that is the treachery of this drug threat,
14:33 which is that the cartels, it is so tiny, they can hide it
14:36 in other things to drive addiction.
14:38 And so many people are dying
14:40 and they do not even know they are taking fentanyl.
14:42 So we have been sounding the alarm for other countries.
14:45 We have incredible partnerships around the world.
14:47 But we have also offered, send us anything you want,
14:50 we will test it.
14:51 Call us, we will send our experts over to train you
14:54 because we do not want it to happen to anyone else.
14:56 >> I will ask a corollary question, which is,
14:59 who are the victims of this wave of the opioid crisis?
15:03 You know, the opioid crisis was initially thought
15:05 of as primarily affecting white rural Americans.
15:08 And that sort of played into some
15:10 of the racial disparities we see in healthcare.
15:12 What is, who is this affecting?
15:15 >> This is affecting everyone.
15:17 This is affecting everyone.
15:18 We started a little over a year ago, a wall at our headquarters
15:23 in Arlington, Virginia, that we said to the families
15:27 who lost loved ones, brothers, sisters, parents, children,
15:30 if you want to send us a photograph of your loved one,
15:32 we will put it on our wall.
15:34 We thought we would get about 100 photographs.
15:36 Today we have more than 5,000.
15:38 And when you look at those photographs, you see America.
15:42 You see black, white, brown.
15:44 You see the youngest on our wall, seven months old,
15:47 forever seven months, Riott Mitchell.
15:49 The oldest, James Cox, forever 70 years old.
15:53 You see people in uniform.
15:54 You see kids at soccer games.
15:56 You see families.
15:58 It is impacting everyone.
15:59 And this is also why I think it's so important to talk
16:02 about it, because no community
16:04 in the United States is immune from this.
16:07 And it is, anyone who has a smart, a smartphone,
16:10 anyone who has a cell phone, whether it's Snapchat or TikTok
16:13 or Facebook or Instagram,
16:14 within three clicks someone can get a fake pill that looks
16:18 exactly like a real pill and people are dying.
16:22 And so it's really important for I think all of us to understand
16:25 that this is 110,757 Americans and we are making progress,
16:31 but we have a long way to go.
16:34 >> This is not the first heavy,
16:36 important systemic problem you have worked on in your career.
16:38 You've worked on human trafficking,
16:40 civil rights, gun tracing.
16:42 But you also made time to be the legal advisor
16:45 for Law and Order SVU.
16:47 How did that happen?
16:52 >> I did. I sometimes joke it was my best law job
16:55 because it's legal-ish.
16:57 And you know, at the end of the day,
16:59 drama always wins over the law.
17:02 I was sitting, I was teaching at NYU Law School at the time,
17:05 and a man called Warren Light, he's an amazing individual.
17:08 He was the showrunner on SVU, called and said, "Will you come
17:12 in and just talk to us about your work?"
17:15 I'd done human trafficking.
17:16 I'd done prosecutions.
17:17 I'd also overseen the Camden, New Jersey Police Department
17:20 and taken it off the list of the most dangerous cities in America.
17:23 So he was really interested in all these different things.
17:26 And I went in and they said, "Would you ever consult with us?"
17:30 And I thought, "What an incredible job."
17:32 So I got to work with them and they've covered
17:34 so many important issues, including human trafficking
17:37 and sex crimes, obviously.
17:39 But a lot of Americans still learn about the law
17:42 and the criminal justice system from Law & Order and TV shows.
17:46 So I felt like it was both incredibly fun
17:50 and a great way to contribute.
17:52 So, you know, that show has been on for a really long time.
17:55 Is that the post-Biden administration retirement plan?
17:59 I'm so focused right now on doing the work,
18:02 I can't even think about it.
18:03 But I do still watch it.
18:04 I do still watch it.
18:06 Well, Anne, thank you so much for making the time
18:09 to be with us today.
18:11 [ Applause ]
18:12 [ Silence ]
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