Opioid Crisis Response

The following statement has been submitted to the President's Commission on Combating Drug Addiction and the Opioid Crisis (https://www.whitehouse.gov/ondcp/presidents-commission). The Board appreciates the work of the Synthetic Opioid Ad Hoc Committee in drafting the response and recommendations.

Statement of the AAFS Board of Directors

October 31, 2017

The American Academy of Forensic Sciences (AAFS) represents over 7,000 members and provides leadership throughout the forensic sciences both in the U.S. and globally.  The AAFS Board of Directors appreciates the opportunity to provide input into the important work of the Commission on Combating Drug Addiction and the Opioid Crisis.

Forensic practitioners are essential components of the response to the opioid crisis from the investigative stages through the presentation of evidence during trials.  In particular, forensic pathologists and forensic toxicologists investigate drug overdose cases and forensic chemists and other forensic scientists are involved in controlled substance investigations.  The forensic laboratory represents a nexus through which valuable information flows that could be put to use in combatting drug addiction and the opioid crisis.

The impact of the current opioid crisis on the forensic science community is enormous and is challenging the provision of forensic science services through the magnitude of the crisis and the constantly changing nature of the drug landscape.  The magnitude of the crisis has outstripped the capabilities of state and local governments to respond. The forensic science community needs to be recognized by the federal government alongside first responders as critical components of the crisis response and supported as such.

Forensic pathologists are bearing the greatest burden of this crisis within the forensic science community.  This crisis has exacerbated the shortage of qualified forensic pathologists that existed prior to the current explosion of opioid related overdoses, impacting their ability to provide critical data for the compilation of overdose statistics. This is of grave concern as the number of drug overdoses defines the crisis and provides the metrics for the response to it.

Our current forensic science infrastructure is simply inadequate to handle the influx of new synthetic drugs.  These new drugs, generally called novel psychoactive substances (NPS) or designer drugs, include synthetic cannabinoids, cathinones, fentanyl derivatives and other novel opioids, as well as others.  Many of them are far more toxic than what has been previously encountered and require special precautions during collection and analysis.

The AAFS Board of Directors offers the following recommendations for consideration:

1. The forensic science community should be recognized as a component of the first responders to the drug crisis and should be accordingly supported.
2. The 21st Century CURES Act and future healthcare funding for the drug crisis response should be made available to forensic pathologists as part of the medical response.
3. A student loan forgiveness program should be established to help grow the forensic pathologist workforce.
4. The Centers for Disease Control and Prevention, the National Institute of Justice, or other pertinent agency should establish grant programs to assist State and local medical examiner, coroner, and forensic science drug surveillance and casework operations.
5. The Centers for Disease Control and Prevention, the National Institute of Justice, or other pertinent agencies should establish instrumentation and associated training grant programs for State and local forensic toxicology operations and academic forensic toxicology educational programs.
6. The Centers for Disease Control and Prevention, the National Institute of Justice, or other pertinent agencies should establish novel drug validation studies grant programs for State and local forensic toxicology operations and academic forensic toxicology educational programs.
7. The Assistant Secretary for Substance Abuse and Mental Health should work with the National Institute on Drug Abuse to establish multiple centers to conduct research and education on the pharmacology, toxicology, and physiologic and cognitive effects on novel psychoactive substances to support forensic toxicology testing, drug level interpretation, scheduling, and prosecution activities.
8. The Drug Enforcement Agency and the National Institute of Standards and Technology should be supported to increase their efforts to make reference drug specimens available to all public and private forensic toxicology and forensic drug chemistry laboratories, as well as academic institutions conducting research on such drugs.
9. The Drug Enforcement Agency and the Food and Drug Administration should be supported to enhance their current scheduling activities.
10. Medical examiner and coroner offices should be granted access to Prescription Drug Monitoring Programs.
11. Appropriate national databases should be built upon relevant medical examiner, coroner, and drug chemistry data. Such databases can be used for decision making and resource allocation purposes on the administrative level, the development of new test methods and geolocation techniques in the laboratory, and sources of critical information for the emergency response, poison control, and medical communities.