12 4. Reduce the supply of opioids from illegitimate sources The President’s opioid initiative contains a provision for federal efforts to focus on interdicting the flow of international and domestic illicit drug supply chains, including by requiring definitive package markings on all shipments into the U.S. as a way of tracking suspicious ones. Carrying this effort forward at the state and local levels includes the potential for such activities as: • detecting and disrupting distribution channels for illicit drugs through local or online means • working with the DOJ Opioid Fraud and Abuse Detection Unit to prosecute corrupt or criminally negligent doctors, pharmacies and distributors • strengthening criminal penalties for dealers of fentanyl and other synthetic opioids Oneofthemosteffectiveactivitiesforsupportingthisstrategyisthedeploymentofdrugtaskforcesdesignedtodisrupt the flow of illegitimate drugs such as heroin and fentanyl. For jurisdictions not yet working with such a multi-agency, multi-jurisdictional task force, a useful play might be to create one and link it to the Drug Enforcement Administration (DEA) and other federal resources, including DOJ funding sources to sustain this effort on a local/regional level. Local task forces have been successful in disrupting and even eliminating distribution networks.  Since most heroin and fentanyl originate outside the U.S., much of the counter-narcotics programming is at the federal level. The 2018 SUPPORT for Patients and Communities Act calls for the Postal Service to step up inspections of all packages coming into the country in order to detect the presence of heroin and synthetic opioids such as fentanyl. However, the current delivery systems in the U.S. are geared to local distribution, and for many years there have been effective multiagency drug task forces in place that concentrate on detecting and destructing distribution channels at the local level, frequently in conjunction with state and federal agencies. As noted in the Washington State strategic plan, funding for such entities has been cut just as the extent of the opioid crisis has grown.48 The Drug Enforcement Administration currently maintains and supports 271 drug task forces throughout the country.49 For jurisdictions that match the criteria, many are involved in the formation of High Intensity Drug Trafficking Area (HIDTA) task forces. The HIDTA program, created by Congress through the Anti-Drug Abuse Act of 1988, provides assistance to federal, state, local and tribal law-enforcement agencies operating in areas determined to be critical drug-trafficking regions of the United States. This grant program is administered by the Office of National Drug Control Policy (ONDCP). There are currently 28 HIDTAs, encompassing approximately 18 percent of all counties in the United States and 66 percent of the U.S. population.50 The Congressional Research Service has published a history and discussion of HIDTA. Theory of Change By reducing the availability of illicit drugs, the task force will prevent the incidence of some substance use disorders and thereby decrease the number of people affected. It is far easier to articulate this theory than it is to measure the complex relationship between involved organizations and environmental values. A study published in Ireland in February 2017 proposes a performance measurement approach based on this theory of change.51 Goals and Objectives Drug task forces seek to identify and destroy distribution networks and their operations in specific jurisdictions. The objectives are to disrupt drug sales in all sectors, arrest and prosecute the sales and delivery forces, and otherwise upset the distribution process. Examples Most states have developed statewide programs to create multijurisdictional task forces that focus on drug-related criminal activity. Ohio has funded numerous task forces the have been found to be highly effective in addressing and interdicting drug crimes. Information is available in the state’s most-recent annual report. An evaluation of Illinois’ multijurisdictional task forces showed that these units had a significantly higher arrest rate than local police agencies, and that the units supported the guidelines for implementation. A state publication provides details of the evaluation.