1. Investment in evidence-based approaches to demand, supply and harm reduction interventions needs to be strengthened given that the retail market for heroin remains the second largest drug market in Europe and the most significant contributor to public health and social harms.
2. There is a need to strengthen capacity to identify signals and respond to new outbreaks of heroin or other opioid use or use among new subgroups.
3. Monitoring of opiate production remains essential and needs to target information gaps in relation to the quantities of heroin produced globally and where heroin production occurs. There is a need to better understand the destination of the opium and morphine exported out of Afghanistan, as well as the dynamics of renewed heroin production in the EU.
4. Forensic profiling of heroin seizures is of great value for strategic purposes and needs to be supported. A mechanism for sharing the results of analysis among stakeholders at national and European level in a timely manner would be beneficial.
5. Prevention of the diversion of acetic anhydride is a key component of a robust control framework. Additionally, information on diversion cases or attempts has value for signalling changes in opiate production. The systematic collection and sharing of additional information pertaining to seizures and stopped shipments of acetic anhydride in Europe, especially the results of backtracking investigations, should be strengthened. This would facilitate targeting of OCGs specialising in the diversion of precursor chemicals in the EU.
6. The threats posed by interaction between the heroin market and the markets for synthetic drugs and cocaine identified in this report need to be better understood at a strategic level. This is likely to require more efforts in information sharing and analysis between the operational and strategic levels at both national and European level.
7. Active monitoring, forensic analysis and timely information sharing on large seizures at major entry points in Europe is strategically and operationally important and should be encouraged and supported to improve our understanding of the evolving criminal networks and routes.
8. Tackling maritime trafficking of heroin needs greater attention drawing on lessons from cocaine interdiction measures. This should encompass both bulk consignments at sea and targeting containers at key departure and transit points, especially ports in Africa, Pakistan and Iran, in addition to landing points in Europe.
9. Cooperation between the countries along the Balkan route, including destination and transit countries, especially Turkey, has proven successful and should be continued and reinforced with new partnerships where possible. This should include intelligence sharing to develop the understanding of the continued diversification and extension of the Balkan route as well as support to develop demand reduction activities in the countries affected by heroin trafficking.
10. Continuous assessment and monitoring of the implications for heroin trafficking of the current instability in the Middle East and associated migration through Balkan countries is required. Closing information gaps on opioid-containing medicines and new synthetic opioids
11. Tools are needed to better monitor and prevent the diversion and misuse of medicines containing opioids both at the population level and within risk groups. This needs to include methods for early signal detection as well as the development and propagation of proven effective responses.
12. The identification of source countries, the extent of production within the EU and online sales remain important information gaps for synthetic opioids.