With opioid-related deaths still a significant public health concern and illicit financial networks driving crime around the world, the opioid crisis and global money laundering remain two of the most urgent and complex challenges facing policymakers. Yet despite their scale, governments struggle to collect credible, comprehensive data needed to understand and address these problems effectively.
That is the central message from Distinguished University Professor Peter Reuter, whose recent commentary in JAMA Health Forum highlights the fact that the U.S. has yet to launch a new nationwide effort to track opioid use and supply, even after years of mounting overdose deaths.
Reuter, along with co-authors Greg Midgette of the UMD Department of Criminology and Criminal Justice and Jonathan Caulkins of Carnegie Mellon University, responded to a study suggesting that official estimates of fentanyl use are far too low. Their piece, “Improving Opioid Use Estimates Through Multiple Data Sources,” outlines the deep limitations of current U.S. data systems.
“That is a tough question and there is no single answer,” Reuter said when asked why better data systems are not already in place. He points to long-standing tensions between public health and law enforcement. “For public health researchers, it was stigmatizing to sample from arrestees, even though that was a critical population for monitoring purposes,” Reuter said, referring to the discontinued Arrestee Drug Abuse Monitoring (ADAM) system.
Reuter explained that enforcement agencies have not always been eager to share data that might contradict their narratives. “Independent analysts often produced findings inconsistent with the official story. Take away the data and that problem goes away,” he added.
Even when researchers are willing, the logistics of studying illegal activity without putting people at risk, legally or physically, are complicated. “It’s impossible to obtain data on how potent the drugs being sold on the streets really are,” said Reuter, noting that current testing methods are not allowed to analyze usable drug samples.
At a time when fentanyl overdoses are surging and three consecutive presidents have publicly prioritized the issue, Reuter said that translating those words into practical sustained monitoring efforts has been slow.
The lack of transparency, inadequate measurement and unintended policy consequences also run through Reuter’s research on anti-money laundering (AML) policies. He and colleague Mirko Nazzari presented findings at the sixth Bahamas Conference on Financial Crime earlier this year, where they challenged whether decades of AML policies have actually made it harder to move criminal money.
“Money laundering doesn’t of itself cause much harm to society,” said Reuter. Instead, he shared, the original goal of AML efforts was to catch drug kingpins by targeting their financial trails. “So the true test of the system is whether it has helped reduce the crimes that generate the money.” As with opioid use, that is hard to measure and rarely evaluated in a meaningful way, Reuter added.
Reuter said both the opioid and AML issues show what happens when big policy goals do not come with mechanisms to track what is actually working. “There are no perfect evaluations,” he shared, “and there are always parties whose interests are hurt by a specific evaluation finding.”
In both cases, Reuter is clear that if we want to see better outcomes, we need better data and a willingness to face whatever it tells us.
