Commentary on Pardo et al.: Whatever the past situation, drug precursor chemicals may in future represent an important source for synthetic drug production in Afghanistan and surrounding countries

While modelling conducted by Pardo and colleagues points to a need to question the role played by medicines and bulk drug precursor chemicals, we would cautiously conclude that the weight of evidence still supports the view that ephedra has played a major role in the expansion of methamphetamine production in Afghanistan. Nevertheless, considerable uncertainty exists in relation to how the drugs situation in Afghanistan will evolve in future which, in our view, is now a more important question. Pardo and colleagues [1] make an interesting contribution to the debate on the precursors used for methamphetamine production in Afghanistan. Through a series of simulations, they raise questions about the plausibility of ephedra as the dominant source of ephedrine for methamphetamine production and raise the possibility that other precursors, including over-the-counter medicines containing ephedrine and pseudoephedrine and bulk drug precursor chemicals (hereafter referred to as 'synthetic precursors'), may play an important but unacknowledged role. This is a possibility, as we agree that methamphetamine production from synthetic precursors is clearly more efficient, in terms of the quantity of inputs required vis-à-vis ephedra. There is also some evidence that medicines may have been used at times for methamphetamine production in Afghanistan. As noted by Pardo and colleagues, in samples of 'synthetic drug tablets' seized in Afghanistan between 2020 and 2021 [2], some pills that contained methamphetamine also contained one or more pharmaceuticals found in cold medicines, in addition to other substances. We agree, however, that generalizing from these data is difficult. There are also some limited historical reports of pseudoephedrine seizures in Afghanistan. However, these are not sufficient, in our view, to provide convincing evidence that bulk chemicals have been an important precursor for recent production. Nonetheless, modelling conducted by Pardo and colleagues points to a need to question the role played by synthetic precursors. It is therefore important to consider what other evidence exists that suggests that ephedra has probably been the main starting material used for large-scale ephedrine and methamphetamine production in Afghanistan in recent years. While there will always be some uncertainty in this area, our understanding is that a broad range of contextual factors influenced the emergence of this phenomenon around 2017 [3], discovered following US airstrikes on drug processing facilities [4]. Before this, methamphetamine production in Afghanistan appears to have been relatively limited in scale and primarily based on synthetic precursors sourced from Pakistan and Iran. However, interviews with 'cooks' involved in the production of methamphetamine indicate that after this date the use of ephedra increasingly became dominant, as it resulted in a significant reduction in production costs [3, 5]. Both recent fieldwork and satellite imagery also support the view that from 2017 onwards the use of ephedra was the catalyst for a scale-up in methamphetamine production in Afghanistan [6], signalled by large seizures [5-7]. Although systematic forensic profiling of seizure has not been undertaken, some analysis exists of methamphetamine samples originating from Afghanistan, which were found to be produced from ephedrine extracted from ephedra plants [8, 9]. Satellite imagery also provides evidence of the bulk use of ephedra in methamphetamine production. For example, both satellite imagery and fieldwork (including video evidence) suggest that on one single day at Abdul Wadood bazaar (a former centre for methamphetamine production in Farah province) there was sufficient ephedra to produce an estimated 220 tonnes of methamphetamine, far in excess of the 29.7 tonnes of methamphetamine seized in Afghanistan and neighbouring countries in 2021 [10]. While the uncertainties that exist mean that all estimates in this area must be treated with vigilance, we would cautiously conclude that the weight of evidence still supports the view that ephedra has played a major role in the expansion of methamphetamine production in Afghanistan. We would accept, however, that the role played by chemical precursors requires continued scrutiny. Importantly, we agree with Pardo and his colleagues that considerable uncertainty exists in relation to how the drugs situation in Afghanistan will evolve in future which, in our view, is now a more important question. The Taliban's ban on drug production in April 2022 appears to have impacted significantly upon methamphetamine production, possibly resulting in the closure of more than 700 ephedrine laboratories [6]. As the Special Inspector General for Afghanistan Reconstruction (SIGAR) recently reported: [the US Department of] 'State told SIGAR there has been a significant disruption to methamphetamine production and trade of ephedra in Afghanistan due to the Taliban's closure of the Abdul Wadood Bazaar… destruction of methamphetamine labs; and prohibition of harvesting the naturally occurring ephedra plant' [11]. Based on the limited information available, it now appears that production is probably declining from a peak in 2021 and that the extraction of ephedrine from ephedra plants has moved closer to the mountainous central region of Afghanistan, where higher-quality ephedra is available [6]. The long-term sustainability of the Taliban's drugs ban remains uncertain, given Afghanistan's deteriorating socio-economic situation. If methamphetamine production in Afghanistan continues to be repressed, we may see a shift to the synthetic precursors outlined by Pardo and colleagues, as the supply of these precursors may prove difficult to disrupt. However, in such a scenario, it seems unlikely that large-scale methamphetamine production would remain in Afghanistan—as ephedra appears to have offered the competitive advantage that catalysed production in the country. There are already indications that production costs of ephedra-based methamphetamine are rising significantly, and it does not appear that methamphetamine production using other precursors would be as attractive. A more likely scenario is that production could diffuse to neighbouring countries and move closer to the sources of the precursors outlined by Pardo and colleagues (mainly Iran and Pakistan). For example, Iran has had a relatively long history of methamphetamine production using synthetic precursors [12]. Further, while debates on the drugs situation in Afghanistan have tended to focus upon the potential impact on European markets, an equally important question is the potential longer-term implications for the large opioid and methamphetamine markets in the countries neighbouring Afghanistan. Methamphetamine use has been an established and growing issue in Iran, with life-time prevalence among adults estimated at almost 7% [13]. Pakistan also appears to be experiencing a worsening methamphetamine problem, especially in areas bordering Afghanistan (although evidence for Pakistan is lacking, due to the absence of a recent general population survey) [14, 15]. We agree, therefore, that there is a pressing need to monitor any possible evidence of a diffusion of methamphetamine production in the region. In this context, it will also be important to understand more clearly the dynamics of the Taliban's drugs ban on opium poppy cultivation, now entering an unprecedented second year (albeit with some possible exceptions, such as in Badakhshan where poppy cultivation appears to be increasing) [16]. The ban's continuation not only has significant political and economic ramifications for Afghanistan, but also potentially for countries further downstream, where a reduction in Afghan opiates may exacerbate a shift towards the production and use of a variety of synthetic substances. In conclusion, regardless of the historical situation, it is possible that we will see increased production of methamphetamine or other synthetic substances using synthetic precursors in the future, either in Afghanistan or in other countries in this region. There is therefore a clear need for careful monitoring of developments in this area, to inform a clearer understanding of the interactions that may exist between the production and use of plant-based and synthetic substances and an analysis of the implications for the region and elsewhere of any changes in the dynamics of drug production. Modelling exercises, such as that provided by Pardo and colleagues, will be helpful, but they will need to be integrated within an analytical framework that also draws upon in-depth fieldwork, routine monitoring sources and other tools, such as high-resolution imagery and geospatial analysis. Alexander Soderholm: Conceptualization (equal); writing—original draft (equal). David Mansfield: Conceptualization (equal); writing—original draft (equal). Teodora Groshkova: Writing—review and editing (equal). Roumen Sedefov: Writing—review and editing (equal). Paul Griffiths: Conceptualization (equal); writing—original draft (equal). The authours wish to acknowledge the insights provided by EU and Non-EU experts who contribute to the technical meetings that the EMCDDA convenes on drug production issues. We would also like to acknowledge here the work of the ALCIS satelite imaging and feild work team whoes work has informed the conclusions drawn here. A.S., T.G., R.S. and P.G. work at the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). The EMCDDA is a decentralised European Union (EU) agency that provides independent scientific evidence and analysis on all aspects of the drugs situation. The agency contributes to EU and national policies to protect Europe's citizens from drug-related harms. D.M. works as an independent consultant and currently has a contract with the EMCDDA. Data sharing is not applicable to this article as no new data were created or analyzed in this study.