The following is a transcript of an interview with DEA administrator Anne Milgram on “Face the Nation with Margaret Brennan” that aired on Aug. 18, 2024.

MARGARET BRENNAN: Fentanyl and other so-called synthetic opioids are the main driver behind overdose deaths in the United States, according to the CDC. But in light of the recent death of actor Matthew Perry from an overdose of ketamine, a controlled substance that can be used in clinical and therapeutic settings, there are growing concerns over the abuse of that drug as well. Joining us now to discuss it all is the head of the Drug Enforcement Administration, Anne Milgram. She’s in New York this morning. Welcome back, Administrator.

ADMINISTRATOR ANNE MILGRAM: Thank you for having me.

MARGARET BRENNAN: So you just had these arrests this week as we outlined, ketamine is an anesthetic, but it can be used to treat depression at times. When you announced these charges, you said this was a case of where substance abuse began in a doctor’s office and then it ended up in the street. How common is the abuse of ketamine now?

ADMINISTRATOR ANNE MILGRAM: That’s right. Margaret, so in the case of Matthew Perry’s death, we announced charges against the five individuals who we believe are responsible for that. And again, what happened there is it started with two unscrupulous doctors who were violating really- we charged- violating their oath, which is to take care of their patients, and instead supplying Matthew Perry with enormous quantities of ketamine in exchange for huge amounts of money. And then it switched to the street where Matthew- where Matthew Perry was buying the ketamine from two drug traffickers on the streets of Los Angeles. And so this, unfortunately, is a tragic [unintelligible] that we have seen thinking back to the opioid- the beginning of the opioid epidemic, where many Americans became addicted to controlled substances in doctors’ offices and through medical practitioners that then turned into street addiction as well.

MARGARET BRENNAN: Well, exactly to that point, it sounds a bit like the beginning of the opioid crisis, we were talking about pill mills. Now you are seeing ketamine clinics pop up and claim to be treatment for depression and other things. Do they need to be more regulated? How do you get your arms around this?

ADMINISTRATOR ANNE MILGRAM: So one of the things that’s important to recognize so ketamine is a controlled substance, and it is, it is, it has a high potential, obviously, for addiction and other challenges. The FDA regulates the medical prescribing of ketamine, and so they have approved it as an anesthesia. They have approved it through a nasal spray for the treatment of depression. And so they regulate the medical side of this. At DEA what we’re focused on, we’re focused on doctors, nurse practitioners, anyone who is essentially diverting legitimate controlled substances from the normal medical practice to do what we saw happening here, where doctors, these doctors, were not evaluating Matthew Perry, they were not supervising injections. They were leaving behind vials of ketamine for Matthew Perry to be injected by his assistant. And so again, we’re focused on the controlled substance side, but we every single day, are targeting and investigating doctors, nurse practitioners, others who are violating this duty of trust to their patients by over prescribing medicine or prescribing medicine that isn’t necessary. And here again, what we’ve alleged is that these doctors were seeking a huge payout from Matthew Perry. They charged him around $50,000 over the course of one month to supply ketamine. 

MARGARET BRENNAN: Fentanyl is also used in medical settings, but it also happens to be the leading cause of death for Americans between the ages of 18 and 45 according to the DEA. That is a stunning statistic. We have heard a lot about this on the campaign trail. We have heard President Biden talk about sanctioning Chinese entities, about charges against Mexican cartels doing business with Chinese groups, and yet, we are still hearing about a high degree of overdoses due to fentanyl. Why is it so hard to crack down on.

ADMINISTRATOR ANNE MILGRAM: So Margaret, you’re- you’re right in pointing this out that in 2022 we lost 107,941 American lives to fentanyl and methamphetamine. And this is a tragic, tragic situation we’re facing where fentanyl is widespread in every single community across the United States, from coast to coast and everywhere in between. And what we are seeing is that the cost of manufacturing fentanyl for the two cartels in Mexico that are responsible, The Sinaloa and Jalisco cartels, is pennies, and so this is the cheapest drug we have ever faced. And the only limit on the amount of drugs that can be made are the chemicals that are being sourced by the cartels from China and essentially th eproduction, which again, costs pennies for these two cartels to make. So we are fighting what I would argue is the greatest threat in narcotics that we’ve ever faced, and at DEA, we’re focused on saving American lives. One of the core ways we’re doing that is working across their entire network. Both of those cartels are operating in more than 50 countries around the globe, and we’re targeting every part of that global supply chain, from the Chinese chemical companies and Chinese nationals who we charged last year and this year to the Mexican cartel leaders, manufacturers, to the people that are selling drugs in the United States on behalf of the cartels, and then the money launderers who are working for the cartels. In 2023 we took action across that entire network. We’ll do the same in 2024 and so we have a strategic plan. We’re working to take apart these networks, and we’re starting to see progress, but there is a lot more work to be done, because how addictive fentanyl is, how tiny quantities can kill someone. And for the first time, the cartels are hiding fentanyl in other drugs. They’re making them look like real prescription medicines, which are all fentanyl and filler. And so this is just a dramatically changed landscape that we’ve now pivoted to address and take head on. And every day, we’re fighting to save lives by defeating those two cartels and stopping fentanyl.

MARGARET BRENNAN: Well, Mexico, Mexico’s president has said he won’t fight the Mexican drug cartels. His slogan is hugs, not bullets. The new incoming president gets sworn in October 1, has said she’ll follow the policies of her predecessor. That’s going to be a big problem for your enforcement, isn’t it?

ADMINISTRATOR ANNE MILGRAM: So we have to work across the globe to stop this threat, to stop Americans from dying, and so again, we’re focused on we’ve made a number of criminal charges in China. We’ve also begun since last November, when President Biden met with President Xi, we’ve started to have engagements again. We’ve reengaged with the Chinese Ministry of Public Security. Recently, we took down a case in Los Angeles where we connected- We basically showed that a Chinese money laundering organization was working directly with the Sinaloa Cartel. In China, they made one arrest, and in Mexico, they made one arrest. It’s that kind of work together that will- will help us to have an impact and to stop this threat.

MARGARET BRENNAN: Administrator Milgram we’ll track your progress. We’ll be right back.