In the midst of national concern over illicit drug use and abuse, prescription drug abuse has been identified as the United States' fastest growing drug problem. Nearly all prescription drugs involved in overdoses are originally prescribed by a physician (rather than, for example, being stolen from pharmacies). Thus, attention has been directed toward preventing the diversion of prescription drugs after the prescriptions are dispensed. Prescription drug monitoring programs (PDMPs) maintain statewide electronic databases of prescriptions dispensed for controlled substances (i.e., prescription drugs of abuse that are subject to stricter government regulation). Information collected by PDMPs may be used to support access to and legitimate medical use of controlled substances; identify or prevent drug abuse and diversion; facilitate the identification of prescription drug-addicted individuals and enable intervention and treatment; outline drug use and abuse trends to inform public health initiatives; or educate individuals about prescription drug use, abuse, and diversion as well as about PDMPs. How PDMPs are organized and operated varies among states. Each state determines which agency houses the PDMP; which controlled substances must be reported; which types of dispensers are required to submit data (e.g., pharmacies); how often data are collected; who may access information in the PDMP database (e.g., prescribers, dispensers, or law enforcement); the circumstances under which the information may (or must) be accessed; and what enforcement mechanisms are in place for noncompliance. States finance PDMPs using monies from a variety of sources including the state general fund, prescriber and pharmacy licensing fees, state controlled substance registration fees, health insurers' fees, direct-support organizations, state grants, and/or federal grants. The federal government has established two grant programs aimed at supporting state PDMPs: The Harold Rogers PDMP grant, administered by the Department of Justice, and the National All Schedules Prescription Electronic Reporting Act of 2005 (NASPER) grant, administered by the Department of Health and Human Services. State PDMPs vary widely with respect to whether or how information contained in the database is shared with other states. While some states do not have measures in place allowing interstate sharing of information, others have specific practices for sharing. An effort is ongoing to facilitate information sharing using prescription monitoring information exchange (PMIX) architecture. Legislation has been introduced in the 112th Congress that would take up these issues. The available evidence suggests that PDMPs are effective in reducing the time required for drug diversion investigations, changing prescribing behavior, reducing "doctor shopping," and reducing prescription drug abuse; however, research on the effectiveness of PDMPs is limited. Assessments of effectiveness may also take into consideration potential unintended consequences of PDMPs, such as limiting access to medications for legitimate use or pushing drug diversion activities over the border into a neighboring state. Experts suggest that PDMP effectiveness might be improved by increasing the timeliness, completeness, consistency, and accessibility of the data. Current policy issues that might come before Congress include the role of state PDMPs in the federal prescription drug abuse strategy and the role of the federal government in interstate datasharing and interoperability. While establishment and enhancement of PDMPs enjoy broad support, stakeholders express concerns about health care versus law enforcement uses of PDMP data (particularly with regard to protection of personally identifiable health information) and maintaining access to medication for patients with legitimate medical needs.

Savvy criminals constantly develop new techniques to target U.S. persons, businesses, and interests. Individual criminals as well as broad criminal networks exploit geographic borders, criminal turf, cyberspace, and law enforcement jurisdiction to dodge law enforcement countermeasures. Further, the interplay of these realities can potentially encumber policing measures. In light of these interwoven realities, policy makers may question how to best design policies to help law enforcement combat ever-evolving criminal threats.

Savvy criminals constantly develop new techniques to target U.S. persons, businesses, and interests. Individual criminals as well as broad criminal networks exploit geographic borders, criminal turf, cyberspace, and law enforcement jurisdiction to dodge law enforcement countermeasures. Further, the interplay of these realities can potentially encumber policing measures. In light of these interwoven realities, policy makers may question how to best design policies to help law enforcement combat ever-evolving criminal threats. Criminals routinely take advantage of geographic borders. They thrive on their ability to illicitly cross borders, subvert border security regimens, and provide illegal products or services. Many crimes-particularly those of a cyber nature-have become increasingly transnational. While criminals may operate across geographic borders and jurisdictional boundaries, law enforcement may not be able to do so with the same ease. Moreover, obstacles such as disparities between the legal regimens of nations (what is considered a crime in one country may not be in another) and differences in willingness to extradite suspected criminals can hamper prosecutions. The law enforcement community has, however, expanded its working relationships with both domestic and international agencies. Globalization and technological innovation have fostered the expansion of both legitimate and criminal operations across physical borders as well as throughout cyberspace. Advanced, rapid communication systems have made it easier for criminals to carry out their operations remotely from their victims and members of their illicit networks. In the largely borderless cyber domain, criminals can rely on relative anonymity and a rather seamless environment to conduct illicit business. Further, in the rapidly evolving digital age, law enforcement may not have the technological capabilities to keep up with the pace of criminals. Some criminal groups establish their own operational "borders" by defining and defending the "turf" or territories they control. Similarly, U.S. law enforcement often remains constrained by its own notions of "turf"-partly defined in terms of competing agency-level priorities and jurisdictions. While some crimes are worked under the jurisdiction of a proprietary agency, others are not investigated under such clear lines. These investigative overlaps and a lack of data and information sharing can hinder law enforcement anti-crime efforts. U.S. law enforcement has, particularly since the terrorist attacks of September 11, 2001, increasingly relied on intelligence-led policing, enhanced interagency cooperation, and technological implementation to confront 21st century crime. For instance, enforcement agencies have used formal and informal interagency agreements as well as fusion centers and task forces to assimilate information and coordinate operations. Nonetheless, there have been notable impediments in implementing effective information sharing systems and relying on up-to-date technology. Congress may question how it can leverage its legislative and oversight roles to bolster U.S. law enforcement's abilities to confront modern-day crime. For instance, Congress may consider whether federal law enforcement has the existing authorities, technology, and resources-both monetary and manpower-to counter 21st century criminals (particularly cybercriminals, e.g., S. 2105, S. 3414). Congress may also examine whether federal law enforcement is utilizing existing mechanisms to effectively coordinate investigations and share information.

Twenty-first century criminals increasingly rely on the Internet and advanced technologies to further their criminal operations. These criminals can easily leverage the Internet to carry out traditional crimes such as distributing illicit drugs and sex trafficking. In addition, they exploit the digital world to facilitate crimes that are often technology driven, including identity theft, payment card fraud, and intellectual property theft. Cybercrimes have economic, public health, and national security implications, among others. For over three decades, Congress has been concerned about cybercrime and its related threats. Today, these concerns often arise among a larger discussion surrounding the federal government's role in ensuring U.S. cyber security. Conceptualizing cybercrime involves a number of key elements and questions that include where do the criminal acts exist in the real and digital worlds (and what technologies are involved in carrying out the crimes), why are malicious activities initiated, and who is involved in carrying out the malicious acts? The U.S. government does not appear to have an official definition of cybercrime that distinguishes it from crimes committed in what is considered the real world. Similarly, there is not a definition of cybercrime that distinguishes it from other forms of cyber threats, and the term is often used interchangeably with other Internet- or technology-linked malicious acts. Federal law enforcement agencies often define cybercrime based on their jurisdiction and the crimes they are charged with investigating. And, just as there is no overarching definition for cybercrime, there is no single agency that has been designated as the lead investigative agency for combating cybercrime. The United States does not have a national strategy exclusively focused on combating cybercrime. Rather, there are other, broader strategies that have cybercrime components. Policymakers may question whether there should be a distinct strategy for combating cybercrime or whether efforts to control these crimes are best addressed through more wide-ranging strategies such as those targeting cyber security or transnational organized crime. Congress may also question whether these broader strategies provide specific cybercrime-related objectives and clear means to achieve these goals. Comprehensive data on cybercrime incidents and their impact are not available, and without exact numbers on the current scope and prevalence of cybercrime, it is difficult to evaluate the magnitude of the threats posed by cyber criminals. There are a number of issues that have prevented the accurate measurement and tracking of cybercrime. For one, the lack of a clear sense of what constitutes cybercrime presents a barrier to tracking inclusive cybercrime data. Additionally, much of the available data on cybercrime is self-reported, and individuals or organizations may not realize a cybercrime has taken place or may elect-for a host of reasons-not to report it. Policymakers may debate whether to direct a thorough evaluation of the threats posed by cyber criminals.