On December 5-6, 2019, officials of the governments of Canada, Mexico, and the United States convened in Washington, D.C. at the U.S. Postal Service headquarters to address current and emerging drug threats facing North America during the Fourth Annual North American Drug Dialogue (NADD). The NADD is the premier forum for continental cooperation on drug issues. It leverages the combined efforts of law enforcement and health officials from all three countries to address the many facets of the transnational opioid crisis, illicit psychostimulants threat facing each country, and the broader drug crisis facing North America.

The NADD is the result of a commitment made by the heads of government of the three countries at the 2016 North American Leaders Summit to develop a trilateral forum to address current and emerging drug threats facing North America. The annual meetings are held at the Assistant Secretary level, and throughout the year trilateral trainings, study tours, and information exchanges occur at the subject matter expert level. To date, all three countries have hosted an annual meeting.

The Fourth Annual North American Drug Dialogue included a day of expert panels on emerging drug trafficking trends, the public health challenges of psychostimulant use disorders, and best practices to combat illicit finance. At the high-level principals meeting, the delegates discussed the need to intensify efforts to combat synthetics, including fentanyl, methamphetamine, and other synthetic drugs, and set the agenda for the NADD entering its next phase.