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Located in Central America along the Pacific Ocean between Guatemala and Honduras, El Salvador lies between the United States and the major drug-producing nations. El Salvador is a transit point for trafficking cocaine and heroin. Although a transit point, El Salvador is not a major drug-producing nation, and precursor chemical production is not a significant problem.

Rates of drug use in El Salvador are relatively low, with approximately 0.5 percent of the adult population using marijuana annually. Cocaine use is El Salvador's most significant drug problem, with between 0.2 and 0.5 percent of the population using cocaine annually. El Salvador is a party to the 1961 United Nations (UN) Single Convention as amended by the 1972 Protocol, the 1971 UN Convention on Psychotropic Substances, the Central American convention for the Prevention of Money Laundering Related to Drug-Trafficking and Similar Crimes, and the UN Convention Against Transnational Organized Crime.

As in much of Central America, drug trafficking is a problem in El Salvador. Drug markets in the country can be divided between domestic trafficking aimed at Salvadorean customers (mainly through gangs) and the international illicit trade. The country's geographic location and poor economy make it an ideal transit point. In 2008, for example, the National Civilian Police seized 1.35 metric tons of cocaine, 430 kilograms of marijuana, and 8.4 kilograms of heroin. The methods used to transit drugs include containerized cargo bins, high-speed boats, and overland transportation. There has also been an increase in the number of Colombian, Guatemalan, Mexican, and Honduran narcotics and money transporters utilizing the international airport in El Salvador.

El Salvador is a major hub for transporting cocaine and heroin from the Andean region of South America destined for the United States. The majority of the illicit drugs transiting El Salvador is controlled by Colombian-based drug groups and supported by Salvadoreans and Colombians living in El Salvador. The competition for the drug trade has left El Salvador with one of the highest homicide rates in the world. The violence is mainly committed by gangs (many originally from Los Angeles). In the first three months of 2009, an average of nearly 12 people a day were slain. The homicide rate is roughly five times that of Mexico and 10 times that of the United States.

One of the main gangs is the Mara Salvatrucha, also known as MS-13; its archrival is the Mara 18, or M-18. The competing gangs are estimated to have over 11,000 members. Reports are also indicating that Mexican drug gangs have entered El Salvador to explore illicit drug opportunities.

Relations between El Salvador and the United States are strong. U.S. policy toward El Salvador promotes the strengthening of El Salvador's democratic institutions, and offers assistance with the drug smuggling problem. Assistance includes increasing the operational capacity of Salvadorean law enforcement agencies to intercept narcotics shipments and combat money laundering and public corruption. In 2000 the United States reached an agreement with the government of El Salvador to address drug smuggling through the detection and monitoring of aircraft by the U.S. Navy in the Eastern Pacific, through which reportedly over 50 percent of the drugs destined for the United States transit. In 2005 the government of El Salvador and several other Central American countries implemented Operation Controlled (Operacion Controlado). This anti-narcotic trafficking operation established joint police patrols among the participating countries to monitor the border areas used by traffickers throughout Central American.

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