Blaming China for fentanyl threat won’t solve America’s opioid crisis

The ease with which synthetic drugs like fentanyl can be made, transported and sold has led to an array of small, scattered traffickers
The US can’t solve its opioid crisis on its own, and as long as its cold war with China continues, effective cooperation is unlikely

David Dodwell

Published: 1:45pm, 27 Oct 2023

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In a world where decoupling, de-risking, near-shoring and a wide range of other national security measures are seen as needed to fend off the existential challenge from China, it is perhaps not surprising to see blame for a deepening US drug abuse crisis placed squarely at Beijing’s door.

US Attorney General Merrick Garland recently laid charges against eight Chinese companies and 28 of their people for trafficking fentanyl precursor chemicals to the US. As Drug Enforcement Administration administrator Anne Milgram noted: “Fentanyl is the deadliest drug threat our nation has ever faced.”

In 2021 and 2022, about 107,000 Americans died each year from drug overdoses, mostly due to fentanyl – more than twice the gun deaths recorded. This has pushed down life expectancy in the US. The most short-lived 10 per cent of Americans die by 41 on average, according to research by the Financial Times. This compares with 60 in Japan and Switzerland, and 55 in France, Germany and Britain. One in 25 American five-year-olds will die before they are 40.

Of course, drug abuse is a problem worldwide. Out of the 296 million drug users globally, 39.5 million suffer from drug use disorders, according to the UN World Drug Report. Cannabis is most commonly consumed, but opioids are the source of two-thirds of drug-related deaths.

As with gun deaths, the US stands alone in the depth of its drug abuse problems: dating back to the 1990s, the “profit motive of the pharmaceutical industry remains ever present”, said Professor Howard Koh at Harvard’s TH Chan School of Public Health.

But the role of fentanyl and related opioids in transforming a grim and damaging social problem into an alarming surge in deaths is also clear: when heroin is mixed with fentanyl, a synthetic opioid 50 to 100 times more powerful, horrible consequences seem inevitable.

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But is it China that has the dirty hands? At the heart of the argument is the age-old difficulty in deciding whether the principle blame sits with the drug consumers or the global criminal networks.

Garland’s assault on a criminal underworld that supplies drug abusers has an urgency and gravity. Today’s synthetic opioids are dangerously powerful: they are easy to make and can be shipped in tiny quantities. Just three to five tonnes of pure fentanyl is thought to be enough to satisfy America’s annual demand for illicit opioids, compared with 47 tonnes of heroin or 145 tonnes of cocaine.

Rising drug demand has been both masked and amplified by the pandemic: e-commerce platforms have made the drugs easier to sell while cryptocurrencies have made it easier to pay – and be paid – without detection.

Perhaps worst of all, the fact that most of the fentanyl – or fentanyl-precursors – originates in China is moving the illicit drug trade away from traditional hubs such as Afghanistan and Colombia, and placing the problem slap in the middle of the deepening cold war between the US and China. The international cooperation necessary to monitor, prevent and prosecute international drug trafficking has all but collapsed.

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Problems have been aggravated by the “synthetic revolution” in global drug markets. While heroin and cocaine rely on crops grown in Afghanistan and Bolivia, the new opioids are a pure product of the chemicals industry – and China accounts for 12 per cent of the global pharmaceutical market. The country has over 5,000 pharmaceutical manufacturers, with 4,000 producing active pharmaceutical ingredients.

The Brookings Institution says the main illicit traders are not China’s big pharmaceutical groups or even Chinese triads, but “a wide panoply of Chinese criminal actors, from small family-based enterprises and specialised groups to businesses that also conduct highly diverse legal trade with organised criminal groups”.

Chinese companies used to sell fentanyl directly in the mail to customers in the US. But the imposition of strict controls transformed the trade and most exporters now sell precursor chemicals to criminal gangs in Mexico. The chemicals are then concocted into fentanyl and smuggled into the US.

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Two Mexican gangs predominate: the Sinaloa Cartel, and the Cartel Jalisco Nueva Generacion. Mexico’s drug export revenues can range from US$6 billion to US$21 billion a year. The Brookings report notes that the “synthetic revolution allows for the production of a vast array of new recreational drugs, including immensely dangerous ones, from a wide range of dual-use chemicals”.

The mere mention of “dual use” immediately pulls the illicit drug trade to the heart of the US-China trade war, with America’s paranoid national security concerns over “dual use” semiconductors going to China’s military.

“The US blames China for poor domestic enforcement of its regulations, inadequate actions against Chinese drug smugglers and money launderers, and insufficient regulatory oversight,” the report added.

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Predictably, China sees it quite differently. A recent foreign ministry paper describes the widespread drug abuse in the US as “an ‘American disease’ that cannot be fixed easily”.

“Drug abuse in the United States is a reflection of deep-rooted social problems, and the result of an interplay of economic interests, lobbying, and social and cultural factors,” it said, adding that the country “should face its own problem squarely”.

Two realities are clear. The US has a profound drug abuse problem that is costing an alarming number of young lives. And while the US-China cold war persists, neither side is likely to offer the cooperation that would enable a solution.

David Dodwell is CEO of the trade policy and international relations consultancy Strategic Access, focused on developments and challenges facing the Asia-Pacific over the past four decades