To slay Hydra-like fentanyl scourge, US needs more than China’s help

The US needs to redouble global cooperation to curb supply and enforce a much stricter drug policy at home to curb demand. China’s support is only a first step

Christopher TangandThomas Choi

Published: 9:30am, 6 Jan 2024

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The fentanyl crisis looms large in the United States. The November meeting between Chinese President Xi Jinping and US President Joe Biden offered a glimmer of hope when Xi agreed to curb the flow of fentanyl into America. While China’s support is a crucial first step, combating covert supply chain operations for fentanyl necessitates global cooperation and a multifaceted approach involving a strict drug control policy.

Fentanyl, a synthetic opioid, is 50 times more potent than heroin: a tiny amount can result in a fatal overdose. In 2022, drug overdose was a leading cause of death for Americans aged 18 to 45 years, with 70 per cent of those cases involving fentanyl.

Fentanyl addictions and overdoses have the potential to become a global crisis. Canada has seen an increase in opioid-related deaths in recent years. While countries such as Australia, Germany and Britain have also experienced an uptick in opioid consumption, it has not reached the same levels as in the US and Canada.

Meanwhile, fentanyl consumption in China, Mexico and India remains relatively low, but this could change given their heavy involvement in fentanyl production.

To reduce fentanyl overdose deaths in the US, it is essential to understand the flow of illegally made fentanyl. Its illicit trade starts with the production of fentanyl precursor chemicals in nondescript factories in countries like China and India, followed by clandestine shipments to Mexico, often concealed in regular cargo.

Fentanyl production using these precursors then occurs in secret labs operated by cartels such as the Sinaloa cartel. The final drug – frequently mixed into counterfeit pills – is smuggled into the US and sold on the street, contributing to the deadliest drug crisis in US history.

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The Biden administration is concentrating its efforts on curbing supply. This includes urging China to crack down on the supply of fentanyl precursors to Mexican cartels and imposing sanctions on Mexican nationals and companies associated with the Beltran Leyva drug cartel.

But covert supply chains will continue to diversify to evade detection. For example, while Mexico and China are the main sources of fentanyl and related substances, India emerged as a source of finished fentanyl powder and precursors after 2019, when China implemented restrictions on the production and sale of fentanyl.

Fentanyl precursors are produced in nondescript factories in China and covertly shipped to Mexico by altering their chemical signatures or concealing them as regular products. Unless China and Mexico are prepared to crack down on these nondescript factories and impose severe penalties, the effectiveness of US customs in keeping fentanyl out will remain a challenge.

US customs has started using artificial intelligence and machine learning models to identify suspicious cars or cargo at the Mexican border. But they face an increasing challenge with production of fentanyl and its precursor chemicals likely to spread to more countries.

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In addition to curbing supply, the US government must devise more effective strategies to control fentanyl demand.

Firstly, education serves to discourage the experimental use of fentanyl and raise awareness about its dangers. Local governments need to spearhead public awareness and prevention programmes, which could include billboards, podcasts and webinars, hotlines and more.

Secondly, local governments should collaborate with health professionals to develop detox programmes to alleviate withdrawal symptoms, prevent complications and prepare for further treatment. Additionally, local communities should establish support groups like Narcotics Anonymous and SMART Recovery.

But even effective prevention and rehabilitation programmes cannot eradicate fentanyl addictions. So some states are considering more drastic measures.

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To reduce fentanyl overdose deaths, state governments are increasing access to naloxone, which rapidly reverses opioid overdoses. Apart from pharmacies, drug users may be able to access mail-based naloxone through harm reduction organisations such as Next Distro. In January last year, California governor Gavin Newsom released a state budget that includes US$3.5 million to supply naloxone to every middle and high school in the state.

In 2022, New York opened the first authorised supervised consumption site in the US. There, individuals can use pre-obtained drugs under the safety and support of trained personnel, preventing overdose deaths. Research shows such sites are effective in reducing drug-related harm. While critics view these sites as illegal and defeatist, supporters see them as a realistic response to the US drug crisis.

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Beyond curbing fentanyl production, reducing demand and lowering overdose deaths, the US government also needs to regulate and clamp down on the financial flows that fuel the supply chain operations. Most of these transactions are conducted through cryptocurrency.

This form of money laundering is challenging to track and trace, necessitating that the US government engage with China, Mexico and India to adopt more robust anti-money-laundering standards in their banking and financial systems, and trading practices.

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Finally, the implementation of much stricter penalties is imperative to dissuade the selling or distribution of fentanyl. In October, Newsom enacted a law to add three years to the prison sentence of anyone guilty of dealing more than 1kg of fentanyl, increasing with the drug weight to top out at an additional 25 years for quantities exceeding 80kg.

While harsher punishments may reduce drug trafficking, it seems life imprisonment, even capital punishment, may be more efficacious, as seen in China, Indonesia and Singapore.

The illicit fentanyl supply chain is like Hydra, the mythological Greek creature with multiple regenerating venom-spitting heads. Just as Hercules recognised his inability to fight Hydra without help, the US cannot win this drug war without global support and a strict drug control policy.

Christopher Tang is a distinguished professor at the UCLA Anderson School of Management

Thomas Choi is a regents professor in the W.P. Carey School of Business at Arizona State University