Drug overdose is the leading cause of death in Americans under the age of 50, and in 2016 alone, drug overdoses killed over 64,000 Americans. Nearly a third of these deaths were attributed to the synthetic opioid fentanyl, the use of which has skyrocketed in the last five years.
The vast majority of fentanyl used in the US is not manufactured domestically. In fact, China is the world’s largest producer of the drug, and exports the vast majority of its fentanyl overseas. Although the United States has pressured Chinese President Xi Jinping’s administration to crack down on fentanyl production, the lack of fentanyl addiction problems in China itself fails to give the country any direct motivation to aggressively prosecute fentanyl producers and exporters. While fentanyl usage has yet to become a matter of concern for Chinese officials, a rise in the use of other synthetic drugs such as methamphetamine and ketamine is the increasing focus of Chinese drug authorities. The image-conscious Chinese Communist Party (CCP) is discontented with being blamed for the United States drug epidemic, especially while receiving little help in combating its own. To effectively address the drug problems of both parties, the US Drug Enforcement Agency (DEA) and the CCP should cooperate, combining the volume of resources available to the US and the source access available to China.
So far, the US has been largely ineffective in pursuing the fentanyl trade on its own. With the increase in opioid usage in the United States, Chinese drug companies have devised increasingly clever ways to supply fentanyl to American buyers. Although many predicted that the fall of the illegal “Silk Road” internet drug trade, a formerly prominent internet marketplace for the trade of drugs such as fentanyl, would decrease its availability, it remains widely available on a specific part of the internet called the “dark web,” and is in fact now harder to track since its sources are more disparate and delocalized. Companies are increasingly deviating from the more traditional drug trafficking routes, which pass through Mexico to the US, and are shipping directly to the US in increasingly innovative ways. Chinese companies ship raw fentanyl powder, counterfeit versions of prescription opioid pills (such as oxycodone) laced with fentanyl, and mixes of heroin, fentanyl, and other drugs directly to consumers. In a recent trend, companies have started to smuggle pill presses that dealers can use to manufacture their own counterfeit pills from much cheaper raw materials, which are also imported from China. The sale of unlicensed pill presses is strictly illegal in the United States, so most come in mislabeled packages or in separate parts, to be assembled in the United States. Although some fentanyl is still smuggled through Mexico or Canada, a large portion of it now enters the United States through conventional carriers like the United States Postal Service, making it increasingly difficult to track. To avoid being seized by authorities, they are often mailed through a chain of forwarding systems, and some companies are so confident in their security that they guarantee a second free shipment if the first one is seized by authorities. The use of the internet has exponentially expanded drug manufacturers’ abilities to reach consumers directly, and American authorities are struggling to stop it.
China has also recently experienced a rise in the use of synthetic drugs such as methamphetamine and ketamine, and has appealed to the World Health Organization to ban the distribution of ketamine. However, WHO has rejected China’s plea, citing ketamine’s prevalent medical use. Ketamine, first developed as a horse tranquilizer, is a useful anesthetic, and a majority of low-to-middle income countries in the world use ketamine for medical procedures. It is even used clinically in the United States for emergency pediatric pain control and is now being researched as a treatment for depression. Banning it worldwide would not only severely inhibit doctors’ abilities to perform surgeries in these nations, but also restrict all legal uses of ketamine––the costs of which would inevitably outweigh the benefits. In light of this, WHO has overwhelmingly voted against the banning of the drug, stating that the responsibility for managing domestic ketamine addiction was China’s alone.
China’s newfound status as a hub for synthetic drug manufacturing uniquely enables it to restrict fentanyl production. In the past, China has targeted and banned specific drugs, but this approach has been largely ineffective since the producers of most of these drugs can make small chemical changes to produce a unique drug with homologous effects. In the last few years a variety of fentanyl spin-offs have hit the market, including a heroin-fentanyl combination known as “china white,” furanyl fentanyl, and carfentanil, a tranquilizer 100 times stronger than fentanyl, which has already caused deaths in Florida, Ohio, and Kentucky. As soon as the United States or China targets a specific drug, it seems that a new chemical is produced, somehow more potent and dangerous than its predecessor.
China also cannot crack down on the pharmaceutical industry too intensely without sacrificing some of its economic growth and stability. As the second largest pharmaceutical producer in the world, China relies heavily on its ability to mass-produce inexpensive generic drugs and its production of the chemical raw materials used to produce marketable pharmaceuticals. The Chinese government considers pharmaceutical production a “high value-added industry,” and has offered a variety of tax rebates to drug companies to export their products overseas. By over-regulating the industry in efforts to suppress fentanyl production, China could potentially destabilize its status as the world’s top exporter of pharmaceutical ingredients. Because much of the fentanyl exported from China comes from illicit operations within legitimate companies, efforts to restrict its export would affect some of the most powerful and integral companies in China’s pharmaceutical industry, which places the CCP in an awkward dilemma.
Furthermore, investigations, either by China or other countries, are hampered by an ineffective bureaucracy. Many drug officials in China put little effort into uncovering the legitimacy of a fentanyl buyer before a shipment is sent overseas, and evidence suggests that efforts by the DEA to conduct investigations in China have been obstructed by regulators, with several recorded instances of delayed visa approvals and deleted lab reports. Taking advantage of the relative inability of US drug inspectors to operate, China alleges that the US has inflated its role in the international drug trade, with top drug official Wei Xiaojun claiming, “While we don’t deny that some fentanyl substances abused in the US have come from China, we don’t see sufficient evidence […] that most of them have come from China.” Bureaucratic ineptitude restricts both American and Chinese efforts to restrict the flow of synthetic drug throughout China and abroad. However, recently, Beijing has been increasingly resolute in targeting drug corruption, expelling 41 officials from Yunnan province in 2014, but it is still difficult to stop all local corruption, especially in low-income and overworked areas.
Synthetic drug restriction in China is proving to be a daunting process for all parties involved; however, through collaborative solutions, both the United States and China can more effectively tackle the rise of synthetic drugs. The DEA has offices in Guangzhou, Beijing, and arguably most importantly, Hong Kong, a major hub through which synthetic drugs are traded. Recent collaboration between China and the United States has yielded fruitful, tangible solutions for both countries. In addition to the scheduling, or restricting the production and distribution, of many new substances, China is establishing a communication system between law enforcement and a central government database to catalog the production and use of new drugs. A proposed effort by the DEA to schedule entire classes of drugs, instead of individual chemicals, would decrease the demand for Chinese companies to produce entirely new chemicals on a regular basis. As China bans more chemicals, it opens up capabilities for joint investigations by the US and China, which are less likely to be hindered by bureaucratic incompetence. Financial investigations into Chinese pharmaceutical practices will reveal which companies are profiting from illegal trade, and cyber-investigative efforts have targeted drug marketplaces online.
To China’s benefit, this collaboration between two global superpowers can extend to other scheduled drugs, including amphetamines and ketamine. With drug tracking systems, investigative teams, an increased corruption crackdown, and real-time communication, almost any set of drugs can be effectively stopped at its source without dismantling an entire pharmaceutical industry. By targeting ketamine in the same way as fentanyl, the US and China can stop the Chinese domestic trade of ketamine without restricting it from the developing nations for whom it is an absolute necessity. By each leveraging their own power to regulate synthetic drugs, the United States and China can form a sustainable, symbiotic drug enforcement relationship.