The United States and China need to work together to address the fentanyl crisis, which has cost hundreds of thousands of American lives. When the two countries do cooperate – such as in 2019 when then-U.S. President Donald Trump worked with Chinese President Xi Jinping to have China control fentanyl substances as a class – strong, positive and concrete actions can take place to disrupt the supply chain of fentanyl precursors coming from China into Mexico and ultimately to the United States. As again demonstrated in the past year, since the 2023 Woodside Summit between Xi and outgoing U.S. President Joe Biden, mutually beneficial cooperation is possible to stop this scourge.
But when the efforts of the major powers instead turn to a blame game where the issue of opioids becomes a political tool used to advance national narratives, the people of both the United States and China lose. In this latter environment, the only winners are drug traffickers, like those in Mexico’s Sinaloa and New Generation Jalisco cartels, who profit from the pain and loss of American families and the law-breaking efforts of short-term profit seekers trying to skirt China’s increasingly stringent measures against trafficking in synthetic opioids and their precursor chemicals.
China is a major producer of chemical precursors for legitimate pharmaceuticals and items that end up in illicit narcotics. Its industry provides many of the active pharmaceutical ingredients (API) and chemical precursors used to manufacture the world’s antibiotics, and fentanyl used for pain management. These same medical precursors that generate life-saving drugs, or opioids used for hospital pain management, can be used by illegal actors for illicit drugs. In this context, it’s not surprising that research by the Council on Foreign Relations reports that illicit actors have used the supply chains provided by Chinese industry to source fentanyl.
China has nearly 200 years of counternarcotic efforts. From 1839-1842 and again from 1856-1860, tens of thousands of Chinese lost their lives in two Opium Wars fought against Britain, other European powers, and the United States. Tired of Western opium drug smuggling, the Chinese emperor sought to enforce Chinese laws against drug smuggling in the 1830s. The more powerful European forces won both Opium Wars establishing a series of unequal trade treaties, the first phase of which were imposed in 1842-1844 and the second round of which ended in 1860 with greater European and U.S. trading access to port cities, including the British concession on Hong Kong.
This history of China’s counternarcotic efforts against Western forces is reinforced in China’s education system and history lessons. The Chinese people despise drugs and drug trafficking. Motivated in part by mandatory incarceration policies toward drug users, the scope of China’s domestic drug use of fentanyl and other synthetic opioids is incredibly small.
Given this, it might be tempting for Chinese officials to react to the United States’ struggles with synthetic opioids by merely saying “that’s your problem.” But China is working with the U.S. to understand and combat the problem. Through increasing educational efforts, they have understood the impact of the fentanyl crisis on American societies and the pain and death fentanyl has caused to U.S. families.
In a series of official and expert-led discussions – including the China-U.S. bilateral counternarcotics working group and Track II dialogues sponsored by the Arsenault Family Foundation’s PAX sapiens, Chinese experts and former officials have agreed to take efforts to advance counternarcotics prosecution, to improve private sector standards to avoid irregular shipment of fentanyl precursors to Mexico, and to learn about U.S. best practices in drug treatment. Those dialogues have led experts to consensus around three shared principles: 1) saving lives, 2) protecting societies, and 3) punishing drug traffickers. If Beijing and Washington jointly focus on these principles, the likelihood of successful cooperation increases.
Recently, positive cooperation has made a dent in the fentanyl epidemic in the United States. Whether one focuses on China’s 2019 classwide action against fentanyl or the 2023 increase in prosecutions resulting from the bilateral China-U.S. counternarcotics working group, numbers don’t lie. Fentanyl deaths in the United States have dropped nearly 10 percent in 2024 as opposed to a year earlier. Experts can debate whether that drop is entirely due to supply chain disruption, decreases in demand, or the increased availability of life-saving Narcan and related overdose reversal drugs, but the bottom line is clear: When the United States and China work together to fight drug trafficking in synthetic opioids and their precursors, results follow. By contrast, when the two countries squabble instead of cooperate, drug traffickers stand to profit.
The United States and China again stand at a crossroads in determining whether they will blame each other for a growing drug crisis or whether they will work together to address the problem. In a striking flashback to 200 years ago, we today again see trade and tariff discussions that could possibly undermine productive counternarcotics campaigns. Recently, U.S. officials have announced plans to implement harsh new tariffs against China and Mexico unless they stem the flow of fentanyl into the United States. Some in the U.S. Congress have gone so far as to claim – without persuasive evidence – that Chinese government organizations offer a bounty or reward for companies that can do the best job of exporting fentanyl to American drug users.
Even as the level of rhetoric rises, Chinese private and government actors remain willing to cooperate in the fight against synthetic opioids. But we need to be careful that we do not disrupt the valuable counternarcotics cooperation of the past year solely for political or rhetorical gains. To do so would resume an unconstructive blame game over whether Chinese supply or U.S. demand is more responsible for the fentanyl crisis and undercut gains that have been made to reduce fentanyl flows and deaths leading up to and since the 2023 APEC Summit.
Misunderstanding or Misleading American Public Opinion on China and Drugs
Why would some politicians focus on rhetoric rather than life-saving cooperation to stop the flow of fentanyl to drug users in their home districts and constituencies? It appears that a mistaken view of American public opinion may underlie such actions.
Earlier this year, PAX sapiens commissioned a public opinion poll asking more than 3,000 American households about their experiences with fentanyl and their opinions on who was to blame for the crisis. As published in our August 2024 report “Blame Game,” we found that Americans across all demographic groups primarily blamed drug cartels, drug users and the U.S. federal government for the fentanyl crisis and overdose deaths in America.
Only after these three primary causes did the Americans surveyed consider the role of the Chinese or Mexican governments, alongside overprescribing doctors, to be a significant factor in the fentanyl crisis. One has to wonder why some are trying to refocus the ire and sadness of American families who fell victim to the fentanyl crisis on China.
Our poll also found that Chinese efforts to help stop the flow of chemical precursors for fentanyl could be a significant factor in improving the American public opinion of China. Again, one has to wonder why popular rhetoric seems to take a different pathway and plunge China-U.S. relations back into a blame game.
The Underlying Story of China-U.S. Cooperation on Fentanyl
Perhaps because of this rhetorical atmosphere, China’s initiatives to work with the United States in addressing the fentanyl crisis frequently go unnoticed. Let’s recognize the history of recent measures undertaken, beginning with Trump’s first term in office.
Trump discussed the fentanyl crisis with Xi, resulting in a decision by China in December 2018 to take action against fentanyl. In 2019, China moved to control fentanyl substances as a class. This closed a loophole traffickers were using to get around regulations and led to a reduction in the amount of fentanyl being shipped directly from China to the United States. The White House also praised Chinese efforts to prosecute drug traffickers, noting it was a “direct result of President Trump’s strong leadership on this issue… China’s fentanyl trafficking and production prosecution is a positive step in following through on the pledge secured by President Trump.”
Unfortunately, this progress was short-lived. Just as China’s 2019 actions began to impact the availability of fentanyl in the United States, Mexican cartels responded by increasing the trafficking of finished fentanyl products across the Mexico-U.S. border, a problem that persists today. The coronavirus outbreak also changed the rhetorical direction and nature of China-U.S. cooperation on public health issues and took the public discourse back to the blame game, rather than focusing on positive cooperation.
Resumption of Cooperation After the Woodside Summit
After four years of increasing flows of fentanyl across the Mexico-U.S. border, the U.S. and Chinese presidents agreed to resume counternarcotics cooperation on the margins of the 2023 San Francisco APEC Summit. Efforts such as intelligence sharing, case coordination, and the removal of online platforms facilitating drug trafficking have yielded some tangible results.
This progress has been both top-down and bottom-up. First, high-level leadership meetings motivated the cooperation. Building on the Biden-Xi Woodside Summit, Chinese State Councillor Wang Xiaohong, director of the National Narcotics Control Commission and minister of public security, met respectively with U.S. Secretary of State Antony Blinken and director of the national narcotics policy office of the White House, Rahul Gupta, who visited China in April and June 2024. Wang also held meetings or video calls with the U.S. Homeland Security Secretary Alejandro Mayorkas many times. The two countries established and launched a drug control cooperation working group. The first working group meeting was held in Beijing in January 2024, and the first high level meeting of the working group was held in Washington in July.
Political efforts have been followed up with China taking substantive measures: First, China added three new substances to its control list since the beginning of the year. On July 1, three new psychotropic drugs, including Dexmedetomidine, and 46 new psychoactive substances were added to the list, including nine nicotine-like substances that are of particular concern to the United States. On July 11, the Chinese side released a management announcement for veterinary anesthetics such as cytarazine that the U.S. is concerned about. On August 5, China implemented regulation on seven chemicals, including three precursor chemicals that can be used to manufacture fentanyl.
Second, in terms of intelligence exchange and case cooperation, the drug law enforcement departments of the two countries are cooperating on multiple cases. On June 19, a case was simultaneously announced, and the public security organs of Liaoning Province carried out work on drug money laundering clues reported by the United States. Chinese authorities investigated and arrested a man surnamed Tong on suspicion of illegal business operations in accordance with the law. This is a typical case of cooperation between the two sides.
Third, China has lawfully cleaned up, closed, and rectified 14 online platforms where fentanyl and other synthetic opioid precursors were traded. It also claims to have forcibly cancelled 332 corporate accounts, removed 1,016 online stores, cleaned up more than 150,000 pieces of information, and reported more than 10,000 items of marketing information related to fentanyl and its precursors to the United States. These efforts should be acknowledged.
The latest data highlights encouraging trends. According to the Centers for Disease Control and Prevention (CDC), overdose deaths in the United States decreased by 10 percent in 2023, with further reductions of 12.7 percent reported between May 2023 and May 2024. San Francisco, a city severely affected by the fentanyl crisis, experienced a 15 percent reduction in drug-related deaths. These achievements underscore the importance of continued international cooperation.
We have also seen that when provided with solid intelligence, Chinese law enforcement partners have shown when they can act and be effective. Of course, some believe China could, and should, be doing more; however their past efforts demonstrate a capacity and willingness to act.
We can take some cautious optimism from other developments, like the action Mexican government authorities took against drug traffickers, resulting in record fentanyl and precursor seizures in Sinaloa, Mexico in early December 2024. Continued actions like this could mark a critical milestone in the fight against fentanyl and present a unique opportunity for the three most affected countries – Mexico, China, and the United States – to collaborate, tracing the origins of the precursors involved and dismantling the entire supply chain from production to distribution.
It remains to be seen if rhetorical distractions about tariffs and migrant deportations will motivate further Mexican actions or whether they will undermine the incentive for Mexican officials to cooperate. Incoming U.S. President Trump’s recent discussions with Mexican President Claudia Sheinbaum hint at both possibilities.
Role for the Private Sector
Innovative ideas from the private sector also can come into play to help stop the scourge of fentanyl. For example, in the Track II dialogue convened by PAX sapiens, experts have identified ways to use the APEC Chemical Dialogue to help train the private sector in all of the region’s economies to better monitor supply chains to check that chemicals are not diverted to drug trafficking and to improve governance measures like Responsible Care and Know Your Customer Programs.
As experts build out this proposal, it will be important to capture political and social support from all of the APEC member economies to encourage private sector involvement in this essentially social endeavor. At the same time, the history of successful APEC meetings of U.S. and Chinese leaders to address fentanyl and other areas of cooperation offers some hope. Perhaps progress can be announced when China hosts the 2026 APEC Summit, if not before.
More Work Remains to be Done
Because fentanyl is just one example of synthetic opioids, which are likely to continue to plague the international market, international cooperation must transcend blame and focus on actionable solutions. Actors in all corners of the globe need to work together to address synthetic opioids. As long as demand for drugs continues, traffickers will continuously shift their efforts and the chemical compounds used to produce addictive and life-threatening narcotics. The U.N. Office of Drugs and Crime has produced a useful toolkit of materials that all nations can use to try to better understand and counter trafficking in synthetic opioids. But still the locus of action remains primarily with Washington, Beijing, and Mexico City.
As the nation where demand drives the market, the United States has much it can continue to do to focus on reducing addiction. China, as a source of precursor chemicals, can reinforce its actions, as it has done effectively in the past, and make further effective actions to curb the ongoing use of precursor chemicals. Mexico, as a transit and production hub, can continue to intensify its enforcement efforts and dismantle cartels’ operations. Each country has more it can do individually and working together, such as gathering intelligence and working to identify those responsible. Solving this crisis requires a shift in perspective, addressing the problem from its core rather than through competing narratives. The stakes are too high to allow inaction or division.
Let’s acknowledge that we can tackle this together and recognize what has already been accomplished. Numerous lives hang in the balance. Together, we must build on the progress made and commit to sustained collaboration. It will be only through steadfast determination and a shared sense of responsibility that we will be able to move past this crisis.