The Fentanyl Crisis

America has an addiction problem. The number of lethal drug overdoses has increased at an alarming rate, with a two-fold increase in opioid related mortalities since 2000. According to the Center for Disease Control and Prevention, there were over 47,000 fatal drug overdoses in 2014, 62 percent of which were caused by opioids, making drug overdose the leading cause of accidental death in the United States.

Drug addiction and overdose cases have been on the rise, and awareness has increased as well. Over the past few years, the addiction treatment industry, valued at $35 billion by the Substance Abuse and Mental Health Services Administration, has gained traction. Although the American addiction problem has caught the attention of policymakers and the general population alike, a subset of drugs has gone largely ignored — synthetic drugs.

Fentanyl is a highly potent synthetic opioid that is 50 times stronger than heroin, 100 times stronger than morphine and has grown in popularity in North America. According to a Wall Street Journal analysis, fentanyl has been linked to 9,600 cases of fatal overdoses since 2013. Music legend Prince was one of those cases this past April.

Prescription fentanyl is a legal painkiller for serious cases of cancer, but most fentanyl overdose cases are usually related to illegally obtained fentanyl, the majority of which can be sourced back to China. Many pharmaceutical or chemical companies in China send fentanyl directly to the United States, Mexican drug cartels or dealers in Canada. The Chinese companies also ship fentanyl precursors, chemicals that are essential to making fentanyl, to North American drug labs. Fentanyl usage is concerning not only because there has been a sharp rise, but also because fentanyl’s high potency and easy accessibility means that there is potential for increased abuse. In some forms, fentanyl can be fatal just from direct contact, and the Wall Street Journal reported a case in which an airport customs officer fell into a coma just from handling fentanyl.

Often times, people are not aware that they are overdosing on fentanyl until it is too late. Drug dealers mix fentanyl with other drugs, such as heroin or Xanax. Fentanyl pills have also been made to resemble less potent pain pills, such as oxytocin or hydrocodone, that are typically more expensive than fentanyl pills. This is dangerous because unsuspecting addicts think they are consuming normal pain pills but end up consuming a chemical that is much stronger, leading to overdose.

The business is ludicrously profitable, and there are loopholes to get through trade regulations. For example, by ordering unregulated chemical precursors and pill presses, Americans can start their own local fentanyl pill labs in their own houses. One pill press can produce thousands of pills per hour, and according to Wall Street Journal calculations, 25 grams of fentanyl costs $810 to make but could be worth $800,000 in pills— a profit of nearly 10,000 percent.

Additionally, Chinese pharmaceutical companies stay ahead of law enforcement by creating fentanyl analogues, variations of fentanyl that are often just slightly different in chemical composition. By shipping fentanyl analogues that have not yet been recognized by the United States government, Chinese companies and drug dealers skirt by the law to continue on with their business. It is difficult for law enforcement to keep up with fentanyl analogues that are constantly being created. For instance, when China made acetyl fentanyl illegal, to curtail drug abuse, other versions of fentanyl started appearing in North America instead, such as furanyl fentanyl, which is 5 times less potent that the original but is still the cause of many deaths.

In October 2014, China banned over 100 chemicals, including 19 fentanyl analogues, but progress remains slow. Trading is still easily accomplished, because many pharmaceutical companies simply “mislabel” their packages as random common goods. Even if a box of fentanyl or fentanyl precursors is discovered before reaching its destination, drug companies make it hard to track them by using multiple freight forwarding companies or fake addresses in China.

China is the second largest pharmaceutical market and has chemical resources, lenient drug regulation and low production costs. This irresistible fentanyl market has made China the main source for illegal fentanyl, and the main focus for United States policy makers who are aware of the fentanyl crisis.

Recently, in August, the United States and China held negotiations to curb the illegal trade of fentanyl. In a joint statement after a G-20 meeting, China agreed to exchange more information and increase regulation of drug exports, especially for drugs that are legal in China but not in the United States. In exchange, the United States Drug Enforcement Agency (DEA) will help train Chinese police to recognize financial irregularities and laundering that may be related to the Chinese synthetic drug business.

Negotiations show improvement, but talks and compromises take time to execute. China itself is preoccupied with heroin, meth and ketamine addictions rather than synthetic opioids. As a result, the country is more focused on regulating heroin than fentanyl.

Moreover, the Chinese pharmaceutical industry has only been growing and shows no signs of slowing down. According to the United States Department of Commerce and the International Trade Administration, Chinese pharmaceutical sales amounted to $108 billion in 2015 with an annual growth of nine percent. More importantly, United States imports from China added up to $2 billion with an annual growth of nearly 27 percent. These numbers indicate that strict trade regulations and decreasing Chinese drug exports are not trends that will be seen in the near future since there is such a large demand for Chinese chemicals. In the case of fentanyl, which is not strictly illegal in China, the synthetic drug operation benefits Chinese businesses, giving China little incentive to cut down on fentanyl trading.

Despite lack of incentive to regulate fentanyl trading, China is currently cooperating with the United States in negotiations. Therefore, it is important that the United States continues to make an effort to eliminate fentanyl usage, especially since fentanyl is increasingly contributing to and sustaining America’s drug user population. Eliminating fentanyl usage is key to fighting the war on drugs, which in turn decreases crime. According to the Bureau of Justice Statistics, 17 percent of state prisoners and 18 percent of federal inmates committed their crimes to get money for drugs. Many studies have also indicated that there is a correlation between being under the influence of drugs and committing a crime.

For the safety and health of Americans, United States policymakers need to not only commit China to strict fentanyl trade enforcement but to also pressure the United Nations to internationally regulate the drug as well. Currently, there are no international laws that have specified fentanyl as a problem, yet people from all countries risk exposure to fentanyl as long as illegal fentanyl is being produced and traded. United Nations recognition of fentanyl trade laws would both force China to comply with the standards of the international community and act as a symbol of unity behind fentanyl elimination. This would give China no choice but to act on promises made, preventing drug overdoses and saving lives.