Where is the fight against Fentanyl, which takes tens of thousands of lives every year in the USA?

Fentanyl is now the leading cause of death among Americans between the ages of 18 and 49, according to US Department of Justice data. The fight against this synthetic drug, which is on the agenda of the Biden administration's diplomatic work, especially with Mexico and China, is one of the main topics in the race for the 2024 presidential election. According to the US Centres for Disease Control and Prevention (CDC), deaths from counterfeit drugs have more than doubled in recent years as they are sold on prescription. In 2022, 109 thousand deaths were recorded due to these drugs. Translated with www.DeepL.com/Translator (free version)

Moreover, fentanyl was detected in 93 per cent of all overdose deaths using these fake pills. What is fentanyl? It is an incredibly powerful synthetic painkiller. As a medicine, it is used for anaesthesia in operating theatres and to treat severe pain in cancer patients. But like heroin and some other painkillers, it can be highly addictive. According to the CDC, fentanyl is 50 times more powerful than heroin and 100 times more powerful than morphine. So even two milligrams can be fatal. Due to its low-cost production and high potency, drug dealers often mix fentanyl with other drugs to increase its addictive properties.

Are there different types? There are two types: the pharmaceutical version prescribed by doctors and used for treatment, and the illicitly produced fentanyl. Both are synthetic painkillers, but it is mainly the illegally produced fentanyl that contributes to the majority of overdose deaths. This type of fentanyl can also come in different forms, including liquid and powder.

Powdered fentanyl is similar to many other drugs. It is often mixed with drugs such as heroin, cocaine and methamphetamine and made into pills that resemble other prescription painkillers. The liquid form can be found in nasal sprays, eye drops, or made into drop candy. How does it enter the US market? Most of the fentanyl sold in the US comes from Mexico, where cartels manufacture drugs by synthesising precursor substances believed to come from factories in China. Some fentanyl is also shipped directly from China to the US. The fentanyl in the healthcare system is produced in state-regulated factories, but very little of this supply makes it into illicit drug markets. Because fentanyl is so concentrated, it is easier to smuggle than heroin. Drug traffickers can smuggle the pure drug into a country in small packages and then distribute it in pieces to street dealers. Sometimes the drugs are also imported as pills or in other street-ready forms. Most of the fentanyl entering Mexico from the US is smuggled in cars and cargo trucks through legal border crossings on the southern border.

Why is the US accusing China of lax co-operation? Some precursors and internationally unclassified chemicals used in the production of fentanyl are legal to produce and export in China. Beijing argues that it cannot restrict the export of precursors that are not illegal. The United States has repeatedly called on China to adopt a "know-your-customer" approach, such as identifying and verifying customer identities, to ensure that these chemicals are not sold to potential drug traffickers and to alert authorities about such buyers. However, in an interview with Newsweek in September 2022, then-Chinese Ambassador to the US Qin Gang said that this approach "goes far beyond countries' obligations under the United Nations Drug Control Convention". What did Xi and Biden agree on? The two leaders met last week on the sidelines of the Asia Pacific Economic Cooperation (APEC) summit in San Francisco, US, and agreed at the summit to block Chinese exports of products related to fentanyl production. A senior US official said that under the agreement, China would go after specific chemical companies that directly produce fentanyl precursors. In exchange for Beijing's pressure on these companies, the Biden administration agreed to lift sanctions on the Physical Evidence Identification Centre and the National Drug Laboratory under China's Ministry of Public Security. In May 2020, the US Department of Commerce had sanctioned the laboratory for its alleged involvement in human rights abuses against Uyghurs and other ethnic minorities in Xinjiang. Biden also met with Mexican President Andres Manuel Lopez at the APEC summit. The two leaders also pledged to work to combat illegal fentanyl trafficking to the US and to cooperate on the growing number of migrants travelling north across the border between their countries. The issues of fentanyl and immigration are interconnected; smuggling people across the border is seen as part of cartel operations that also include drug smuggling into the US.