China: Secret Driver of Opioid Overdose Deaths

Who is to blame for America’s opioid crisis? Purdue Pharmaceuticals is among the first that comes to mind. With Purdue’s aggressive marketing practices, oxycodone, an opioid, rapidly infiltrated pharmacies and pain clinics. Although the supply of oxycodone is now declining as the Drug Enforcement Administration (DEA) is cracking down, the supply of fentanyl, a synthetic opioid 50 times stronger than heroin, is increasing. In 2013, the National Forensic Laboratory Information System had 934 reports on fentanyl from the US law enforcement. In 2017, they had almost 59000 reports. China is the biggest driver of this 63-fold increase.

The U.S.-China Economic and Security Review Commission reported in 2018 that China is “the largest source of illicit fentanyl and fentanyl-like substances” in America. China mails in fentanyl through its preferred public carrier, United States Postal Service (USPS). This is because the US Customs and Border Protection (CBP), which is responsible for inspecting incoming packages, is severely overextended. As the volume of total shipments has grown exponentially, intercepting incoming fentanyl has become increasingly difficult, rendering the task of inspection futile.


The Trump administration seeks to curb the vast fentanyl supply. Last December during the G20 summit, President Trump urged Chinese President Xi Jinping to control illicit fentanyl production. On April 1st, Xi Jinping agreed to a complete ban on fentanyl related substances. Previously, there only existed a partial ban, which failed to account for fentanyl variants that Chinese pharmaceutical companies manufactured through molecular modifications.

Time has yet to tell if China has the manpower, or even a genuine will, to enforce this ban. This is because the fentanyl ban may merely be the latest in a series of concessions China has made to alleviate trade tensions. In fact, President Xi Jinping agreed to the complete fentanyl ban just days before Treasury Secretary Steve Mnuchin would travel to China to continue negotiations. Considering how the trade war has already distressed the Chinese economy, China’s fentanyl ban may simply be lip service to the Trump administration, a form of appeasement to curtail the trade war.


Regardless of how well China enforces the ban, it only addresses the supply side of the opioid crisis. United States demand will remain the same, and now, Mexico may step in to meet that demand. Crime experts refer to this as the “Balloon Effect,” where banning a drug is like trying to squeeze air out of a balloon - the air just moves somewhere else. The ban may cause Chinese supplies to ship fentanyl precursor chemicals to Mexico, where fentanyl could be manufactured and distributed to the United States through drug cartels. Considering how deadly fentanyl is, the consequences of our Southern neighbor filling in this supply gap could be devastating, sending us miles back in the progress we’ve already made against opioid abuse.


#opioidcrisis #fentanyl #syntheticopioids


Samhitha Sunkara is a rising Junior at Duke University. She is majoring in Economics and minoring in Computer Science. She is passionate about development economics and financial empowerment. On campus, she is involved with the Community Empowerment Fund, Duke Impact Investing Group, and Duke Women in Politics. In her free time, she dances on a Bhangra team and bullet journals. She is excited to be with Pilleve this summer and can't wait to explore D.C.!

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