When President Xi landed in San Francisco in November 2023 for a high-profile summit with President Biden, media commentators noted the absence of unhoused Americans on the streets. Indeed, like many other US cities, San Francisco has struggled to cope with a worsening homelessness crisis. There are many causes—mental health struggles, housing unaffordability, etc.—but opioids remain a growing contributor. The reach of synthetic opioids in the United States has now grown into an issue that transcends homelessness and California. Opioids remain a major killer of Americans—over 88 percent of reported overdoses in the United States in 2021 involved synthetic opioids.
Prominent US politicians have publicly accused China of sending opioids to the United States. In August 2018, Trump famously stated that Chinese-made fentanyl had been “pouring into the US postal system.” Since then, the problem has pushed US law enforcement and rehabilitation networks to the breaking point. There is a severe lack of shelters and rehabilitation centers to provide treatment for individuals struggling with these kinds of substance addiction.
To get a better understanding of how China is involved in the US opioid crisis, it is important to first look at how the crisis is currently affecting the United States. Notably, the Chinese angle in the opioid crisis is complicated by the fact that many of the drug networks involve Mexican cartels that help smuggle the drugs across the US-Mexican border. China’s production of opioids exacerbates both the US opioid epidemic and issues at the Southern border. However, China’s active efforts to combat drug trafficking domestically and transnational initiatives in Southeast Asia demonstrate that there is room for cooperation with the United States if relations improve.
Fentanyl Epidemic in the United States
The opioid epidemic in the United States is a major issue that is increasing in severity. According to statistics from the Centers for Disease Control and Prevention (CDC), the number of overdoses in the United States reached a staggering 80,411 in 2021, compared to the 21,089 deaths from opioids in the United States in 2010. The increased spread of synthetic opioids not only shatters families but also has contributed to new waves of crime and homelessness that remain so visible in many of the largest US cities.
With the number of opioid-related deaths rising, debating solutions to the “drug problem” has become a fixture in US domestic politics. Both parties came together to pass the SUPPORT Act in 2018, but policy discussions on the US opioid epidemic have also been subject to partisan disputes. Besides expanding Medicaid to cover some treatment services as well as improving the quality of medication-assisted treatment, the SUPPORT Act of 2018 also provisioned the STOP Act. The STOP Act authorized the US Postal Service to crack down on international mail containing fentanyl. Despite the flurry of legislation combating the opioid crisis from 2016 to 2018, the annual death toll from opioids continued to rise throughout the pandemic. Given the limited effects of combating the opioid epidemic through just policy legislation, policymakers have also sought to identify and seal off the suppliers of opioids. According to the Council on Foreign Relations, the majority of fentanyl coming into the United States is smuggled across the US-Mexican border—with some of those base precursors originating in China.
Chinese Drug Enforcement in Southeast Asia
China’s involvement in producing many of the base chemicals needed for the production of fentanyl and other opioids is explained by the fact that China is the world’s largest producer of chemicals overall. And yet, the Chinese Communist Party (CCP) has repeatedly emphasized its zero-tolerance policy on drugs. Worldwide, China has some of the harshest penalties for smuggling or possessing illegal drug substances.
In terms of the manufacture of fentanyl, authorities have taken a two-track approach. On the one hand, Chinese manufacturers have at least since the 2010s manufactured some of the base chemicals required to make synthetic opioids. On the other hand, it has been reported that at least one convicted manufacturer of fentanyl in China has been executed in connection with Chinese crackdowns on underground fentanyl production destined for the United States. That China carried out such a sentence is not surprising given the regime’s approach to drug trafficking enforcement. Perhaps as a consequence of such an approach, China has not faced an opioid crisis reminiscent of that in the United States.
Official statistics suggesting that China—unlike Europe and North America—does not face an opioid crisis are artificially low due to restricted reporting; however, China’s more stringent drug regulation policies suggest that there may be a grain of truth in this disparity. The controlling nature of the ruling regime is a key factor. The penalty for trafficking illicit substances in China—like in other East Asian countries—can be capital punishment. China has devoted serious efforts towards tracking down drug smuggling rings domestically. According to the 2021 China Drug Situation Report: “In 2021, 123 drug clan labs were destroyed with 1.2 tons of drugs seized, down by 26.4% and 89% year-on-year respectively.” The Chinese government has demonstrated a strong legislative commitment to extensive counter-narcotics cooperation in the country. Such a no-tolerance policy is enabled by China’s tight domestic security infrastructure with which citizens’ private lives may be surveilled by the government without probable cause.
In addition, China participates in drug trafficking detection enforcement with regional partners. Chinese military forces have reportedly worked alongside Myanmar, Laos, and Thailand to help patrol the Mekong’s “Golden Triangle” region, through which many of the opioids produced in Southeast Asia are smuggled. Published fact sheets from the Chinese embassy to the United States highlight the fact that China has 26,000 policemen dedicated to stopping drug trafficking and consumption domestically. The focus on cracking down harshly on domestic drug trafficking recalls the nation’s difficult history: several Western powers profited from pumping opium into China and creating one of history’s worst drug epidemics in the 19th century.
Sino-Mexican Drug Enforcement Cooperation
According to multiple reports from US governmental and nongovernmental sources, the main vector for entry of illicit opioids into the United States is smuggling operations on the US-Mexican border. Therefore, the question of China’s involvement with the production, sale, and consumption of opioids is also partly reflective of China’s relationship with Mexico. According to a March 2023 US Congressional Report: “The China-Mexico connection grew when Chinese traffickers increased fentanyl precursor sales to Mexican cartels that established networks of manufacturing plants, or ‘pill mills’ of synthetic drugs.” Once these compounds arrived in Mexico, in other words, the cartels could take charge of the assembly and distribution. Therefore, according to the Congressional report, the basic culpability and desire to smuggle drugs remains with the cartels. Opioids are particularly dangerous because they do not require poppy fields and can be made from chemical compounds, which makes it much more difficult to track their production and assembly.
This collaboration between Chinese and Mexican criminals has prompted collaborative efforts between their respective governments to combat drug trafficking. In the fall of 2023, the president of Mexico, Andrés Manuel López Obrador (AMLO), secured an agreement with Xi to combat the spread of the base chemicals that are used in the manufacture of synthetic opioids. Also that fall, Mexico announced the creation of a joint Mexico-China task force with a counternarcotics focus.
Future Prospects for US-China Drug Cooperation
Although Chinese leaders have pledged at several summits to increase the amount of scrutiny given toward domestic chemical manufacturing and exports to North America, crises in US-China relations will likely limit the amount of cooperation possible between both sides on stemming the international flow of synthetic opioids. This tragedy is emphasized by the fact that the United States is facing the worst drug crisis in its history, and that ongoing violence in Latin America and Southeast Asia related to the drug trade also threatens Chinese visions of promoting stability around the world. In this regard, the drug crisis may continue to spiral out of control unless the United States and China can decouple this question from other divisive issues. If the Biden-Xi summit in San Francisco at the end of 2023 is any indication, the United States will have difficulty getting China to agree to cooperate on opioids without ameliorating existing tensions.
