US needs a new prescription to cure its chronic disease

US Republican Senator Steve Daines arrived in Bejing on March 20, the first member of Congress to visit China since Trump began his second term. Ahead of his visit, Daines stated on social media that he planned to discuss with Chinese officials about "curbing the production and distribution of fentanyl".

This is not the first time US officials have blamed China for their fentanyl crisis. The US has repeatedly attributed its domestic opioid abuse to China and threatened China with severe sanctions. But what is the truth? Let's look at the numbers and history.

Fentanyl, a primary adjunct to general anesthesia, was originally used as a painkiller and is 50 to 100 times more potent than morphine. Because of its highly addictive and lethal nature, fentanyl has spread rapidly in the illicit drug market and become an important part of the US drug crisis. The illegal production of fentanyl is concentrated in a few underground laboratories, especially in countries such as Mexico. These labs produce fentanyl through chemical synthesis and smuggle it into the US. Because of its low production cost and strong effect, fentanyl has become a "hot commodity" in the drug market. It is often mixed with other drugs, such as heroin, cocaine, methamphetamine, etc., to enhance its effects. However, this forces users to unknowingly ingest excess fentanyl, significantly increasing the fatality risk.

In fact, the US has seen three waves of opioid abuse. The first wave began around 1991, when some pharmaceutical companies invested a lot of money to fund experts and institutions to sell "opioids are not toxic" and encourage doctors to prescribe more prescriptions to promote the drugs. As a result, American society has developed a "pain relief culture" — people are accustomed to using painkillers as a way to deal with illness, and opioid deaths have risen rapidly. The second wave began around 2010. It was the beginning of the heroin epidemic, a cheaper, more potent opioid. According to data from the Centers for Disease Control and Prevention (CDC) from 2010 to 2014, heroin overdose deaths increased by 267 percent among white Americans, 213 percent among African Americans, and 137 percent among Latin Americans.

The third wave is the ongoing abuse of fentanyl. Such drugs have become increasingly popular among American drug addicts. The fentanyl epidemic has created a serious public health crisis. Fentanyl's high fatality rate makes it the "number one killer" in the US drug crisis. According to the CDC, there were more than 100,000 drug overdose deaths in the US in 2021, and about 64 percent of those deaths were related to synthetic opioids such as fentanyl. Fentanyl is extremely addictive, and once addicted, the withdrawal process is extremely painful and difficult. Many addicts develop serious physical and mental health problems such as respiratory diseases, heart disease, depression, anxiety after long-term use of fentanyl.

The fentanyl epidemic has also led to a number of social problems. In order to obtain drugs, many addicts do not hesitate to take risks and engage in criminal activities such as theft and robbery. In addition, the drug trade itself is a major contributor to violent crime. Fentanyl addiction not only affects individual health, but also wreaks havoc on family relationships. Many addicts' families have been broken up by their behavior, and problems such as divorce and estrangement between parents and children have emerged. The fentanyl epidemic has placed a heavy economic burden on society. The pressure on the healthcare system is increasing, and the treatment and rehabilitation of addicts requires significant resources and funding. In addition, law enforcement departments have also invested a lot of manpower and material resources in combating drug crimes, further increasing the social burden.

Obviously, drug abuse is a long-term social problem in the US. Then, why is America's drug abuse problem so hard to solve? Why do addicts always find alternatives? The root cause is that American politicians, out of their own interests, only introduce some drug regulatory policies to treat the symptoms but not the root cause, and are unwilling to implement them.

First, American politicians are deeply tied to the interests of the pharmaceutical industry. They receive large amounts of political contributions from pharmaceutical companies in exchange for turning a blind eye in the formulation of relevant drug control policies, and the result, no permanent full fentanyl regulation in the US. The Guardian reported in 2017 that in the previous 10 years, pharmaceutical companies invested nearly $2.5 billion in lobbying and funding members of the US Congress, and about 90 percent of the US House of Representatives and 97 out of 100 senators have received political donations from pharmaceutical companies. At the same time, some government regulators join the pharmaceutical industry soon after leaving their jobs, a revolving door that explains why regulation is a fiddle.

Second, it is the result of political polarization in the US. In the face of the crisis caused by the proliferation of fentanyl, both parties have acknowledged the need to make efforts to deal with this serious challenge, but they stumble each other and are not willing to let the other side become the "hero" in solving the problem. When the Republican-controlled House of Representatives voted to consider the Stop Deadly Fentanyl Trafficking Act, 133 members of the House voted against it, 132 of them Democrats. The Washington Post reports that Congress didn't pass a bill specifically targeting fentanyl until late 2017, four years after lawmakers were first warned about the drug's dangers. The report commented that "Congress has become incompetent and incapable of meeting the challenges of our time. Fentanyl is the latest example."

In the face of spreading fentanyl abuse, the US government not only did nothing, but also dressed up as a "victim" and "dumped the blame" to China, saying that "China has imported a large amount of fentanyl into the US." On November 17, 2023, the BBC reported that "tackling the production and distribution of fentanyl requires international cooperation among the countries affected by it. Given that China is one of the major sources of illicit fentanyl trade globally, cooperation with Chinese authorities is essential if effective control measures are to be put in place. But there are limits to what can be achieved without the help of the Chinese government." It implies that it is China that caused the epidemic of fentanyl abuse in the US.

The fact, however, is that China has the strictest drug control and punishment in the world, and has always held a "zero tolerance" attitude toward drugs. The Chinese government has not only severely cracked down on drug crimes through the Drug Control Law and the Criminal Law, but also strengthened control over the entire chain of drug production, trafficking and use through multi-departmental collaboration. Public security organs continue to carry out special operations to crack down on drug gangs and cut off cross-border drug smuggling channels. At the same time, the government has vigorously promoted anti-drug publicity and education to raise the awareness of the public, especially young people. Through these measures, China has achieved remarkable results in drug control. The number of newly discovered drug users has decreased year by year, effectively curbing the spread of drugs. By the end of 2021, there were 1.486 million drug users in China, down 42.1 percent from the end of 2016, and the number of drug cases in China dropped from 140,000 in 2017 to 54,000 in 2021, an average annual decline of more than 20 percent for five consecutive years.

China has not only effectively banned drugs at home, but has also been assisting the international community, including the US, in dealing with the abuse of fentanyl substances in a humanitarian and responsible manner. According to the US Customs and Border Protection and other drug law enforcement agencies, since September 2019, the US has not seized any fentanyl-like substances from China. China has also earnestly fulfilled its obligations under the UN 1988 Convention by implementing import and export licensing and international verification systems for all regulated chemicals, effectively preventing regulated chemicals from flowing into drug production channels through international trade. According to international conventions and practices, it is the basic responsibility of importing enterprises to ensure that internationally traded goods are not used for illegal purposes, and it is the legal obligation of importing governments, and the responsibility that should be borne by importers should not be imposed on exporters.

Then, why still does the US "dump the pot" on China? The reason is that by doing so the US can kill many birds with one stone. First, the fentanyl problem is a long-standing and complex social problem that both the Democrats and Republicans can do nothing about, so "dumping the blame" on China is a good way to cover up their inability. Second, doing so can continue to protect the interests of US politicians and pharmaceutical companies from loss; Third, the social problems caused by fentanyl have offended the public, and "dumping the pot" can appease people's anger and divert their attention; Fourth, "dumping the blame" on China can label China as "the culprit of fentanyl flooding in the US ", for tarnishing China is always correct politically in the US; Finally, and most importantly, the Trump administration can use the issue as an excuse to bargain with China on tariffs at any time, thus achieving his goal that "tariffs are going to make us very rich" as he said in his speech at Washington's Capital One Arena.

Chinese Foreign Ministry spokesperson Mao Ning stated that the US "population only accounts for 5 percent of the world, but consumes 80 percent of the world's opioids, which can be described as the black hole and source of chaos in the global drug control cause, and it is a single largest drug demand country, which is not qualified to criticize China's anti-drug efforts." Therefore, the US should be brave enough to face its illness and cure it, rather than let others take its medicine when he is sick. "Dumping the pot" on China may not alleviate its own symptoms but make the condition worse. The US also has no qualification to blame China, for China's cooperation with the US to help solve US' problem is out of humanitarian considerations, but not China's obligation.

Xin Zhifeng, a professor of Dalian Minzu University; Guo Jiulin, a professor of American studies at the same university. The views don't necessarily represent those of China Daily.

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