About fentanyl & related synthetic opioids

For years, there has been reporting about about how bad the problem of fentanyl and related synthetic (man-made, not natural) opioids is. Supplies of precursors to make fentanyl in Mexico and the US come from China. The US asked China to crack down on the precursors and it agreed. Then US-China relations went to hell. Despite the agreement, China still supports the fentanyl disaster in the US by supplying precursors. China uses supplies of fentanyl and related synthetic opioids to inflict as much damage on American society and economy as it can. The cost in human life in the US is of no concern to the Chinese government. The WaPo reports (not paywalled):

Despite fentanyl crackdown, Chinese sellers are open for business

A booming online marketplace in shipping small but potent packages of the chemicals used in the production of fentanyl from China to Mexico remains largely unhindered

 

When President Biden and Chinese President Xi Jinping pledged to revive a joint crackdown on illegal drug trafficking in November, it sent a brief shock wave through the vast network of Chinese suppliers fueling the production of fentanyl.

Drug suppliers hit pause on international orders, as local Chinese officials conducted site inspections and began circulating fresh reminders of regulations. Beijing sent a warning notice to its pharmaceutical industry and shut down 25 Chinese companies selling fentanyl precursors — the chemical building blocks of a drug that accounts for the majority of more than 70,000 synthetic opioid overdose deaths a year in the United States.

But seven months later, those same sellers say it’s business as usual.

The three people — two salespeople for Chinese chemical companies and a Chinese reseller based in Mexico — described resuming sales this year after making minor adjustments to avoid scrutiny, including tweaking customs labeling on packages and pivoting to alternative compounds that have virtually identical applications.

“Possibly in the future there is some impact, but it’s not a problem right now,” said one Hubei-based salesperson for a chemical company that produces 1-Boc-4-AP — a fentanyl precursor — and the sedative xylazine. The person claimed the company had resumed sales of both compounds to Mexico in January after a six-week pause that started around the time of the Xi-Biden meeting.

“Like water flowing around rocks … if there is a demand there is a way,” the person said.

Water flowing around rocks

The CDC reported that for 2017, the economic cost of opioid use was about $1 trillion:

In the 39 jurisdictions studied, combined costs of opioid use disorder and fatal opioid overdose varied from $985 million in Wyoming to $72,583 million in Ohio. Per capita combined costs varied from $1,204 in Hawaii to $7,247 in West Virginia. States with high per capita combined costs were located mainly in the Ohio Valley and New England.

A congressional analysis for 2020 indicated that the total cost had increased significantly compared to the 2017 analysis:

Today, in Recognition of National recovery Month, the U.S. Congress Joint Economic Committee (JEC)—led by Chairman Don Beyer (D-VA)—released a new analysis that finds the opioid epidemic cost the United States a record of nearly $1.5 trillion in 2020. This is up 37% from 2017, when the CDC last measured the cost.

After the pandemic disrupted the U.S. health care system, reducing access to substance abuse treatment and exacerbating social and economic stress that can worsen addiction, opioid use increased. Data show the highest numbers of fatal opioid overdoses ever reported in 2020 and 2021—69,061 and 80,926 fatalities, respectively—and opioids are now the main driver of drug overdose deaths.

A 2024 Congressional Research Services report commented:

DEA alleges that PRC-based chemical companies advertise and sell online fentanyl precursor chemicals, including some that are not internationally controlled and are correspondingly legal to export out of China. PRC firms also sell other synthetic drugs of concern, including xylazine and nitazenes. PRC companies ship such items to Mexico or directly to the United States, including via the U.S. Postal Service and express consignment services, “carefully packaged to deceive customs inspectors.” According to DEA, customers, often associated with Mexico-based transnational criminal organizations (TCOs), may pay for the chemicals and drugs in cryptocurrencies, making it harder for DEA “to follow the money.” They also pay using U.S. and PRC payment services or bank transfers. DEA alleges that the TCOs use largely PRC-sourced chemicals to synthesize fentanyl substances in clandestine laboratories, and often mix xylazine and nitazenes into fentanyl-related products, making the substances “even deadlier,” before distributing them across North America.  

The U.S. Centers for Disease Control and Prevention estimate that synthetic opioids (primarily fentanyl-related substances) may have resulted in more than 78,000 U.S. overdose deaths between September 2022 and August 2023.

A trillion here and a trillion there, and pretty soon, the US goes bankrupt. The human life cost? Meh, just the cost of inept government? Who is mostly responsible for this disaster? China? Mexico? The US? All three about equally? No one, because the markets should be left free and wild to run butt naked in pursuit of profit and free, wild markets always solve all problems far more effectively than any government ever could? Should fentanyl be legalized and the industry taxed, leaving markets free & wild to run butt naked?

So many good questions, so many bad answers. 

Fentanyl victim

Lethal doses

Note the speck of carfentanil