What to Do About Fentanyl

How China Can End America's Overdose Crisis, and What it Will Cost to Make Them

Three hundred thousand kilograms of methamphetamine precursor chemicals sit in a Houston warehouse, their blue barrels arranged in an oddly orderly display of chaos. The chemicals — enough to produce a million kilos of meth — were bound for Sinaloa from China when U.S. authorities intercepted them last week. Officials celebrated it as the largest seizure in American history, “a major win for public safety.”

But a record seizure is not a victory. It is a glimpse of the flood we are failing to stop. And if we are still catching this much meth 50 years after first declaring war against it, then we should shudder to think of what is happening with fentanyl, the leading cause of death for young Americans — which crosses our border in quantities too small to seize.

In the 12 years since it first materialized on American streets, Washington has treated the fentanyl crisis as a law enforcement problem with a public health component. We’ve indicted Chinese chemical companies and sanctioned their executives. We’ve militarized the border, deployed sophisticated detection equipment, and still watched overdose deaths climb beyond 75,000 annually.

The truth few in Washington want to admit is that fentanyl is the first drug crisis where we have no leverage. Too deadly for our institutions to absorb, too compact for our border agents to catch, we are left with only one option: stop it from being made at all.

It’s going to be expensive.

It’s Not a War — It’s an Economy

Every great power that has faced a narcotics crisis has at first misdiagnosed it. The British considered opium in China to be a trade issue until they realized it was eating the Qing Dynasty from within. America treated crack cocaine as a criminal justice problem for a decade before recognizing it as a symptom of social disintegration. America today is making the same category error with fentanyl, treating symptoms while ignoring the disease.

History offers unforgiving lessons. When the British flooded China with opium in the 1840s, the Qing Dynasty tried everything: moral suasion, then targeted enforcement, then prohibition. Nothing worked until Mao simply shot every addict and dealer he could find — a solution unavailable to democracies. The Golden Triangle heroin trade survived decades of DEA operations, military interventions, and crop substitution programs. It only declined when Chinese synthetics made poppy cultivation obsolete. Colombia’s cocaine cartels endured billion-dollar counternarcotics campaigns, only fragmenting when Mexican competitors offered better logistics.

Each case teaches the same lesson: Traditional supply-side interventions — raids, seizures, slash-and-burn campaigns — cannot crush a drug trade when demand remains robust and profits astronomical. A kilogram of fentanyl precursors worth $1,000 in China becomes $1 million worth of street drugs in America — a 1,000x return that no amount of enforcement can deter.

Why America Can’t Address Demand

Strip away the political posturing and bureaucratic inertia, and America has exactly three options for curbing opioid demand. All involve tradeoffs that our politics have made nearly unthinkable.

Option 1: Medicalization. Treat addiction as a chronic disease. Provide pharmaceutical-grade opioids in clinical settings, collapsing the black market by removing its customers. When Switzerland did this with heroin in the 1990s, overdoses fell 64 percent. The first Trump administration nodded in this direction, authorizing $6 billion in treatment funding and expanding Medicare coverage for related services. But fentanyl is not heroin. It is 50 times more potent, with relapse rates above 40 percent even under treatment. Scaling “medicalization” would mean admitting that some percentage of Americans will remain chemically dependent indefinitely, and that the state will be their dealer. No U.S. politician will own that choice.

Option 2: Coercion. Make addiction intolerable. Mandate treatment and strip services from active users. Singapore executes dealers and locks addicts in detention for years. Japan stigmatizes addiction so thoroughly that users are pushed to the margins of society. The model works — but only by exercising a level of social control that would shred the Fourth Amendment and abandon the millions of Americans already struggling with addiction.

Option 3: Resignation. Accept 75,000 annual deaths as the price of a free society. Let fentanyl burn through vulnerable populations until it reaches some grim equilibrium. This is our current policy, dressed up with enforcement theater to maintain the illusion of action.

The political economy of fentanyl makes demand reduction nearly impossible. The communities most devastated — Rust Belt towns, rural America, and the urban poor — lack political power. Meanwhile, the sectors with capacity to intervene — pharmaceutical companies and the treatment industry — are structured to manage the crisis, not resolve it.

Which leaves supply.

Why China Holds the Key to Supply

The fentanyl supply chain is elegantly simple. Chinese companies produce precursor chemicals that aren’t technically illegal — compounds structurally similar to scheduled substances, but modified just enough to evade regulation. They ship these to Mexico, where cartels complete the synthesis in makeshift labs. The finished product crosses our border in quantities so small that a year’s supply for a mid-sized city fits in the trunk of a Nissan Altima.

This is what makes fentanyl different from every previous drug epidemic. Cocaine required thousands of acres of coca, industrial-scale processing facilities, and multi-ton shipments to turn profits. Heroin needed poppy fields visible from space. Meth required pseudoephedrine in quantities that would raise eyebrows at your local Walgreens.

Fentanyl requires only chemistry. A few shipping containers of Chinese precursors can amount to America’s entire annual supply. The dose is so potent — just 2 milligrams can kill — that interdiction becomes mathematically impossible. We could inspect every vehicle crossing the border and still miss enough fentanyl to kill millions.

This is why, unlike past drug wars, the most effective chokepoint is not our southern border. It’s Chinese chemical plants. There are perhaps a few hundred companies in the world capable of producing fentanyl precursors at scale. The overwhelming majority of them are in China. By monitoring these facilities and tracking their shipments, we could avoid the pitfalls of blunt-force interdiction.

We could disrupt the entire supply chain at its source.

What We Need China to Do

Beijing knows exactly how central it is to the global synthetic opioid supply chain. In 2019 it imposed class-wide controls on fentanyl analogues, and since then it has plodded along with U.S. demands to schedule certain precursors. Law enforcement cooperation between the two countries is not entirely hollow: Chinese authorities occasionally raid a lab, arrest some executives, and issue stern warnings to industry. But for every precursor they ban, chemists create three substitutes. For every firm they close, two more pop up in another province.

Forget the working groups and diplomatic coalitions. Disrupting cartel operations requires four concrete measures:

1. Chemical Birth Certificates. Every batch of fentanyl precursor should receive a unique identifier at the point of synthesis, tracked through sale, export, and end-use. When Mexican authorities seize precursors in cartel labs, we should be able to trace them directly back to the Chinese factory that produced them. This isn’t technically difficult — the United States already tracks nuclear materials this way using batch IDs, Material Balance Areas (MBAs), and centralized reporting. Many pharmaceutical manufacturers already log batches of active ingredients for quality control. If China were serious about combatting fentanyl production, it could construct a similar system with tamper-evident barcodes, QR codes, or RFID tags.

2. Know-Your-Customer Rules. Chinese chemical firms should be legally required to verify the legitimacy of their buyers — no more shipments to “Juan’s Cleaning Supplies” in Culiacán. A company that handles some of the most hazardous materials on earth should only be shipping its products to real businesses, with real addresses and end-use declarations. Chinese banks already follow similar rules under the country’s Anti‑Money Laundering Law; chemical companies can be held to the same standard. Last week, the U.S. House of Representatives passed legislation authorizing sanctions on firms that refuse.

3. Export Pre-Clearance. U.S. export control officers already conduct end-use checks in China for sensitive technologies — interviewing companies, inspecting facilities, and verifying that goods go where they are supposed to. These visits inform designations on the Commerce Department’s Unverified List (UVL), which flags Chinese entities that obstruct or evade scrutiny. We should apply a similar system to fentanyl precursors. Chinese firms that want to export dual-use chemicals would be eligible for pre-clearance inspections. Passing a check would ensure fast-track access to legitimate markets, while failing or refusing access would result in severe financial and export penalties.

4. Financial Transparency Requirements. All payments for precursor chemicals should flow through monitored, auditable channels. China is, in practice, a cashless economy. No legitimate pharmaceutical company should need to accept duffel bags of RMB or million-dollar crypto transfers. If the cartels can’t pay for precursors, they can’t make fentanyl.

Why China Won’t Do It

Some in Washington maintain that Beijing’s inaction is not a failure of capacity, but a strategic choice — to tolerate, or even subtly abet, the unraveling of American society. It is a cold, cynical logic: Every American lost to fentanyl is one fewer soldier in a Taiwan Strait crisis. Every dollar spent on addiction treatment is one that cannot be spent scraping rust from ship hulls or rebuilding the arsenal of democracy.

Beneath the air of conspiracy lies a more plausible and unsettling truth: China doesn’t have to weaponize fentanyl. It only has to let the market do its work. Chinese companies make profits, Mexican cartels handle distribution, and Americans die — 75,000 a year, more than Vietnam, Iraq, and Afghanistan combined, every year.

When pressed for aid, Chinese officials cite real constraints. They oversee 5,000 companies producing 44 percent of the world’s chemical supply. Many precursors have legitimate uses in plastics, pharmaceuticals, and agriculture. They can’t monitor every transaction, inspect every shipment, and verify every end-user. It would crater their chemical industry, they claim, disrupting global supply chains for everything from antibiotics to electronics.

This is both partially true and completely irrelevant. During COVID-19, China implemented QR-code surveillance for 1.4 billion people in a matter of weeks. The CCP monitors every social media post for political dissent. It tracks Uyghurs’ household purchases down to the kitchen knife. When the CCP wants to control something, state capacity materializes instantly.

It doesn’t track fentanyl precursors because it doesn’t want to.

Creating Real Incentives

The Biden administration tried to coax Beijing into cooperation through the familiar rituals of diplomacy: working groups, coordinated statements, and targeted sanctions on a handful of firms. The result was predictable: Companies dissolved and reconstituted under new names. Enforcement was piecemeal. Beijing scheduled a few chemicals we identified while leaving others unchecked.

The Trump administration has gone louder, threatening to designate cartels as terrorist organizations, floating military action in Mexico, and authorizing lethal strikes against suspected traffickers at sea. The President’s 20 percent tariff on Chinese goods is a more serious attempt to impose costs on Beijing for its inaction — and signals that the United States is finally willing to absorb economic pain to compel Chinese cooperation. But broad tariffs are still too crude an instrument to change the behavior of China’s chemical sector. A blanket penalty hits legitimate exporters alongside bad actors, fails to distinguish between compliant and non-compliant firms, and gives Beijing little incentive to police its own industry rather than simply pass costs onto consumers.

Both administrations have struggled to change Beijing’s basic calculus: Why incur costs, crater a profitable industry, and absorb domestic backlash just to save American lives? The answer is not a doubled or quadrupled tariff. It is building a system where compliance is the cheapest path and evasion is ruinous. That means five things:

First, no paperwork, no trade. Require that all shipments of fentanyl precursors entering the United States or its immediate trading partners carry 1) a valid pre-export notification (PEN) filed through the International Narcotics Control Board; and 2) a verifiable batch identifier, such as QR code or RFID-linked ledger, traceable to the point of synthesis. Without them, banks refuse the wire, insurers cancel coverage, and carriers won’t load the container. We don’t need Beijing’s proactive buy-in to start enforcing this, ourselves. We just need to make the global logistics system treat un-notified chemistry as radioactive.

Second, choke the money. The small Chinese banks and payment processors moving cartel funds should face the same treatment we once applied to Iran’s financial system: cut off from dollar clearing until they certify a whitelist of legitimate exporters. Under Section 311 of the PATRIOT Act, the United States could treat unregulated Chinese banks and payment processors moving fentanyl-related funds as primary money laundering concerns. Beijing can shrug off sanctions on shell companies, but it cannot ignore the risk of banks losing access to the dollar.

Third, force the carriers to police their own cargo. Amend U.S. Customs and Border Protection regulations and segments of the Shipping Act to impose strict liability on ocean and air carriers that haul unverified precursor shipments into North America — with a safe harbor if they demand paperwork at booking and share it with customs authorities. Shippers won’t argue with compliance when Maersk and COSCO refuse to move their freight.

Fourth, weaponize America’s own health market. Direct HHS, DoD, VA, and CMS to exclude pharmaceutical products whose supply chains include unverified Chinese chemical suppliers from federal procurement eligibility. Beijing may not care about abstract sanctions. It will care when Chinese exporters lose the single largest healthcare buyer on earth.

Finally, lock the back door. Mexico cannot remain the pressure valve. A USMCA side-letter should impose the same paperwork and importer checks at Mexican and Canadian ports, with snap-back penalties for violations. Otherwise every safeguard we build risks transshipping through Manzanillo.

Today Chinese firms profit by looking the other way. Taken collectively, these steps could flip the incentive structure — ensuring profits flow only to those who prove their chemistry is clean, while evasion becomes a commercial nightmare to navigate. That is our best chance of compelling cooperation from a regime that will never offer it freely.

The Price of Victory

Here’s what victory in a war with an abstract noun actually costs: About $50 billion in pharmaceutical trade disruption as we force China to implement real controls, months of supply chain chaos as companies scramble to get verified, and certainly higher prices for everything from antibiotics to electronics as Chinese companies pass compliance costs to consumers.

Victory means accepting that China will retaliate — probably against our agricultural exports, and possibly against rare earth magnets or other industries. It means having the strategic patience to endure that retaliation without blinking, and explaining to voters why their prescription drugs cost more and their electronics arrive later — all to save 75,000 strangers they’ll never meet.

During the Cold War, we paid such prices routinely. We subsidized industries, restricted trade, and accepted higher consumer costs to prevent Soviet dominance and protect our way of life. We understood that strategic competition required economic sacrifice.

The fentanyl question is not merely a test of American enforcement prowess or medical compassion. It is a test of whether we still possess the state capacity and political will to impose our preferences on hostile powers. Can we create incentive structures that compel Chinese compliance? Can we absorb economic retaliation without capitulating? Can we maintain strategic focus through multiple election cycles?

China is betting we can’t. They are betting we’ll choose cheap antibiotics over American lives, economic convenience over strategic imperative, and short-term profits over long-term survival. They’re betting that our political system, optimized for diffusing responsibility and avoiding hard choices, cannot sustain the pressure required to change their behavior. And so far, they’ve been right.

Precursor chemicals sitting in DEA warehouses in Houston are evidence of our failure, not our success. Until we’re willing to impose costs that actually change Chinese chemical companies’ behavior, we can’t claim to be fighting a war against fentanyl. We’re managing our decline, one overdose at a time.