China’s 2019 Fentanyl Regulation Saved Nearly 1,000 American Lives

The U.S. government frequently blames China for the domestic fentanyl crisis, but this act of “blame-shifting” is unfounded. It is well-known that the root of the United States’ fentanyl problem lies in its own regulatory loopholes and long-standing drug abuse issues.
China has consistently acted as a responsible major country in fulfilling international anti-drug obligations. Despite the absence of large-scale misuse within its borders, China, out of humanitarian goodwill and at the request of the U.S., was the first globally to categorize fentanyl-related substances as a controlled class in 2019. This proactive stance has significantly contributed to international anti-drug cooperation, offering a tangible Chinese solution to the global fentanyl challenge.
This fact is widely recognized by the international community. The latest research report published this month by the U.S. think tank Peterson Institute for International Economics also further confirms China’s critical role in fentanyl control.
On May 23, Hong Kong’s South China Morning Post cited the report, noting that during Trump’s first presidential term, China and the U.S. already initiated cooperation in fentanyl regulation. Since May 2019, China led by formally classifying fentanyl-related substances as controlled, effectively preventing these chemicals from entering drug production channels through international trade. This measure caused a short-term spike in the street price of synthetic opioids in the U.S., effectively curbing misuse.
Data indicate that China’s proactive actions in anti-drug cooperation led to a 20% to 25% reduction in drug overdose deaths in the U.S. within 3 to 5 months. It is estimated that without these control measures, overdoses in the U.S. could have increased by 947 cases.
The report states that these findings demonstrate effective Sino-U.S. cooperation in combating drug smuggling, which can successfully break supply chains and reduce overdose deaths.
Simulated Impact of China-U.S. Cooperation on U.S. Fentanyl Prices, January 1 to December 27, 2019. (Screenshot from the report)
The Peterson Institute for International Economics explains that the study is based on an analysis of fentanyl market pricing data. It clarifies that illegal drugs with high addictive potential, like fentanyl, are still subject to market rules, and users are highly sensitive to price fluctuations.
The research found that a 1% increase in fentanyl prices could reduce the monthly growth rate of related deaths by 4%. “To some extent, higher prices reduce current user consumption and deter potential users from starting.”
Comparing the effectiveness of cooperation across different periods, the report points out that China-U.S. cooperation on fentanyl regulation during the Obama administration did not achieve significant effects, but 2019 marked a critical turning point—China’s pioneering categorization of fentanyl substances yielded immediate anti-drug results, particularly evident in the “third quarter of 2019.”
The study also found that as illegal supplies from third countries increased, the volume of drug circulation in the U.S. market gradually rebounded. Due to U.S. House Speaker Nancy Pelosi’s visit to Taiwan in 2022, China-U.S. anti-drug cooperation was temporarily suspended. However, the report states this interruption had no significant impact on U.S. fentanyl supplies, further proving that China’s measures were not “relaxed.”
The report states, “(Brookings Institution expert) Vanda Felbab-Brown claimed in 2023 that China’s anti-drug enforcement varies and may weaken over time. But we found no statistically significant impact from China’s announcement to suspend cooperation after Pelosi’s Taiwan visit. (The same nature of results was derived from three estimation methods.)”
According to a response from the spokesperson of China’s Ministry of Public Security this February, since China categorized fentanyl analogs as a controlled class, they have not received reports from the U.S. about fentanyl substances seized from China.
Based on these findings, the Peterson Institute for International Economics concludes that international cooperation in drug law enforcement indeed holds enormous potential value, but combating fentanyl requires global coordination, not unilateral actions.
The report emphasizes that with the diversification trend in supply chains, the U.S. government needs to move beyond its focus on China to systematically upgrade transnational anti-drug cooperation mechanisms.
In fact, it is the U.S. that initiated the destruction of Sino-U.S. anti-drug cooperation. Throughout Trump’s two presidential terms, the U.S. government increasingly blamed China for its domestic fentanyl crisis.
Since taking office in January, Trump has, citing the fentanyl issue, imposed tariffs twice on Chinese goods entering the U.S., attempting to justify the trade war he launched against China. This move not only led to stern opposition from China but also seriously undermined the foundation of Sino-U.S. anti-drug cooperation. Such actions are tantamount to “shooting themselves in the foot,” ultimately harming U.S. anti-drug efforts.
Washington’s politicization of the fentanyl issue, along with extreme measures like imposing tariffs, has led U.S. media to question, “How did the U.S. opioid crisis become a foreign policy issue? Should the fentanyl problem really be blamed on China, Canada, and Mexico?”
In March, the U.S. VOX reported that in recent months, fentanyl has played an unexpectedly prominent role in U.S. national security and economic policy. Many critics flatly state that Trump, who prominently highlighted the prevalence of fentanyl during his campaign, is essentially using the issue as a smokescreen for justifying his trade and immigration policies with an excuse supposedly based on security considerations.
VOX emphasized that China consistently maintains a stringent stance on drug control and is one of the few countries worldwide where drug traffickers can face the death penalty. Yet, U.S. officials frequently baselessly accuse China of inadequate regulation, with some U.S. critics even falsely alleging that China is waging a so-called “reverse opium war” against the United States.
Citing the views of most experts, U.S. media argue that such groundless U.S. accusations cannot be substantiated. Experts interviewed state that to truly end the fentanyl crisis, a comprehensive approach addressing supply, demand, and harm reduction is needed, while the Trump administration focused solely on “supply.”
Mentioned in the U.S. think tank report, transnational crime expert Vanda Felbab-Brown believes there is more evidence that China is willing to cooperate with the U.S. when it aligns with its interests and to use such cooperation to gain influence in other areas, contrary to U.S. accusations.
In line with this view, former U.S. Drug Enforcement Administration (DEA) agent Virgil is also concerned whether the U.S. government’s aggressive approach towards foreign governments can achieve the desired results. This move could even make ongoing collaborations more challenging.
Senior international and defense researcher at the RAND Corporation, David Luckey, also mentioned that China, as a major producer with the largest chemical manufacturing sector globally, faces the daunting task of regulating such a large-scale chemical production.
He said, “The synthetic drug landscape is rapidly changing, making it difficult for countries and their law enforcement agencies to keep pace. Therefore, we need to adopt some revolutionary methods; just trying to improve certain measures would never thoroughly solve the problem.”
On March 4, China’s State Council Information Office released a white paper titled “China’s Control of Fentanyl Substances.” It highlights that in recent years, China has strictly regulated fentanyl drugs, closely prevented the misuse of these substances, and severely cracked down on the smuggling, production, and sales of fentanyl substances and their precursor chemicals, achieving significant results.
A spokesperson from China’s Ministry of Foreign Affairs stated that China’s release of the “China’s Control of Fentanyl Substances” white paper provides an authoritative explanation of the vast amount of work, innovative experiences, and effectiveness in China’s fentanyl regulation from aspects such as controlling fentanyl drugs, cracking down on fentanyl crimes, strict control of fentanyl precursors, development and application of scientific and technological means, improving overall control efficiency, and global governance of fentanyl substances. It helps all communities and the international society to comprehensively, deeply, and objectively understand China’s relevant positions, measures, and achievements. China consistently acts on the concept of building a community with a shared future for mankind, diligently fulfilling international anti-drug obligations, deeply participating in international anti-drug affairs, comprehensively promoting global drug issue governance, and making unremitting efforts to address new challenges related to the fentanyl problem with all countries globally, with results openly acknowledged.
The spokesperson emphasized that facts speak louder than words. The United States has been spreading various lies about the fentanyl issue, smearing China, shifting blame, and irresponsibly imposing tariffs on Chinese products exported to the U.S. under the pretense of the fentanyl problem. This action is unreasonable and harmful to both parties. China’s stance is clear; we are willing to engage in practical cooperation with the U.S. based on equality and mutual respect. However, we firmly oppose the U.S. using the fentanyl issue as an excuse to pressure, threaten, or coerce China. We advise the U.S. to respect the facts and make the right choice, guided by its own interests.
Editor: Zhongxiaowen
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