The United States is suffering the deadliest drug epidemic in its history. Overdoses claimed the lives of more than 100,000 Americans between August 2021 and August 2022 alone. Over the span of just a few years, drug deaths have doubled. Most of these overdoses involve fentanyl, which now kills around 200 Americans every day.

To address the crisis, the U.S. government is not only deploying law enforcement to crack down on fentanyl dealers but also taking steps to prevent and treat substance use and the harms it produces. But the continued growth of the fentanyl epidemic makes clear that these measures are not enough. Since all fentanyl used in the United States is produced abroad, stemming the flow of the drug into the country is essential as well.

So far, such supply-side efforts have run aground. For one thing, synthetic opioids such as fentanyl can be produced from a wide array of chemicals, many of which also have legitimate commercial uses. That means restricting the supply of these chemicals is difficult and impractical. What is more, when regulators ban or restrict synthetic opioids or their ingredients, producers simply tweak their recipes.

Less talked about, but just as consequential, are the geopolitical obstacles that make it so hard for the U.S. government to plug the supply channels. Most of the world’s fentanyl and its precursor chemicals come from China or Mexico, countries whose current policies and priorities make effective control of fentanyl production very difficult. U.S. law enforcement cooperation with China, which was limited to begin with, has in recent years collapsed altogether. Absent a reset in U.S.-Chinese relations, that is unlikely to change. The Mexican government, too, has eviscerated law enforcement cooperation with the United States. Although a series of high-level bilateral meetings in April may have opened a path to increased cooperation down the line, it is far from clear if they will lead to substantive action from Mexican authorities.

But there is much more that the Biden administration can do. Washington still has unexplored options at its disposal to induce stronger cooperation from Chinese and Mexican authorities, for instance by combining constructive proposals with the threat of sanctions against state and private actors in those countries. It can also adopt additional intelligence and law enforcement measures of its own, with or without foreign cooperation. It is high time that Washington takes action on this front. If it does not, the record death rates that fentanyl is causing today will be eclipsed by even higher ones tomorrow.

MADE IN CHINA

U.S. officials have long understood that cutting off fentanyl production at its source means cutting it off in China. Since 2015, they have pushed Beijing to tighten controls on fentanyl-class drugs and to get serious about enforcing them. Initially, those efforts seemed to bear fruit. In 2019, China began to place restrictions on the entire class of synthetic opioids, and it has since extended those laws to the main precursor chemicals used in synthetic opioid production. For a while, the United States and China even worked together on a drug busts. In 2019, Chinese authorities in Hebei Province used U.S. intelligence to arrest and convict nine traffickers for mailing fentanyl straight to consumers and dealers in the United States.

Since then, however, Chinese traffickers have evaded controls by rerouting their operations through Mexico. Unlike drugs such as methamphetamine, which remain firmly in the hands of Chinese organized crime syndicates, the production chain for fentanyl often starts with small and middle-level players in the country’s chemical and pharmaceutical industries, including the odd mom-and-pop outfit. These seemingly legitimate businesses ship fentanyl precursors to Chinese or Mexican drug cartels. The cartels synthesize the chemicals into finished fentanyl and then move it onto the U.S. market.

It is hard for outsiders to get a clear view of the current state of China’s domestic drug enforcement. But there have been no high-profile Chinese prosecutions since the 2019 trial in Hebei; neither does Beijing appear to be doing anything to stem the flow of precursor chemicals to Mexican cartels. This inaction is no accident. The arrests in Hebei took place when Beijing still hoped for a broader thaw in relations with Washington. As that hope has eroded, so has China’s willingness to coordinate with U.S. authorities on the opioid front.

Put simply, Beijing thinks of counternarcotics collaboration as downstream from its geostrategic relations. Unlike the U.S. government, which seeks to delink the issue from geopolitics, China views the fentanyl crisis through the lens of its growing rivalry with the United States. It did so even before last year’s visit by then U.S. House Speaker Nancy Pelosi to Taiwan, after which China formally ended all law enforcement cooperation with the United States. U.S. punitive measures against China, such as sanctions and indictments, are unlikely to change this. Even in Southeast Asia and the Pacific, where Beijing takes drug trafficking very seriously, its engagement with foreign authorities tends to be highly selective, self-serving, and subordinated to its geopolitical interests.

At home and abroad, the Chinese government rarely takes action against the top echelons of crime syndicates unless they infringe on a narrow set of core state interests. These criminal groups provide a variety of services to legal businesses, including to firms with ties to government officials and the Chinese Communist Party. Efforts to better regulate precursor chemicals and fentanyl analogs are also hampered by systemic corruption and the incentive structures within which Chinese officials operate.

Taken together, these conditions leave plenty of room for Chinese criminal networks to expand their scope and reach, including in the Americas. There are signs that Chinese fishing vessels in Latin American waters sometimes carry drugs and precursor chemicals. What is clear is that Chinese actors play a significant role in laundering money for Mexican cartels through informal financial and trade networks. Of particular note is the rise of payment in kind: in exchange for drug precursors, Mexican cartels provide Chinese traffickers with coveted black-market products, especially timber and protected wildlife. The potential damage to economic sustainability, food security, and global biodiversity is severe—not to mention the potential for the global spread of zoonotic diseases.

STUCK IN THE FIFTIES

Although relations with Mexico have not deteriorated to the same degree, U.S. drug policy there faces serious obstacles as well. The collapse of the rule of law in Mexico goes far beyond the human toll of its drug war, which has killed more than 30,000 Mexicans every year since 2017—not counting the more than 112,000 people that went missing during the same period. In addition to controlling the drug trade, the cartels have expanded their extortion rackets and have come to dominate even parts of the country’s formal economy. They now have a hand in agriculture, fisheries, logging, mining, and the water supply. Their assault on state power and civil society has taken on new, more brazen forms, too, including increasingly aggressive attempts to influence elections and infiltrate state institutions.   

Upon taking office in 2018, Mexican President Andrés Manuel López Obrador pledged that he would address the spiraling crisis with “hugs, not bullets.” By this, he meant social and economic measures to better address the structural forces driving many young people into the hands of the cartels. But besides creating a new National Guard—the latest in a long series of haphazard institutional reshuffles in the Mexican security forces—López Obrador has never articulated any clear vision of how to stabilize the situation in the shorter term.

The Mexican government’s hope, it seems, is that if it lets the cartels duke it out among themselves, they will eventually reach a balance of forces and the violence will subside. But the conflict that is causing much of the bloodshed—a brutal war for primacy between the Sinaloa Cartel and its main rival, the Cartel Jalisco Nueva Generación—has not abated. If anything, it has intensified and spread to other parts of Latin America, even as far as Chile.

To make matters worse, Mexico has systematically hollowed out cooperation with U.S. law enforcement. López Obrador blames U.S. pressure on the cartels for fanning the violence, and his 1950s vision of politics and foreign affairs revolves around limiting any non-economic U.S. presence in his country. In 2020, when the United States arrested Salvador Cienfuegos, Mexico’s former secretary of defense, for colluding with a vicious drug cartel, López Obrador threatened to expel all U.S. law enforcement personnel and end all cooperation with U.S. authorities. Washington bent backward to assuage him, handing Cienfuegos back to Mexico, where he was promptly acquitted. But the Mexican government has since passed a national-security law that further hobbles cooperation with U.S. agents. In March, López Obrador started claiming that no fentanyl is cooked in Mexico, a falsehood roundly debunked not just by the U.S. Justice Department but also by parts of his own government. In recent weeks, he once again threatened to expel U.S. agents from Mexico.

With the Mexican government also threatening to withdraw from the Mérida Initiative, a bilateral framework for security cooperation that had been in place since December 2008, the U.S. government worked hard to negotiate a successor agreement. Mexican officials, however, have interpreted the new framework very narrowly: the United States should reduce domestic drug demand, arrest more Mexican fugitives on U.S. soil, and keep weapons and illicit money from flowing south into Mexico, while Mexico does what it wants on its side of the border without letting the United States in on it.

The Mexican government has offered only limited and intermittent cooperation ever since. Whereas Mexican authorities have kept the U.S. Drug Enforcement Administration in a deep freeze on their territory, they have allowed for occasional intelligence sharing and have at times worked with the investigative branch of the U.S. Department of Homeland Security. Ultimately, however, the Mexican government is not taking on the criminal groups and their fentanyl trade. Instead, as a recent Reuters investigation revealed, it is cooking its reports about fentanyl lab busts to placate Washington. In any case, the Trump administration taught Mexico a valuable, albeit unfortunate, lesson: the United States will give up on a wide range of interests as long as Mexico suppresses migration flows to the U.S. border. The Biden administration has not reversed that lesson.

CLOSING THE FLOODGATES

At present, the odds of getting more cooperation from either China or Mexico in the fight against the fentanyl trade are slim. But Washington must keep on trying. When it comes to Beijing, U.S. diplomats should play to its desire to be a global counternarcotics leader in the eyes of the world. China likes to project an image of being tough on drugs. But it has come under fire from countries in Southeast Asia for the steady flow of Chinese methamphetamine precursors into the region, which has set off a devastating drug epidemic. The United States could team up with these countries, as well as with Australia and New Zealand, to pressure China in multilateral forums. Concerted calls on Beijing to take action against synthetic drugs, implement better monitoring systems even for dual-use nonscheduled chemicals, and set best practices for its chemical firms could finally induce China to act.

Among the best practices the United States and others should push for are self-regulation systems to detect and police suspicious activities and “know your customers” policies. It should continue demanding that China take down websites that illegally sell synthetic opioids to Americans or to Mexican criminal groups. And it should encourage China to adopt more robust anti-money-laundering standards in its banking and financial systems and trading practices. Washington can underpin such requests with the threat of sanctions. Punitive measures could include cutting off noncompliant Chinese firms from the U.S. market and targeting prominent pharmaceutical and chemical industry officials. U.S. law enforcement, meanwhile, should indict as many Chinese traffickers and their companies as possible.

In Mexico, too, U.S. policy can still make a difference, although not all current proposals are workable. U.S. politicians, such as South Carolina Senator Lindsey Graham, have recommended that the U.S. government designate Mexican cartels as foreign terrorist organizations (FTOs) on top of their current designation as transnational criminal organizations. Doing so would open the door to more intelligence gathering and even to U.S. military strikes on fentanyl labs. But the number of realistic targets would be limited, and striking them would not hobble the cartels for long. Nor would the FTO designation add anything to the regime of sanctions and financial intelligence tools already in place. In fact, it would only complicate U.S. policies in Mexico.

Instead, the United States could intensify border inspections, even at the risk of substantially slowing down the legal trade and causing serious problems for perishable Mexican agricultural exports. Ideally, U.S.-Mexico law enforcement cooperation would be robust enough to keep legal border crossings efficient and enable joint inspections far from the border. But if Mexico refuses to act as a reliable partner, the United States should intensify border inspections on its own initiative.

The economic cost of the opioid epidemic—to leave aside its immeasurable human toll—is simply too enormous to countenance inaction. In 2020, estimates put that cost at nearly $1.5 trillion. In contrast, in 2019, U.S. goods and services trade with Mexico totaled only $677.3 billion, with imports from Mexico at $387.8 billion. As with China, Washington should develop packages of leverage to underwrite its demands, including indictment portfolios against Mexican officials and politicians who sabotage cooperation with the United States. Instead of shying away from holding to account criminal officials such as Cienfuegos, the former Mexican defense minister, the United States should be arresting more of them.

HIT THEM WHERE IT HURTS

At the same time, U.S. officials should rethink their own measures against criminal actors involved in the fentanyl business. Given the diversified economic portfolios of Mexican and Chinese criminal networks nowadays, more drug seizures simply will not do. Authorities need to take aim at the traffickers’ entire business empires and try to cut off their revenue streams wholesale, whether that means going after poaching and wildlife trafficking, illegal fishing, or other illicit activities.

That requires bringing on board a wide range of U.S. departments and agencies for a whole-of-government approach, starting with the U.S. intelligence agencies, the Department of State, the Department of Defense, and the U.S. Fish and Wildlife Service. By taking a better look at the various offshoots of the fentanyl trade—the wildlife trafficking, the illegal fishing, and so forth—the United States would also get a better picture of the linkages between organized crime and foreign governments, including China. Greater intelligence sharing within the U.S. government would help, as would increasing the role of Fish and Wildlife special agents in joint anti-organized-crime task forces. Alongside this effort, wildlife trafficking should be designated as a predicate offense for wiretap authorizations, which would empower authorities to start gathering intelligence without having to prove a link to other crimes a priori.

To get moving down this path would require a change of mindset, but it would not be particularly costly in absolute or relative terms. It would certainly amount to a fraction of the cost that an out-of-control fentanyl epidemic is already exacting on American lives and communities. Considering what is at stake, only a whole-of-government approach, at home and abroad, will do justice to the magnitude of the crisis.