Four Fentanyl Frames
Making sense of the opioid scourge
Fentanyl has wrought a trail of devastation across the United States; upending east coast cosmopolitan enclaves, the deep South, the Midwest heartlands, the desert Southwest, and everywhere in between. As the illicit narcotic has surged over the border—sending accidental fatalities skyrocketing, and rapidly overwhelming government capacity—it’s catalyzed one of the worst public-health disasters in modern history. This all marks a drastic escalation in America’s multi-decade opioid crisis. The scale and potency of the epidemic are so great that Congressional Republicans have campaigned to slap fentanyl with a provocative “weapon of mass destruction” label.
Some extremely grim context:
FT:
Illicit fentanyl has displaced legally prescribed painkillers as the main cause of overdoses in the US. The skyrocketing death rate — equivalent to one American overdosing every five minutes — and the $1.5tn annual cost to the economy is forcing a national debate about how to solve a public health emergency that, alongside Covid-19, has helped drive US life expectancy down to a 25-year low of 76.4 years.
WAPO:
Presidents from both parties failed to take effective action in the face of one of the most urgent threats to the nation’s security, one that claims more lives each year than car accidents, suicides or gun violence. Fentanyl is now the leading cause of death for Americans ages 18 to 49, according to a Post analysis.
Source: NIDA
I see the fentanyl crisis, first and foremost, as a story of tremendous sadness and human suffering. It’s also a story of the US criminal justice system, public health failure, addiction, and despair. Beyond that, though, I see four additional stories or “frames” via which the opioid pandemic sadly intersects with some of this newsletter’s core themes.
The Globalization Frame
Our buoyant global trading system contains a dark underbelly: a sprawling illicit economy—shaped by vast transnational supply chains—trafficking people, weapons, exotic animals, counterfeit goods, and narcotics across national boundaries. These networks operate on a truly global scale: sometimes brazenly and out in the open, with the complicity of host governments; sometimes taking advantage of loopholes and legal gray areas; and sometimes operating in direct contravention of the rules and regulations put in place to organize commerce, safeguard national security, and protect human welfare.
While smuggling and illicit commerce are age-old human activities, I would argue the origin story here traces back to the end of the Cold War. During the 1990s, a confluence of truly transformational developments—technological, economic, ideological, geostrategic, and financial—greatly diminished the saliency of national borders and birthed contemporary globalization as we know it.
Against the backdrop of a digital revolution—and the ideological triumphalism of free trade, deregulation, and marketization—geography suddenly mattered a lot less. The cost and complexity of moving goods, information, and capital across national boundaries plummeted and international trade volumes exploded, particularly between the developed and developing world. This chart below tells the story:
Source: Our World in Data
There was, of course, a major downside to these flourishing trade links. As Moises Naim points out in his excellent (albeit somewhat dated) book on the topic, criminal networks and corrupt government officials willing to facilitate the flow of illicit goods proved remarkably adept at navigating this new global shadow economy. Decades on, the scale is simply massive. While hard to accurately quantify, the WEF estimates the overall size of the illicit trade in the range of $2.2tn, or roughly akin to 3% of all human economic activity.
All these dynamics are on full display when looking at the fentanyl industry; arguably the most damaging manifestation of the highly globalized illicit economy. DEA administrator Anne Milgram lays out how this transnational supply chain operates in written testimony for the Senate Foreign Relations Committee, writing:
The Sinaloa Cartel and the Jalisco Cartel and their affiliates control the vast majority of the fentanyl global supply chain, from manufacture to distribution. The cartels are buying precursor chemicals in the People’s Republic of China (PRC); transporting the precursor chemicals from the PRC to Mexico; using the precursor chemicals to mass produce fentanyl; pressing the fentanyl into fake prescription pills; and using cars, trucks, and other routes to transport the drugs from Mexico into the United States for distribution. It costs the cartels as little as 10 cents to produce a fentanyl-laced fake prescription pill that is sold in the United States for $10 to $30 per pill.
What we see when examing the fentanyl supply chain is that many hallmarks of 21st-Century globalization are here: complex, cross-border networks extending across the Pacific; China’s centrality and disruptiveness; an oft-promiscuous and opaque global financial system; economies of scale and the utilization of emerging markets for production; and the enduring allure of the vast American consumer market.
The Connectivity Frame
What I find equally striking is the extent to which digitization—instant and omnidirectional connectivity, anywhere in the world, at negligible cost—creates, facilitates, and expands the global fentanyl market. To be blunt, there’s complicity to go around here. As the DEA notes, the cartels rely heavily on the power of the smartphone and social media to a) advertise, b) connect, and c) take payment.
Here’s how it all works:
Social media apps—think Meta, TikTok, and Twitter—provide powerful platforms to advertise and quickly reach a new, mostly young, audience.
Encryptors—think Telegram and Signal—allow buyers and sellers to discreetly communicate and finalize sales info.
Fintech—think crypto wallets, Venmo, and the Cash App—allows traffickers to quickly request and take payment.
What’s noteworthy to me here is this: the exponential reach, relative anonymity, and secure communications afforded by the digital economy—the very factors that make these tools so empowering, convenient, and appealing—act as a massive force multiplier at every stage in the fentanyl supply chain: production, coordination, distribution and delivery, marketing, sales, and payment.
The China Frame
It’s comically cliched but still true: for better or worse, China’s multi-decade rise is one of the most disruptive and consequential developments in modern history. Despite a torrent of international criticism and blowback, China’s economy remains a manufacturing, technological, and consumer powerhouse that serves as a critical global growth engine. Glancing at the news cycle today, it’s hard to find a story—any story—without a pronounced China angle.
This is true when looking at fentanyl.
To be clear, China has not always been a uniformly intransigent actor here. Following years of both diplomatic cultivation and public criticism, in May 2019 Beijing scheduled the entire class of fentanyl-like synthetic opioids, as well as two essential precursor chemicals (NPP and 4ANPP); effectively outlawing their sale and production unless cleared via special license.
Going against the grain of a rapidly deteriorating Sino-American relationship, in this instance, bilateral cooperation succeeded in cracking down on online sales and cutting off direct shipments of China-made fentanyl. While enforcement has been patchy, the deterrent effects of Beijing’s regulatory crackdown successfully disrupted the transpacific pipeline.
Sadly, that’s not the end of the story, however. Despite landmark changes in China’s drug control regime, the production process evolved rather than dissolved, with a major assist from the powerful Mexican cartels. Today, Chinese precursor manufacturers remain the key node in global synthetic opioid supply chains, and Chinese state complicity—in the form of still-lax regulation and inadequate enforcement—continues plaguing bilateral relations.
When assessing the scale of the challenge, it’s also worth keeping in mind the titanic scale of China’s science-medical-industrial complex, where the “pharmaceutical and chemical industries involve tens of thousands of firms and hundreds of thousands of facilities, and China lacks adequate inspection and monitoring capacity,” per Brookings. The crucial point here, I think, is this: China does not suffer from a domestic opioid crisis, and, accordingly, there is little domestic pressure to crack down on a prominent and lucrative large-scale industry that creates an untold number of jobs and draws support from powerful local and national-level interests.
Now this is where all that built-up tension, distrust, and toxicity between the two superpowers come into play. There’s a specific pattern of behavior here: China downplays responsibility, bristles under US criticism, underwhelms on the enforcement side, and links/subordinates narcotics cooperation to (what Beijing deems) more pressing geopolitical imperatives. Vanda Felbab Brown elaborates on the fraught geopolitical dynamics as such:
The overall geopolitical relationship deeply influences, and has sapped, the extent of U.S.-China counternarcotics collaboration. The persisting tensions between the two countries has led China to significantly scale down counternarcotics cooperation. At best, the U.S.-China counternarcotics engagement goes in fits and spurts, determined by the overall geopolitical environment.
We can see evidence of this geopolitical dynamic in real-time. The case in point, to my mind, comes from (then) House Speaker Pelosi’s controversial Taiwan visit last August, which prompted Beijing to formally suspend US-China anti-drug cooperation and withdraw from talks on managing the climate crisis.
This all raises something of a dilemma. China ultimately exercises sovereignty over its internal affairs but, as an ascendant hyperpower surpassed in influence only by the United States, what happens inside its borders—be it decisions over economic policy orientation, stringent COVID control measures, human rights abuses, fentanyl precursor manufacturing, or rampant cyber-espionage and IP theft—powerfully affects a broad array of stakeholders far beyond its shores. This is the often-frustrating reality of our interdependent world.
Given how much distrust and open hostility is now baked into the post-COVID US-China relationship versus four years ago, it’s questionable whether upbraiding and threatening Beijing will unlock tangible results on domestic precursor enforcement…or merely reinforce the narrative that China is being unfairly victimized and yield only intransigence.
Moreover, as Chinese officials seem unwilling to “decouple” cooperation on any one issue from the broader basket of thorny geopolitical challenges, there’s a tremendous calibration dilemma for DC policymakers to, on the one hand, stand with Taiwan, or call out China’s myriad human rights abuses, while simultaneously securing buy-in on greater narcotics enforcement. China is a sovereign, highly-disruptive superpower with the power to resist. Try as it might, the US and its allies are hardpressed to simply make Beijing do as they wish without inviting massive risks and trade-offs.
The Borders & Disorders Frame
One final frame for looking at fentanyl, as with many other hot-button issues, is through the lens of hyperpartisanship. While globalization as a system—however nebulously defined—once enjoyed robust bipartisan support, heated debates over free trade, protectionism, immigration, and border control, rooted in wildly different ideas about the balance between openness and security, are now front and center of American politics.
To the extent that the post-Trump GOP has a coherent raison d'etre (a generous assumption), I would argue it’s this: borders—both tangible and intangible—matter tremendously. A rigidly defined, nativist version of American nationalism—with clearly delineated lines between a virtuous “us” and predatory “them”—is the taproot of MAGA’s appeal.
In this telling, the outside world is full of menace and threat, and the American ruling class’ inability to manage transnational flows—be it dark-skinned immigrants, illicit narcotics, or Chinese-made goods—has brought the country to its knees. I see several prevalent beliefs and narratives flowing from meta-worldview: a) that America is now in a state of acute economic, political, and moral crisis, b) our political establishment—the “deep state” or “enemies of the people”—are directly responsible, and c) only through unconstrained, strongman-style leadership can order be re-established, America’s place is the world secured, and its people made great again.
If one holds to this worldview (and, again, it’s worth pointing out that millions of American voters are now aligned with this political heuristic) then globalization—the central organizing principle of the last 30 years of world history—isn’t some immensely complex set of interlocking technological, financial, ideological, and regulatory dynamics but rather a total snow job sold by an effete, anti-patriotic, and deeply corrupt coastal elite (in league with nefarious foreign actors) to hollow out the United States by shipping jobs overseas while importing culturally alien immigrant to dilute and degrade bedrock cultural values.
That I may find this narrative to be reductive, misleading, and, in the hands of Trump and his acolytes, littered with crypto-fascistic undertones is beside the point; this “big story” around disruption and decay (“borders and disorders”) resonates deeply with millions of voters. It now drives a vast amount of the political discourse, both in the United States and across the Western democratic world. It’s the story that propelled Trump into the White House back in 2016 and may do so again in 2024.
Unsurprisingly then, the “borders and disorders” narrative frames conservative messaging around fentanyl, where Congressional Republicans have aggressively linked the opioid crisis to the Democratic Party’s “weakness” on the border and illegal immigration, as this clip from February’s SOTU showcases:
Republicans see immigration and border control as a winning issue and have steered the conversation around fentanyl toward that North Star—trying to create a powerful, and electorally toxic, association in the minds of American voters ahead of the 2024 election cycle. Having said that, the link appears tenuous. The FT piece writes: “There is little evidence to suggest migrants are the primary drug smugglers. Data published by the US Sentencing Commission shows 86 per cent of fentanyl trafficking offenders in 2021 were US citizens. In 2020, 83 per cent were US citizens.”
I don’t think that data point matters all that much in the context of an uber-polarized political environment, however. The fentanyl crisis cannot be disaggregated from superheated partisan debates over core questions of American identity, security, and openness in the context of our wired, globalized age.