China Killed Prince – Foreign Policy

When Jorge Guajardo arrived in Beijing as Mexican ambassador in 2007, he came with a directive about what was his country’s most urgent issue with the Chinese government. Mexico needed China to curb its manufacturing and sale of a dangerous class of chemicals—precursors to making fentanyl and other synthetic drugs—that flowed nearly unchecked into North America.

The drugs were legal in China, sold openly online and through factory reps. Drug cartels in Mexico used the China-made chemicals to fuel their growing arsenal of heroinlike synthetics sold into the United States to feed the country’s hunger for opioids. For six years, his tenure as ambassador, Guajardo tried to get China’s government to stop production of the chemicals powering the deadly epidemic. The issue was so critical to his country’s future that Mexico started bringing it up at every cabinet-level meeting with the Chinese side.

“Every single time, the Chinese would shrug and say, ‘We don’t know what you’re talking about,’” he recalled. “They never wanted to pay attention to it.”

So when Guajardo heard the news that Chinese President Xi Jinping, in a sit-down dinner with U.S. President Donald Trump in Argentina last weekend, had promised to take steps to curb fentanyl production and sales, he was both surprised and optimistic.

“The mere fact that they’re acknowledging there is a role on their end, to me, that’s important. They have literally pretended the issue does not exist,” Guajardo said.

China’s refusal to acknowledge the problem has already left a trail of dead behind. In the five years since Guajardo left Beijing, opioids produced from Chinese precursor chemicals killed the musical icon Prince, sparked a surge of drug overdoses unlike anything ever seen before in the United States, and helped power an unprecedented slump in Americans’ lifespans. Last year in the United States, 72,000 people died of drug overdoses—a 10 percent spike from 2016—and more than were killed by guns or car wrecks. The majority of those deaths involved opioids, now almost inevitably containing fentanyl.

Fentanyl is a potent synthetic opiate – the standard formulation is 50-100 times stronger than morphine – developed in 1959 that came into widespread medical use in the 1990s. It’s now widely used as a treatment for severe pain in everything from surgery to cancer therapy.  The dozens of its cousins now flooding America’s street drugs range to far, far stronger and more dangerous, including carfentanil, an elephant tranquilizer.

Most of the time, users no longer know exactly what they are taking. When Prince took those bought-off-the-street pills labeled as painkillers in April 2016, he didn’t know that they contained a lethal amount of fentanyl that would leave him dead in an elevator at his Minnesota estate.

But as so often in China, and in Trump’s America, it’s entirely unclear what this means in terms of tangible, enforceable regulation. The White House announced that China had agreed to declare fentanyl as a controlled substance, something that already happened several years ago. China’s Ministry of Foreign Affairs has framed the issue in more extensive, and explicit, terms, saying, “China has decided to list all the fentanyl-like substances as controlled substances and start working to adjust related regulations.”

That’s big, if it happens. Xi Chen, a researcher at Yale University who specializes in U.S.-China public health issues, also saw the somewhat vague statements from both countries about fentanyl as a good sign. Still, he cautions, enforcement will be difficult for China, especially when the industry was until very recently aboveboard and legal.

There is a known risk in taking China’s leaders at their word, especially when it comes to law enforcement. China has a long litany of unenforced laws and regulations. In its worst pollution years, the country had strong environmental protections; it enshrines free expression and free press in its constitution but is one of the world’s leading jailers of journalists. Add to that, as Xi Chen notes, the chemical industry is both a big employer and a source of revenue for local governments outside Beijing. Yet remember the scary U.S. headlines a few years ago about the made-in-China street drug flakka? It’s gone because the Chinese government eradicated it.

Even if all these obstacles can be overcome, a tricky technical problem remains: the number of fentanyl-related compounds churned out by China’s chemical manufacturers. By only tweaking a few molecules, or even just one, chemists can fairly easily make a new variety of fentanyl, one not subject to regulations. Fentanyl is easier to alter, and regulatory systems in the United States and China must first identify new varieties before they can regulate them. Hence, the game seems rigged in favor of unscrupulous chemists.

So why has China been so reluctant in the past to acknowledge its role in the opioid crisis and take stronger steps to stem the tide? The best guess is that it’s not a problem killing Chinese citizens.

Though it’s mostly hidden, China does have a drug problem, including a steady rate of heroin addiction, but it’s mostly confined to border towns close to Myanmar. Chinese drug usage is intertwined with a long and tragic history, from the Opium Wars to the AIDS crisis. Up until recently, HIV in China was spread more frequently by blood than by sex. But the specific conditions that produced the U.S. opioid crisis—namely the rampant overprescription of opioids such as OxyContin and the targeting of those drugs and their illicit synthetic opioid cousins to struggling communities, coupled with a crumbling health care system—are absent in China.

All of this makes it hard to believe a growing chorus, mostly on the political fringes of social media, that contends China is deliberately funneling fentanyl to the United States to kill Americans. What’s much more likely is absolute indifference to a problem not killing Chinese people or causing problems at home. That has its own parallel in the United States—a Republican stance on health care that almost certainly jeopardizes the lives of opioid users. In states such as Montana and elsewhere where lawmakers have expanded Medicaid, overdose deaths have declined.

I spent a week in Cincinnati—one of the epicenters of America’s addiction crisis—reporting on the complex web of fentanyl and how scientists and cops are forever two steps behind the changing formulas of China’s covert chemists. I stood behind a lab tech in the coroner’s office while she tallied up the number of different chemical substances in a single dose of a street drug that had killed someone. There was heroin, meth, ketamine, and more than one variety of fentanyl.

It was then I understood what I’d been told for months while reporting on the issue: Even if China cuts off the supply, the hunger for something to fill the void of poverty, pain, and hopelessness will still be there. Until the United States addresses its underlying social ills, even China can’t stop America’s opioid crisis.