America’s Fentanyl Epidemic: The China Connection

Over the past few years, a new threat has emerged as a leading cause of death in the United States: fentanyl. Yet even as the drug wreaks havoc on Americans lives, preventing its flow into the United States is complicated, partially because of the supply’s overseas origins, which is often China. What is China’s role in the U.S. fentanyl crisis?

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  • Gabrielle Sierra
    Director, Podcasting

Asher Ross - Supervising Producer

Markus Zakaria - Audio Producer and Sound Designer

Molly McAnany - Associate Podcast Producer

Episode Guests
  • Thomas J. Bollyky
    Bloomberg Chair in Global Health; Senior Fellow for International Economics, Law, and Development; and Director of the Global Health Program
  • Zongyuan Zoe Liu
    Maurice R. Greenberg Fellow for China Studies
  • Shannon K. O'Neil
    Vice President, Deputy Director of Studies, and Nelson and David Rockefeller Senior Fellow for Latin America Studies

Show Notes

The prolonged opioid epidemic has become the worst drug crisis in U.S. history. Its modern era has been defined by fentanyl, a synthetic opioid that is cheap to make and deadly to consume, even in small doses.


China is the primary manufacturer of the ingredients to make fentanyl, which often go to Mexican cartels that smuggle most of the fentanyl that reaches the United States across the southern U.S. border. While China has made some efforts to restrict fentanyl production, more Americans died from drug overdoses in 2022 than ever before, and the majority of those overdoses involved fentanyl or a similar drug. Meanwhile, geopolitical competition between Washington and Beijing has continued to heat up, and experts are pessimistic that the two will be able to cooperate on curbing the flow of fentanyl. 



From CFR


David P. Fidler, “Fentanyl and Foreign Policy,” Think Global Health


Claire Klobucista and Alejandra Martinez, “Fentanyl and the U.S. Opioid Epidemic” Editors, "Mexico's Long War: Drugs, Crime, and the Cartels"



From Our Guests

Reporting on Fentanyl and the Opioid Crisis,” CFR Events



Read More


Vanda Felbab-Brown, “China’s Role in the Fentanyl Crisis,” Brookings


Sadie Gurman, “Biden Administration Indicts Chinese Firms Allegedly Tied to Fentanyl Distribution,” Wall Street Journal


Horrifying Numbers of Americans Will Not Make it to Old Age,” The Economist


Shannon K. O’Neil, “The Western Hemisphere Drug Policy Commission: Charting a New Path Forward” [PDF], U.S. Drug Policy in Latin America and the Caribbean, House Foreign Affairs Committee



Watch and Listen


China’s Role in the Smuggling of Synthetic Drugs and Precursors,” Brookings


Why the U.S. Is Pressuring China Amid a Crackdown on the Global Fentanyl Trade,” PBS News Weekend


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