Fentanyl crisis resulted from institutional flaws in the United States

The United States has been battling a grave opioid crisis. But instead of setting its house in order, it has been blaming China for the problem. In a memorandum for the US secretary of state on Sept 15, President Joe Biden identified, among other countries, China as a "major drug source country" and directed him to submit it to the Congress and publish it in the Federal Register.

Refuting the US claim on Monday, Chinese Foreign Ministry spokesperson Mao Ning said "the Chinese government has always been serious about fighting drugs. China has the strictest drug control policy in the world and enforces it in the fullest way. Our efforts are widely recognized by the international community."

She added: "In contrast, the US, with 5 percent of the world's population, consumes 80 percent of the opioid produced in the world — which makes the US a black hole and source of problem for global drug control. The US is the single largest major drug demand country and is in no position to wag its finger at China's counter-narcotics efforts."

The abuse of opioids, particularly fentanyl, has become a leading cause of death in the US — it claims more lives than gun violence or car accidents. Many say the fentanyl crisis is the result of the US' institutional flaws.

First, US politics is nothing but money politics. The abuse of opioid in the US started with OxyContin, an opioid painkiller made by Purdue Pharma and approved by the US Food and Drug Administration in 1995. After that, some US pharmaceutical companies spent huge amounts of money to use experts and organizations to promote the harmlessness of opioids, and lobby physicians to indiscriminately prescribe and pharmacies to aggressively sell opioids as painkillers. As a result, American people became accustomed to using opioid painkillers as a symptomatic but not a curative medicine to cope with several illnesses.

According to a 2017 report in London-based The Guardian, pharmaceutical companies in the US outspent all other industries in their efforts to influence politicians. The report said pharmaceutical companies have spent nearly $2.5 billion on lobbying and financially supporting Congress members over the past decade.

Additionally, pharmaceutical companies have contributed to the campaigns of nine out of every 10 House of Representatives members and all but three of the 100 senators in the hope that they would shape legislation on drug pricing and make the approval process for new medicines easier.

In the US, it is quite normal for former government officials to join pharmaceutical companies, and former pharmaceutical executives to become health department officials. For example, former FDA chief Scott Gottlieb resigned in April 2019 and joined Pfizer's board of directors two months later. And in 2017, then US president Donald Trump nominated Alex Azar, who had served as president of the US division of Eli Lilly and Company for five years, as secretary of health and human services. Trump tweeted that Azar would be a "star" in the position and help lower drug prices. Ironically, Eli Lilly tripled the price of a top-selling insulin product when Azar led its US operation.

Second, political polarization in the US hinders drug control. While both Democrats and Republicans vow to tackle the fentanyl crisis, they have been preventing each other from doing so. For neither wants the other to solve the fentanyl problem and gain political points which would favor them in elections.

According to The Washington Post, the Congress passed a bill specifically targeting fentanyl only in December 2017, nearly four years after legislators first received warnings about the dangers of the drug.

In May this year, the Republican-led House of Representatives approved the Halt All Lethal Trafficking of Fentanyl Act with a 289-133 vote. Surprisingly, 132 Democrats opposed the bill even after the White House had announced its support for it.

Third, there is a need for US citizens to raise their awareness of laws and the harms of abusing drugs. It is the people who help maintain the country's economic and social advantages, while politicians do everything in their means to please the people and garner votes, even at the cost of allowing the fentanyl crisis to linger. Which means the Congress as well as the administrative departments tend to cater to the weaknesses of the people, and blame other countries for the woes of their own making.

And fourth, some US politicians may even move bills in the Congress, seeking the decriminalization of certain drugs to please a certain section of society which could include drug users. In Western-style democracy, a small political clique with common interests and capable of making concerted moves can play a more critical role in lobbying and elections than a larger but less cohesive group. Hence, those politicians seeking the decriminalization of certain drugs may garner more support.

Perhaps this is why the anti-drug campaign launched in the US in the 1970s began weakening after some years. The US should therefore strengthen legislation and make greater efforts to combat drug abuse and trafficking instead of lecturing other countries on how to control drug trafficking, even legitimate drug exports. The US' fight against drug abuse and trafficking will not succeed if the administration continues to do nothing to reduce drug abuse at home.

As for the "know your customer" rule some in the US have been advocating, its proposed provisions far exceeds the obligations under the United Nations Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances. According to international practice, it is up to the importer and importing country, not the exporter or exporting country, to ensure the imported goods are not used for illegal purposes.

Besides, it is impossible for exporters to thoroughly verify their clients in a foreign country. The exporter has no right or responsibility to act on behalf of or against the importer. The onus of tackling the opioid crisis is therefore squarely on the US.

The author is a researcher at the Chinese Academy of International Trade and Economic Cooperation.

The opinions expressed here are those of the writer and do not necessarily represent the views of China Daily and China Daily website.

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