Christopher Tang and Thomas Choi

Fentanyl, a potent synthetic opioid, has created a major public-health crisis in the United States. One of the most pressing questions our leaders face is: How can government at the federal and state level deter the flow of illicit fentanyl? By developing a multipronged supply-chain strategy that controls the demand and stamps out the supply.

For now, China has agreed to curb the flow of fentanyl to the U.S., as well as the chemical precursors for producing fentanyl that it sends to Mexico. Moving forward, the U.S. must seek global support to develop a comprehensive plan to combat the fentanyl crisis.

Overdoses from fentanyl, a drug that is 50 times more powerful than heroin, were a leading cause of death among Americans ages 18 to 45 in 2022, the Centers for Disease Control and Prevention reported. The issue of fentanyl addiction and overdose has the potential to escalate into a global crisis. While other Organization for Economic Cooperation and Development countries such as Australia, Germany, and the United Kingdom have seen an uptick in opioid consumption, it has not reached the same levels as that in the U.S. and Canada.

In efforts to combat the crisis, lawmakers in the U.S. have passed several policies and regulations. For instance, some states have imposed harsher sentencing, and other states have considered imposing the death sentence for distribution.

In California, people who are convicted of dealing more than 1 kilogram of fentanyl face a longer prison term by three years under a new law signed by Gov. Gavin Newsom. The higher the drug weight, the more severe the penalties become — for example, an extra 25 years of prison time can be imposed for trafficking more than 80 kilograms. However, it seems that more drastic measures, such as a life term in prison, may be more effective in eliminating such crimes, as demonstrated by China, Indonesia, Malaysia, and Singapore.

Virginia has classified fentanyl as a “weapon of terrorism” in a move to increase prison sentences for dealers. In July, the attorneys general of 18 states pressed President Joe Biden to declare fentanyl a weapon of mass destruction, given that in a single month, U.S. customs seized enough of the drug to kill every American.

Besides laws and punishments for selling and distributing illicit fentanyl, the U.S. government is developing key strategies to control the demand by preventing and treating fentanyl addiction.

• Education: Educating people about the dangers of fentanyl can discourage them from trying it out as an experiment. Local governments can spearhead public awareness and prevention programs, which could include billboards, podcasts, webinars, hotlines, and more.
• Detox programs: Local governments should collaborate with health professionals to develop detox programs. These programs aim to alleviate withdrawal symptoms, prevent complications, and prepare individuals for further treatment. Additionally, local communities should establish support groups like Narcotics Anonymous and SMART Recovery to provide mutual support and maintain motivation during recovery.
• Naloxone accessibility: State governments are increasing the accessibility of naloxone, a federal government-approved medication designed to rapidly reverse opioid overdoses. Last January, Newsom released a state budget that included $3.5 million to purchase naloxone for every middle and high school in California.
• Supervised consumption sites: New York City opened the first authorized supervised consumption site in the U.S. in 2021. At these designated sites, individuals can use pre-obtained drugs under the safety and support of trained personnel, thereby preventing overdose deaths.

Controlling fentanyl demand through prevention and treatment is a defensive strategy, and the U.S. should take a proactive strategy to stamp out the supply of the drug.

To reduce preventable overdose deaths in the U.S., it is crucial to understand the flow of fentanyl. Its illegal trade involves numerous illicit supply-chain activities. They start with the production of fentanyl precursors in factories in countries such as China and India, followed by the clandestine shipment of these precursors to Mexico, which are often concealed with regular cargo.

The production of fentanyl using these precursors then occurs in secret labs operated by cartels such as the Sinaloa Cartel in Mexico. The final drug — frequently mixed into counterfeit pills — is smuggled into the U.S. Ultimately, these fentanyl-laced pills are sold on the street.

Unless China and Mexico are prepared to crack down on these factories and impose severe penalties, U.S. Customs and Border Protection has limited resources and capabilities for preventing fentanyl from entering the U.S.

CBP has been using artificial-intelligence models to identify suspicious cars or cargo at the U.S.-Mexico border. However, CBP must expand its efforts beyond the border because fentanyl production and its precursor chemicals are likely to spread beyond China and Mexico. For example, while Mexico and China are the main source for fentanyl and fentanyl-related substances, India emerged as a source for finished fentanyl powder and fentanyl precursors following China’s implementation of restrictions on the production and sale of fentanyl in 2019.

The illicit fentanyl supply chain can be compared to a virus — a microscopic organism that can mutate and infect many hosts. Just as doctors need vaccines and treatments to combat a virus, the United States cannot stop this drug epidemic without international cooperation as well as harsher punishment.

Christopher Tang is a distinguished professor at the University of California at Los Angeles’ Anderson School of Management. Thomas Choi is a Regents professor of the W.P. Carey School of Business at Arizona State University.