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1 1 (December 8, 2022)

handle is hein.crs/govejrh0001 and id is 1 raw text is: Con gressionl Research Service Informing th legisIlive deAme sinceo 1914 China Primer: Illicit Fentanyl and China's Rote Addressing illicit fentanyl in the context of the ongoing opioid crisis in the United States is a domestic and foreign policy issue for Congress. In addressing the international dimension of the problem, policymakers have endeavored to stop foreign-sourced fentanyl, fentanyl-related substances (i.e., analogues), and chemical inputs (i.e., precursors) from entering the United States. Early in the U.S. opioid epidemic, the People's Republic of China (PRC, or China) was the primary source of illicit fentanyl. Direct flows of fentanyl from China are now largely stemmed. U.S. counternarcotics policy with regard to China has shifted to preventing Chinese-sourced fentanyl precursors from entering the U.S.-bound fentanyl supply chain via third countries, and targeting illicit fentanyl- related financial flows linked to the PRC. U.S.-PRC cooperation on drug control issues has been severely strained since 2020. Background Fentanyl is a potent synthetic opioid that has been used medically as a painkiller and an anesthetic since it was first synthesized in 1959. Due to fentanyl's potential for abuse and addiction, the United Nations (U.N.) placed it under international control in 1964. Domestically, fentanyl is regulated by the Drug Enforcement Administration (DEA), pursuant to the Comprehensive Drug Abuse Prevention and Control Act of 1970, as amended (21 U.S.C. §§801 et seq.). Controlling the production and trafficking of fentanyl and its analogues has emerged as a major international drug policy concern for the United States. The U.S. Centers for Disease Control and Prevention estimates that synthetic opioids (primarily fentanyl-related substances) may have resulted in almost 73,000 overdose deaths between July 2021 and June 2022. Moreover, traffickers appear to be marketing a growing number of fentanyl analogues for nonmedical, often unregulated use. As of November 2021, the International Narcotics Control Board-an independent expert body that monitors government compliance with international drug control treaties-reported the existence of more than 150 fentanyl- related substances with no currently known legitimate uses. The U.N. Office on Drugs and Crime estimates that laboratories could potentially synthesize thousands of other fentanyl analogues. As of December 2022, more than 30 fentanyl-related substances, including precursors, are scheduled for international control pursuant to the U.N. Single Convention on Narcotic Drugs of 1961, as amended, and the U.N. Convention Against Illicit Traffic in Narcotic Drugs and Psychotropic Substances of 1988. In 2017, U.N. member states agreed to list two fentanyl precursor chemicals on Table I of the 1988 Convention, subjecting them for the first time to international controls: N-Phenethyl-4-piperidone (NPP) and 4-Anilino-N- Updated December 8, 2022 phenethylpiperidine (ANPP). (In February 2018, consistent with the U.N. decision, the PRC implemented corresponding domestic controls.) In March 2022, U.N. member states decided to add three more fentanyl precursors under international control: N-Phenyl-4- piperidinamine (4-AP), tert-Butyl 4- (phenylamino)piperidine-1-carboxylate (boc-4-AP), and norfentanyl. Sources and Trafficking Pathways In the years immediately prior to 2019, China was the primary source of U.S.-bound illicit fentanyl, fentanyl- related substances, and production equipment. PRC traffickers supplied fentanyl and fentanyl-related substances directly to the United States via international mail and express consignment operations. Trafficking patterns changed after the PRC imposed class-wide controls over all fentanyl-related substances, effective May 2019. Today, Mexican transnational criminal organizations (TCOs) are largely responsible for the production of U.S.-consumed illicit fentanyl, using PRC-sourced primary materials, including precursor chemicals that are not internationally controlled (and are correspondingly legal to produce in and export out of China). According to DEA assessments cited by the U.S.-China Economic and Security Review Commission in 2021, PRC traffickers and money launderers appear to have increased cooperation with Mexican cartels. Fentanyls destined for nonmedical consumption may be produced in clandestine laboratories. Pharmaceutical preparations of fentanyl may also be diverted through theft and fraudulent prescriptions. Legitimate chemical and pharmaceutical companies also produce fentanyl analogues and precursors that are not domestically or internationally regulated. In February 2022, the final report of the U.S. Commission on Combating Synthetic Opioid Trafficking, established pursuant to Section 7221 of the National Defense Authorization Act for Fiscal Year 2020 (P.L. 116- 92), concluded that the PRC's chemical and pharmaceutical sectors have outpaced the government's efforts to regulate them, creating opportunities for unscrupulous vendors to export chemicals needed in their illegal manufacture. Addressing China's Role U.S. foreign policy efforts to stem the flow of illicit fentanyl-related substances into the United States have focused on bilateral engagement and multilateral cooperation with entities including the U.N. and other stakeholders on such goals as scheduling more fentanyl analogues and precursors for drug control. Such efforts fit within broader goals of targeting the foreign supply of U.S.- destined illicit drugs, which has long been a pillar of U.S. counternarcotics strategy and features centrally in the

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