The fentanyl crisis in the United States has escalated into an unprecedented public health disaster, claiming tens of thousands of American lives each year. According to a new report from the Heritage Foundation titled Holding China and Mexico Accountable for America’s Fentanyl Crisis, the situation is not just a domestic issue but a deadly product of global forces. The report highlights the critical roles played by both China and Mexico in fueling this crisis, and it calls for urgent action from the U.S. government to confront these countries for their part in what is being described as “America’s most deadly drug threat in history.”

Fentanyl is a synthetic opioid 50 to 100 times more potent than morphine. It only takes a small dose to be fatal, and in 2023 alone, it was responsible for an estimated 75,000 deaths in the U.S. The toll from this crisis has exceeded the total number of American casualties in the Vietnam War. The Drug Enforcement Administration (DEA) estimates that just in 2021, the U.S. seized enough fentanyl to kill every person in America. Despite these alarming statistics, efforts to stem the flow of fentanyl have been insufficient, largely due to the complex and international nature of the drug trade.

The Role of China: “America’s Top Geopolitical Adversary”

The Heritage Foundation report makes it clear that China is a significant player in the fentanyl crisis. While the Mexican cartels are responsible for smuggling the drug across the U.S. border, the precursor chemicals necessary to make fentanyl are primarily sourced from China. These chemicals are then sent to Mexico, where they are processed by cartels and eventually distributed in the U.S.

The report explicitly states that “the Chinese Communist Party (CCP) is actively funding, supporting, and pushing America’s most deadly drug threat in history.” It also notes that “the combined forces of deadly Mexican drug cartels and hostile Chinese ambitions have delivered to the United States a destabilizing crisis and a death toll that each year eclipses the total of U.S. casualties from the Vietnam War.” China’s role in this crisis goes beyond mere neglect; it actively facilitates the export of fentanyl precursors through subsidies and tax rebate programs.

According to the report, China has provided direct subsidies for the manufacturing and export of these dangerous chemicals. It even offers tax rebates that incentivize Chinese chemical companies to export fentanyl precursors, many of which are banned under international law. “It may also be possible that China might not have a full understanding of the specific precursor shipment volumes,” the report suggests, due to insufficient regulation and oversight of its pharmaceutical industries. However, the Heritage Foundation argues that this is more likely a convenient excuse, allowing China to profit from the illicit trade while avoiding responsibility.

Even when China pledged to control fentanyl and its precursors during negotiations with the U.S., the results have been lackluster. In 2018, Chinese President Xi Jinping promised then-President Donald Trump that China would regulate fentanyl, placing all fentanyl-related substances on a control list in 2019. Yet, in practice, Chinese producers have found ways to evade these restrictions. As the report puts it, “China’s announcements don’t carry substantial costs for [its] chemicals industry,” meaning that the production and export of fentanyl precursors remain profitable despite international agreements.

Further compounding the issue, China has refused to cooperate with U.S. efforts to address the crisis. The report describes how, after initial talks between the two nations, China suspended conversations on opioid trafficking altogether. Instead of working to prevent the export of fentanyl precursors, the CCP has used the crisis to leverage other concessions from the U.S. The report criticizes the Biden administration’s diplomatic efforts, saying they “are likely to ring hollow” unless China faces real consequences for its involvement.

Mexico’s Role: Cartel Control and Government Corruption

While China plays a key role in supplying the ingredients for fentanyl, Mexican drug cartels are responsible for manufacturing and trafficking the drug into the U.S. The Sinaloa and Jalisco New Generation cartels, in particular, have become the main suppliers of fentanyl to the U.S. The DEA’s 2024 National Drug Threat Assessment confirms that “Mexico’s cartels are the main driver behind the ongoing epidemic of drug poisoning deaths in the United States.”

Fentanyl from China typically arrives at Mexican ports through air, sea, or postal routes, where cartels bribe corrupt officials to secure its transport to clandestine labs for processing. Once produced, the fentanyl is smuggled into the U.S. through various means, including tunnels, vehicles, and even pedestrian traffic. The vast networks these cartels have developed over decades of drug trafficking have made them incredibly efficient at moving large quantities of fentanyl across the border.

However, the role of the Mexican government in this crisis is more than just passive oversight. The report condemns the “complicity” of corrupt Mexican officials, many of whom are on cartel payrolls. This corruption, it argues, has allowed the cartels to operate with near impunity, smuggling lethal amounts of fentanyl into the U.S. without facing significant resistance from Mexican authorities. Under President Andrés Manuel López Obrador, the Mexican government has adopted a “hugs, not bullets” policy, focusing more on social programs than direct confrontation with the cartels. The report notes that López Obrador’s strategy has “limited operations against the drug cartels and gravely undermined the capacity of U.S. law enforcement to operate in Mexico.”

As a result, the report argues that the U.S. must recognize that it no longer has “good-faith partners” in the Mexican government. Instead of relying on ineffective promises of cooperation, the U.S. should impose sanctions on corrupt Mexican officials and expose their connections to the cartels. By “naming and shaming” these individuals, the U.S. could cut them off from the American financial system, making it harder for them to profit from the drug trade.

The U.S. Response: Why Diplomatic Efforts Are Failing

Despite the Biden administration’s efforts to address the fentanyl crisis through diplomacy and border security measures, the Heritage Foundation report argues that these efforts have been insufficient. The administration has increased funding for treatment programs and technology at ports of entry, and the Treasury Department has sanctioned individuals and entities involved in fentanyl trafficking. However, the report asserts that these measures are not enough to stop the flow of fentanyl into the U.S.

One of the key issues, according to the report, is that China and Mexico have little incentive to cooperate. The CCP has consistently used negotiations to gain concessions from the U.S., and its chemical industry profits from the export of fentanyl precursors. Meanwhile, Mexico’s cartels continue to thrive due to widespread corruption and a lack of serious law enforcement efforts. As the report states, “If past patterns are repeated, then the Biden Administration’s fentanyl diplomacy is unlikely to curtail this deadly scourge.”

Recommendations: What Needs to Change

The report offers several recommendations for how the U.S. can effectively combat the fentanyl crisis. First and foremost, it calls for a recognition that China and Mexico are not acting in good faith. The U.S. must take aggressive and proactive measures to protect itself from these transnational criminal networks.

One of the most critical steps is to target the financial networks that support the fentanyl trade. The report urges the U.S. Treasury Department to increase its number of financial investigators and forensic accountants to uncover and disrupt the money laundering operations that fuel fentanyl trafficking. Additionally, the U.S. should implement stricter oversight of Chinese pharmaceutical imports, placing new tariffs and non-tariff barriers on these goods to ensure they are not linked to fentanyl production.

The report also calls for greater transparency in financial dealings involving Mexican and Chinese actors. By publicly exposing the involvement of Chinese companies in fentanyl trafficking, the U.S. can hold these entities accountable and limit their ability to operate internationally. Similarly, the report suggests that U.S. intelligence agencies should be tasked with investigating and exposing corruption within the Mexican government, particularly among officials with ties to the cartels.

Finally, the U.S. must prioritize reshoring and nearshoring its pharmaceutical supply chains to reduce its dependence on China. By relocating pharmaceutical manufacturing to areas like Puerto Rico, the U.S. can safeguard its supply chain while minimizing the risk of exploitation by criminal networks.

Conclusion: A Call to Action

The fentanyl crisis is not just another chapter in America’s long struggle with illegal drugs—it is a uniquely deadly threat that requires urgent action. The Heritage Foundation’s report makes it clear that both China and Mexico are complicit in this crisis, and neither country is likely to change its behavior without strong U.S. action. As the report warns, “If the U.S. government continues to passively accept the fentanyl crisis as simply another illicit drug challenge and fails to prevent the CCP from facilitating this deadly trade, hundreds of thousands—if not millions—of Americans are at risk of losing their lives.”

The solutions outlined in the report are ambitious, requiring significant political will and resources. However, the cost of inaction is far greater. Only by holding China and Mexico accountable for their roles in the fentanyl crisis can the U.S. hope to protect its citizens and restore stability to its communities.

But the current administration will not hold anyone accountable, lest they be held accountable themselves.