Drug trafficking is inherently transnational, and no single country can address the problem on its own. For years, cooperation between the United States and China has been critical to begin understanding and confronting drug trafficking organizations that source precursor chemicals from China to manufacture synthetic drugs in Mexico, with a direct impact on the United States.
This past February, American and Chinese officials convened in Colorado under the framework of the Bilateral Drug Intelligence Working Group (BDIWG). Law enforcement officials, customs agents, and experts on licensing and financial oversight came together to discuss best practices to stem the flows of illicit drugs into the US and save American lives. It was an important step in the long process of addressing the synthetic drug crisis and its interlocking parts: chemical supply chains, pill presses and illicit finance, and the latest chapter in a long, on-again-off-again history of counter-narcotics cooperation between the US and China.
Given the competitive and sometimes turbulent relationship between the US and China, an upcoming meeting in Beijing in May between Presidents Trump and Xi is a high-stakes engagement and an opportunity to advance anti-narcotics cooperation and stem fentanyl flows.
Beginning in 2012, the availability of fentanyl and other synthetic opioids exploded, leading to a sharp rise in overdose deaths. Since its start, it has impacted hundreds of thousands. About 33.6% of Americans reported direct or indirect contact with someone who has overdosed on opioids in 2025 — up from 31% the year before — according to the organization where I serve as director of the counterdrug program, PAX sapiens, in its 2025 national fentanyl survey, The Blame Game. That means roughly one in three Americans knows someone who has either struggled with this or died from it. Overdose continues to be the leading cause of death for Americans ages 18 to 44, leaving local communities and families stunned, grieving and destabilized by the speed at which these drugs have become available.
Part of what makes fentanyl so dangerous is how lethal it is in very small quantities. At the illicit street level, the difference between a dose that gets someone high and one that results in a fatal overdose can be as little as about one milligram (1 mg), given that the lethal dose is approximately two milligrams (2 mg). With quantities that small, there is no margin for error.
Fentanyl is also routinely added to counterfeit pills or mixed into powders of other illicit drugs; in these cases, the user is typically unaware it is even present in the drug they are consuming. The vast majority of those encountering fentanyl for the first time, and many who have overdosed, had no intention of taking fentanyl. The combination of potency and unpredictability is why many overdose deaths happen so quickly and why large user populations can be impacted in a short period of time when fentanyl first hits drug markets.
There is also a separate population of long-term users who intentionally seek out fentanyl or similarly potent synthetic opioids. For people with years of opioid dependence, tolerance steadily increases and drugs that once produced a strong effect no longer do. What would incapacitate or kill a new or unsuspecting user may barely register for someone with a long history of use. Over time, the pursuit of relief from withdrawal and the pursuit of a meaningful high converge, pushing users toward increasingly potent substances. In that context, fentanyl is not an accident or an unknown additive, but a drug deliberately sought out because it can overcome tolerance when other opioids no longer can.
As law enforcement makes progress in controlling one type of fentanyl or the precursors used to make it, which can include 1-Boc-4-AP, 4-anilinopiperidine, 4-piperidone benzylfentanyl, among other chemicals, traffickers and chemists develop new fentanyl analogues or entirely different synthetic opioids that are more potent than the one that was controlled. This creates a moving target where lethality continues to increase despite controls because manufacturers and distributors are actively manufacturing substitutes. Many times, this results in a more potent alternative.
I have seen firsthand the rise and evolution of the synthetic drug crisis and the grave threat it poses to public health and security as it continues to outpace the institutions responsible for understanding and containing it. I had a front row seat to the evolving crisis when I worked as a DEA agent assigned to China from 2002 -2005 and again at the height of the synthetic drug crisis from 2011-2014. I returned to the US as the crisis continued to unfold and was the Section Chief responsible for China at DEA Headquarters from 2014 to 2020. From this perspective, I observed the unfolding history of law enforcement coordination between the United States and China. At times inconsistent and often difficult, there have nonetheless been moments when practical engagement delivered real results. I had the task of organizing the first BDIWG meeting in October 2002 in Beijing and worked directly with counterparts on both sides who genuinely wanted to address drug trafficking and the harm it causes.
During my time in Beijing, I quickly came to understand not only the complexity of trafficking networks, but also the intricacy and fragility of the US-China relationship and the critical role law enforcement cooperation on drug control plays in maintaining that relationship. One important outcome of this engagement was the signing of a memorandum of agreement to cooperate on law enforcement investigations in 2005, which remains in place today. The exchange of intelligence that followed the BDIWG helped facilitate one of the most successful joint investigations ever conducted between the United States and China, known as the 125 Case.
The 125 Case involved a joint investigation in 2003 between the US DEA and China’s Narcotics Control Bureau and resulted in the dismantling of a large international heroin trafficking network tied to Fujian Province and operating in the United States. The investigation was intelligence-driven and required sustained, coordinated investigative work by both countries over an extended period, with close contact between US and Chinese law enforcement.
The recent decline in overdose deaths, evidence of a real supply side shock and the formal resumption of US-China law enforcement cooperation, offer a narrow but meaningful window for progress.
The circumstances surrounding the fentanyl crisis today are more complicated. In the 125 case, the heroin involved was illegal in both countries, which made enforcement decisions more straightforward. With fentanyl, many of the precursor chemicals being shipped from China to Mexico fall into a legal gray area. China has moved to control several substances, but distributors and chemical sellers often shift to alternative compounds once a particular chemical is scheduled. That creates gaps where substances being used to produce lethal synthetic drugs may not yet be controlled under Chinese law, making timely intervention more difficult. One example was in May 2019, when China added all fentanyl-related substances to its Supplementary List of Controlled Narcotic Drugs and Psychotropic Substances with Non-Medical Use. These class-wide controls effectively stopped direct flows to the United States; however, traffickers adjusted and began focusing on precursor chemicals, shipping them to the US and Mexico directly via USPS and other shipping services.
With the precursors now flowing to Mexico, where they are converted into finished fentanyl, it is crucial to establish a standing trilateral framework involving Mexico, the US and China. A meeting this year in March in Washington, DC, between the US DEA Administrator and the Secretary of Security and Citizen Protection for Mexico highlighted the importance of sustained senior-level coordination to close gaps that traffickers exploit. Coordination is necessary to detect and destroy clandestine labs, identify chemical brokers, identify logistics nodes, and regulate the financial and logistical systems that support them.
Formally establishing a trilateral framework would allow investigators to identify emerging precursor substances and share information quickly. In practical terms, that means maintaining working relationships that support direct discussion about chemicals that may be legal at the point of export but are clearly being used downstream for illicit manufacture (often referred to as “dual use chemicals”). Without that level of coordination, law enforcement and regulators cannot keep pace with the way these networks adapt.
US–China counternarcotics cooperation began to slow around 2020 as the broader relationship deteriorated and law enforcement channels became harder to sustain. As tensions increased and COVID-19 disrupted normal engagement, routine cooperation lost momentum. During this period, the US relied more on unilateral actions, including indictments and sanctions tied to individuals and companies connected to drug trafficking and chemical supply chains. Those steps addressed specific US concerns but also made cooperation more difficult to maintain. The situation worsened in 2022 after Speaker Nancy Pelosi’s visit to Taiwan, when China suspended several bilateral dialogues, including counternarcotics cooperation. From that point on, cooperation was clearly affected by the wider political relationship, and whatever working‑level engagement remained became harder to maintain.
When the Trump administration raised tariffs on Chinese goods from 10% to 20% last year, citing the fentanyl crisis, trade between the two nations was impacted, with China calling the tariffs “bullying.” In a subsequent meeting between Presidents Trump and Xi that led to a reduction in tariffs and port fees, China followed with controls on 13 fentanyl precursor chemicals.
Then in 2024, the US and China resumed formal counter-narcotics cooperation and established a dedicated channel focused on synthetic drugs and their precursors. That engagement produced concrete steps, including China scheduling actions on several fentanyl-related substances. Further, China added 12 psychoactive substances to its control list and controlled the entire class of nitazenes, a dangerous and highly potent synthetic opioid.
According to a January 2026 report in the journal Science, China’s regulatory controls and enforcement actions may have created supply shocks, leading to a decline in fentanyl potency. Online drug user communities reported sustained shortages. Lower potency, the authors argued, may have translated into fewer fatal overdoses across North America.
The recent decline in overdose deaths, evidence of a real supply side shock and the formal resumption of US-China law enforcement cooperation, offer a narrow but meaningful window for progress.
For this work to continue to be effective, it should include sharing watchlists, identifying common forensic signatures of finished drugs, and aligning actions against front companies. Done well, these measures could limit opportunities for traffickers to freely operate and challenge their ability to manufacture future synthetic drugs. Accessible treatment is also essential, along with investment in analytical capacity to stay ahead of precursor substitution.
Practical results are not only possible but likely already visible. Lower potency drugs mean fewer deaths. Technical engagement between enforcement, regulatory, and customs authorities has shown that such coordination can impact supply chains and require criminal networks to readjust at a disadvantage.
The upcoming Xi-Trump engagement is an opportunity to lock in and extend this progress by insulating counternarcotics cooperation from broader geopolitical tensions, reinforcing shared expectations around precursor control and illicit finance, and setting clear direction for sustained law enforcement operational cooperation. The value of this could show up in measurable outcomes. With sustained cooperation, the supply of illicit fentanyl can be constrained, leading to lower potency, and saving lives.
