China's 2019 fentanyl embargo led to drop in US overdoses, study finds
US President Donald Trump angered Beijing when he cited China's involvement in the fentanyl trade as the reason for imposing tariffs in February.
But new research indicates that cooperation between the two nations to crack down on the drug's trafficking can disrupt its supply chain and reduce overdose deaths.
A paper by the Peterson Institute for International Economics this month found that a 2019 embargo by China on the export of fentanyl and precursor chemicals caused a temporary spike in the drug's street price in the US, which deterred its use and reduced fentanyl-related overdose deaths by up to 25 per cent over a period of three to five months.
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Beijing imposed a strict drug control policy in May 2019, adding all fentanyl-related substances to its list of controlled substances, restricting their export.
'The Chinese embargo of fentanyl exports to the United States in May 2019 does appear to have affected prices,' the paper said, estimating that absent China's restrictions, as many as 947 more Americans would have died from a fentanyl overdose.
The Centres for Disease Control and Prevention (CDC) estimated that nationwide deaths from fentanyl overdoses from May 1 to August 1 in 2019 was 2,254, rising to 3,807 by October 1, with the total death toll for the year estimated at 34,268.
Despite the drug's addictive nature, the study found, users responded to price changes: a price rise of 1 per cent was associated with a decrease of as much as 4 per cent in the monthly growth rate of fentanyl-related overdose deaths.
Fentanyl, a synthetic opioid, is the primary driver of US drug overdoses, an issue that Washington has blamed on China, where many of the drug's precursor ingredients are produced.
The US and China have engaged in multiple rounds of negotiations related to fentanyl since Trump's first administration.
Beijing's restrictions on fentanyl came after Trump, then in his first term, met with Chinese President Xi Jinping in 2018 at the G20 summit in Argentina.
Peterson determined that a clear and immediate effect could be seen, with prices for the drug increasing in the US over a limited duration.
However, the research also indicated that as supply routes shifted into Mexico, the effect did not last.
In 2022, for example, after then-US House Speaker Nancy Pelosi visited Taiwan, Beijing suspended all counternarcotics cooperation with Washington.
The report, though, found this breakdown had no significant effect on fentanyl supply or use, indicating that the drug's supply chain had already shifted to third-country smuggling.
After the break over Pelosi's trip, cooperation resumed in November 2023 following a meeting between President Joe Biden and President Xi Jinping at the Apec summit in California.
A bilateral counternarcotics working group was formed in early 2024, but the study did not include its impact.
Fentanyl-related deaths in the US rose steadily for years, from an estimated 29,725 in 2018 to a high of 76,282 in 2023. Until 2023, CDC did not publish exact figures for fentanyl alone, instead tracking death rates involving 'synthetic opioids other than methadone'.
But the sharp upwards trend has begun to ease. According to CDC estimates, overdose deaths linked to fentanyl dropped to 48,422 in 2024.
Fentanyl has also been among the second Trump administration's primary issues with China.
In February, Trump imposed 20 per cent duties on Chinese imports – as well as 25 per cent tariffs on Mexican and Canadian imports – in the name of stopping trafficking of fentanyl into the US.
Those China tariffs remain in effect despite the talks in Switzerland this month that led to significant cuts in other levies.
As fentanyl production has shifted to Mexico, the Peterson report concluded, Washington may need to expand its focus beyond Beijing, meaning that real progress in the fight against fentanyl will require coordinated international efforts – not only with China.
'Our analysis highlights the large potential benefits of international cooperation regarding drug enforcement,' it added.
Chinese foreign ministry spokesman Lin Jian said this month that the US had used fentanyl as 'a pretext' to impose tariffs on China 'without justification', and that China would maintain its retaliatory tariffs.
He also said in a separate briefing that the tariffs 'significantly undermine the dialogue and cooperation between China and the United States in the field of counter-narcotics'.
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