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Explainer: Why blaming China won't address opioid epidemic in America?

(Xinhua) 13:38, September 20, 2023

NEW YORK, Sept. 19 (Xinhua) -- The United States has chosen to place the blame squarely on China for its opioid epidemic and released a presidential memorandum singling out China as one of the major drug transit or illicit drug-producing countries.

The die-hard epidemic, primarily fueled by the abuse of opioids, notably fentanyl, has surpassed both gun violence and car accidents as the leading cause of accidental deaths in the United States.

While the crisis remains complex, a significant part of this prolonged issue can be attributed to domestic factors, including overprescribing legal pain medications and insufficient and fragmented anti-drug strategies tainted by questionable connections between pharmaceutical companies and politicians.

The opioid epidemic continues to devastate communities across the United States. Rather than tackle the roots of the problem, the United States has instead resorted to blaming China.

CHEAP, ABUNDANT STREET DRUGS

Fentanyl and its derivatives sufentanil, alfentanil and remifentanil, are all synthetic phenypiperidine drugs, which are synthetic opioid receptor agonists.

A painkiller for countless patients, fentanyl has many side effects. The drug has gradually become a menace to social security across the United States, a society long plagued by opioid addiction and abuse.

Statistics by the Council on Foreign Relations in April indicated that opioids, primarily fentanyl, are the leading cause of U.S. overdose deaths, which have roughly quadrupled over the last 10 years for which data is fully available. In 2021, the death toll surged to 80,411, more than 10 times the number of U.S. military service members killed in the post-9/11 wars in Afghanistan and Iraq.

There have been three waves of opioid abuse in U.S. society, with fentanyl being the "main character" of the third wave.

The first wave began around 1991 when some pharmaceutical companies invested heavily to fund experts and organizations to promote the harmlessness of opioids, lobbying physicians to prescribe them indiscriminately and pharmacies to sell them aggressively.

On the one hand, this practice led to a "painkilling culture" in American society, in which people were accustomed to using painkillers as a symptomatic but not a curative way of coping with illnesses. On the other hand, it led to a sharp increase in the prescription of opioids, and the number of deaths caused by opioids rose sharply. The most typical example is OxyContin, a drug developed by U.S. pharmaceutical company Purdue Pharma. From 1999 to 2017, 200,000 Americans died from overdoses related to OxyContin and other prescription opioids. Ultimately, Purdue Pharma was sued.

The second wave started around 2010. As opioid pills became more difficult to obtain consistently by prescription and on the street, drug users, especially young and new users, transitioned to heroin.

Its potency, accessibility and affordability fueled the grip of this insidious drug. From 2002 to 2013, heroin-related overdose deaths surged by 286 percent. A 2013 study showed about 80 percent of heroin users reported their previous addiction to prescription opioids. After fentanyl entered the market, its ubiquity meant many unsuspecting users risk being killed by the drug.

The third wave is mainly driven by synthetic opioids, primarily illicitly manufactured fentanyl. Fentanyl, up to 50 times stronger than heroin and 100 times stronger than morphine, became the new cash cow of the illicit drug industry.

Drug dealers mix cheaper fentanyl with heroin or counterfeit pills to boost profit and cut transportation risks, which means many patients developed fentanyl use disorder without the slightest knowledge. The consequence? An alarming surge of fentanyl-related overdose deaths.

Cheaper and more potent substances drive each wave of the drug overdose epidemic. The research community is warning that fentanyl overdose and mental health struggles characterize Wave Four.

More alarmingly, with fentanyl use spiraling upward, victims of opioids are changing. Across the United States, the drug kills disproportionately, with Black people suffering a higher rate of deaths than Whites, and those aged below 45 hit the hardest, according to Bloomberg.

WASHINGTON'S BOTCHED RESPONSE

Today, the epidemic is wreaking havoc on the U.S. economy and workforce. Although fully aware of the problem, Washington seemed at its wits' end over how to fix it fundamentally. At times, it seems uninterested.

Without investing sufficient resources in helping patients, the U.S. government left hundreds of thousands of citizens at the mercy of new and more powerful drugs, condemning itself to endure more tragedies.

According to the U.S. Centers for Disease Control and Prevention, 107,375 people in the United States died of drug overdoses and drug poisonings in the 12 months ending in January 2022, with a staggering 67 percent of them involving synthetic opioids like fentanyl.

In April, Mexican President Andres Manuel Lopez Obrador questioned the U.S. strategy against the fentanyl crisis, saying it relied on "palliatives" instead of tackling the roots of the problem.

Behind a botched response from previous U.S. administrations and the incumbent Biden administration is a sophisticated institutional fabric that has long frayed efforts to address the epidemic.

First, U.S. politicians buckle under money politics.

Sizable political donations from pharmaceutical companies require them to turn a blind eye instead of formulating policies to control fentanyl use.

The United States, a major chemical raw material country, has taken few steps to halt the spread of fentanyl-related substances.

By contrast, China took the lead in including the entire category of fentanyl-related substances in a controlled regulatory list as early as in May 2019, a step conducive to preventing illicit manufacturing, trafficking and abuse of the substance.

As the British newspaper The Guardian reported in 2017, pharmaceutical companies in the United States spent far more than any other industries to influence politicians. "Drugmakers have poured close to 2.5 billion U.S. dollars into lobbying and funding members of Congress over the past decade."

Furthermore, nine out of 10 members of the House of Representatives and all but three of 100 senators have "taken campaign contributions from pharmaceutical companies seeking to affect legislation on everything from the cost of drugs to how new medicines are approved."

Moreover, medical representatives, who play a vital role in the U.S. medical system, lobby doctors to prescribe medicines through lectures and funding, giving rise to more addictions.

Second, political polarization hinders drug control.

While both parties admit they must tackle fentanyl abuse as the problem gets increasingly out of control, they stumble over each other and stall progress.

In May, the Republican-led House of Representatives approved the Halt All Lethal Trafficking of Fentanyl Act in a 289-133 vote that saw 132 Democrats oppose the bill even though the White House signaled support for it.

American politicians know that various factors, including domestic politics, the economy and social divisions, triggered this fentanyl crisis. It did not develop overnight, nor can it be resolved overnight.

However, Washington finds it much easier to blame China for its own inadequate supervision of fentanyl when the problem is, in essence, demand-driven and a product of U.S. institutional failure.

The United States must look within, strengthen regulation and control of prescription drugs at home, step up public awareness campaigns about narcotics harm, and reduce domestic demand for drugs instead of smearing and discrediting other countries.

Such irresponsible acts are detrimental to the worldwide campaign against drug abuse, nor can they help the United States fix an intractable scourge at home.

(Web editor: Zhang Kaiwei, Liang Jun)

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