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Why one expert says America's fentanyl crisis has geopolitical roots


In 2022, nearly 110,000 Americans died from drug overdose, according to preliminary data from the CDC. That's an average of about 300 people per day. As the opioid crisis escalates, the U.S. continues to grapple with solutions on how to combat it. One expert argues that this public health crisis also has geopolitical roots. That expert joins me now. Vanda Felbab-Brown is a senior fellow at the Brookings Institution. Welcome to ALL THINGS CONSIDERED.

VANDA FELBAB-BROWN: Thank you very much.

SUMMERSS: So we know that pharmaceutical companies are the main driver of the opioid crisis. Their complicity is the subject of a number of lawsuits and news reporting that we don't have time to get into here, but you argue that this crisis can also be considered a geopolitical issue. Can you just explain that point to us briefly?

FELBAB-BROWN: So the opioid crisis started with pharmaceutical companies in the 1990s making fallacious claims about the lack of addictive qualities of pharmaceutical palliative like OxyContin, but since that moment, a lot has changed in terms of U.S. domestic regulation and a lot has changed in the U.S. drug market - specifically, starting about 2013, fentanyl, at the time produced in China, started entering the U.S. market. As a result of actions of the U.S. government that persuaded the government of China to schedule fentanyl-class drugs, the market has changed to firms, traders, dealers, brokers in China producing and selling precursor chemicals to Mexican cartels that are then producing fentanyl in Mexico and shipping it to the United States. The traffickers themselves have taken it upon themselves to mix fentanyl into all kinds of substances.

SUMMERSS: Many of the drugs we're talking about are being trafficked by non-state actors like cartels and other criminal networks, and you wrote in your piece about how drug producers can easily tweak their recipes whenever a particular substance is banned or restricted. So practically speaking, what are one or two things that can be done to deal with the fentanyl that is coming into the United States?

FELBAB-BROWN: Trying to resurrect cooperation with China and Mexico is important. We have more or less exhausted soft approach with Mexico. Perhaps it is an important time right now to start thinking about other measures - increasing inspections at the U.S.-Mexico border, even if this will have economic consequences for Mexico, also for the United States. After all, putting aside the immense human cost of the fentanyl epidemic, the economic cost is over $1 trillion and growing worse. Second, we should not shy away from indicting Chinese and Mexican officials and businessmen that are complicit either in the illegal trade or in subverting cooperation.

SUMMERSS: You've made the case that tackling this issue as a geopolitical one is going to require a shift in mindset, but I want to ask you - do you really think that's possible? Lawmakers in the United States can't agree on much of anything lately, let alone how to deal with very complicated geopolitics.

FELBAB-BROWN: The change that should happen is how we respond with respect to law enforcement, namely to get away from simply thinking of the cartels as movers of illegal contraband, illegal drugs and really tackling every single dimension of economic and political activity in which they are involved. Is it easy politics? Absolutely not, but there are the dimensions that don't require complex politics, such as the expanded anti-organized crime task forces featuring a much wider set of agencies, adopting a whole-of-government approach that breaks down the stovepiping around countering criminal groups that is still very much present in the Department of Defense, the Department of State and Homeland Security.

SUMMERSS: Vanda Felbab-Brown is a senior fellow at the Brookings Institution. Her piece, "Why America Is Struggling To Stop The Fentanyl Epidemic: The New Geopolitics Of Synthetic Opioids," is in Foreign Affairs. Thank you so much for being here.

FELBAB-BROWN: My pleasure. Transcript provided by NPR, Copyright NPR.

Erika Ryan
Erika Ryan is a producer for All Things Considered. She joined NPR after spending 4 years at CNN, where she worked for various shows and CNN.com in Atlanta and Washington, D.C. Ryan began her career in journalism as a print reporter covering arts and culture. She's a graduate of the University of South Carolina, and currently lives in Washington, D.C., with her dog, Millie.
Tinbete Ermyas
Juana Summers
Juana Summers is a co-host of NPR's All Things Considered, alongside Ailsa Chang, Ari Shapiro and Mary Louise Kelly. She joined All Things Considered in June 2022.