Overdose deaths from the painkiller fentanyl are rising steeply and it’s clear President Donald Trump blames China for failing to stop illegal exports of the drug.
Around 60,000 Americans have died taking the drug over the past two years, according to official figures.
The painkiller is the most used synthetic opioid.
Fentanyl was introduced to the US in the 1960s as an anaesthetic billed as a hundred times more powerful than morphine and a dose of just two milligrams can prove fatal. The main use is to manage pain for cancer sufferers and other terminally ill patients.
Although the drug is available at hospitals and on prescription, a thriving black market driven by imports from China through Mexico and Canada allows dealers to sell the fentanyl, often mixed with heroin or cocaine.
Cost is the main driver of the drug’s popularity.
Dealers can buy fentanyl as a powder cheaply online for between $1,700 and $3,500 a kilo. The dosage for a pill is so small, hundreds of thousands can be created easily in a makeshift lab from the kilo bag and sold at $10 to $20 each.
The gangs selling the tablets are big business. Just 100,000 pills generates income of $1.7 million on the black market.
Trump wants China to tackle the smuggling of illicit fentanyl to the US.
He claims Chinese premier Xi Ping agreed to this but has failed to act.
However, academic Roger Bate, of the American Enterprise Institute, has published a fentanyl study that suggests even if China acted to stop trading the drug, the problem would persist.
“Fentanyl use is widespread, its effects are devastating, and that it will be difficult to address importation even with the assistance of Chinese authorities,” he said.
He says fentanyl use is soaring. US customs officers seized just a kilo of the drug in 2013. That rose to around 17,000 kilos in 2016, the last period figures are available for. At the same time, legal sales have dropped.
Sellers advertise openly online in China, but identifying them is almost impossible without the help of the Chinese authorities, Bate added.