Isolationist approach may stymie US bid to control fentanyl crisis

Very rarely has a pharmaceutical drug been at the centre of global geopolitical contestations, transnational organised criminal activity and public health crisis as complex as fentanyl. Starting life as a miracle pain medicine in the early 1960s and rising in popularity over the next few decades as an important analgesic and anaesthetic drug, the current status of fentanyl as a deadly killer and the central actor in the ongoing ‘opioids epidemic’ in the US, is a story with multiple dimensions.

Often referred to as the ‘opioids epidemic’, the use of fentanyl and fentanyl-like synthetic drugs has resulted in an alarming public health crisis in the US, with more than half a million drug overdose deaths directly connected with these substances being reported in the past decade. Domestically, the transition from a ‘war on drugs’ response to a ‘public-health-oriented’ approach towards opioids reduced deaths and offered positive outcomes to drug users. However, on the issue of curbing the transnational illicit manufacture and trade of fentanyl and its precursors, the US has achieved limited results. While there was a degree of agreement in US policy approaches over the past decade, the current Trump administration has shifted the goalposts. Instead of engaging with countries and institutions, the Trump administration has weaponised the fentanyl issue as an instrument of coercion through threats of imposing punitive tariffs on several countries. 

There are two key takeaways from this approach. First, the failure of the US in effective bilateral dialogue with countries such as India, China and Mexico, which have emerged as dominant geographies where illicit manufacture and trade of these substances takes place. US government reports, including the recent “Annual Threat Assessment of the US Intelligence Community 2025”, have accused them of complicity in the trade without due appreciation of actions and mechanisms put in place by these nations to tackle the fentanyl issue. The US-India cooperation on illegal drugs has been on an upward trajectory over the past decade, with the establishment of improved information-sharing mechanisms, including the bilateral Counter Narcotics Working Group, formed in 2020. These paved the way for the “US-India Drug Policy Framework for the 21st Century”, signed on 10 September 2024, which put fentanyl and precursor controls as part of the mandate on bilateral anti-drug activity. China-US co-operation, likewise, was bolstered when the dialogue process on fentanyl was started in 2018, which led to China’s control of all forms of fentanyl as a class of drugs from 1 May 2019 onwards. The dialogue process delivered effective outcomes with China leading global bans on new precursors and restricting exports, and efforts were formalised with the formation of the bilateral Counternarcotics Working Group in January 2024. However, these mechanisms and frameworks have been effectively put on deep freeze in recent months because of mounting trade tensions and policy uncertainties.

The second area of concern is the increasing lack of coordination and cooperation of the US with multilateral organisations, including the UNODC and agencies working against transnational crime, which provided an umbrella to tackle emerging threats such as the rising popularity of online marketplaces driving the illegal fentanyl trade. This has emboldened transnational criminal organisations (TCOs), including Mexican cartels, which smuggle chemical precursors from Asia, manufacture fentanyl and fentanyl-like drugs in Mexico and neighbouring countries, and then traffic them into American cities. Driven by the current US administration’s loss of faith in multilateral institutions, this isolationist approach could potentially exacerbate the US opioid crisis in the coming months and years.

In light of the current US domestic and foreign policy reset, India needs to take a pragmatic and results-oriented approach to the fentanyl and precursors issue. This approach needs to be based around three essential pivots. First, deeper engagement with the US administration and its agencies to reiterate India’s commitment to stop illicit exports and diversion from the chemicals and pharmaceutical trade. Second, proactively tackle illegal domestic production by streamlining information-sharing modalities between central and state agencies, while also developing a quicker and more efficient enforcement paradigm. Third, strengthening existing bilateral and multilateral anti-trafficking and narcotic control mechanisms, and fostering greater co-operation with important partners like China and Mexico. Working in tandem, these measures have the potential to make dents in the global illegal fentanyl trade. 

 

(The writer is a Senior Research Fellow at the International Centre for Drug Policy Studies, Shanghai University)