A DEA instructor holds a bag of drugs containing nitazenes (DEA photo)
Nitazenes: The Newest Synthetic Opioid Threat From China
A new synthetic opioid potentially 40 times deadlier than fentanyl is wreaking havoc on American streets. Despite the work of law enforcement and regulators, nitazenes continue to proliferate around the world due to China-based transnational crime organizations (TCOs), potentially having enormous impacts on U.S. public health and safety. While the U.S.’s counter-nitazene approach is on the right track, further progress can be made through additional diplomatic, customs, and harm reduction approaches.
Developed as a potential alternative to morphine, nitazenes activate the same receptors in the brain as heroin and fentanyl. However, due to their high addictive potential, severe withdrawal symptoms, and toxicity, they were never approved for medical use. Nevertheless, nitazenes’ high potency has led criminal organizations to cut them into other illegal drugs. Chinese organized crime groups appear to be the prime culprits, using online sales and common air and ground mail carriers to transport them to the United States. Since nitazenes’ first appeared in the U.S. in 2019, the DEA has received almost 7,000 reports and estimates they are responsible for 2,000 deaths.
The current U.S. counter-nitazene strategy consists of public awareness and law enforcement measures. The Trump administration has also sought to incentivize China to take stronger action against its domestic manufacturers and sellers through a 20% “Fentanyl Tariff” on all Chinese imports. American states and other countries have also taken steps to ban them. Nevertheless, TCOs continue to spread nitazenes into global illicit drug supplies using Chinese suppliers. Thwarting these supply chains will require increased Chinese domestic drug enforcement, improved border security, and a renewed focus on harm reduction.
First, the U.S. should use diplomacy to incentivize China to disrupt its domestic nitazene supply chains. Chinese cooperation with the U.S. on opioids has been inconsistent for two main reasons. Until only recently, China has judged substantive narcotics cooperation with the US to be against their strategic interests. Additionally, since China has a less severe problem with fentanyl, it is viewed as America’s problem to solve. However, the U.S. has both carrots and sticks available to encourage China to counter nitazene production and sales.
To do this, the Trump administration should grant its party to the U.S.-PRC Counternarcotics Working Group the authority to drop the 20% “Fentanyl Tariff” in exchange for increased action on nitazenes. Should China refuse, the U.S. can publicly name and shame China-based entities proven to be involved in the manufacture or online sales of nitazenes, an approach that has produced prior cooperation. By utilizing its ability to effect China’s economic goals and global reputation, the U.S. can motivate China to take increased action against domestic producers and sellers, countering nitazenes at their source.
Additionally, the U.S. should increase and improve its international mail facilities (IMFs) to improve drug detection. As of 2021, the U.S. had 9 IMFs which screened all incoming mail to the U.S. However, the 2022 closure of the San Francisco IMF has likely resulted in an increased burden on the other 8 facilities. Furthermore, a 2023 DHS report identified the presence of critical deficiencies at multiple IMFs and limited screening capabilities at the San Juan IMF. As most nitazenes enter the U.S through these points of entry, the reduced capacity of these faculties may be allowing nitazenes into the United States. To remediate this, the Trump administration should prioritize the re-opening of the San Francisco IMF to allow more thorough package inspections at all facilities. Increasing and improving nitazene detection capabilities at their most likely point of entry can greatly reduce their overall supply in the U.S.
While these strategies are being employed, harm reduction at home should be a top priority. Harm reduction seeks to reduce the negative effects of drug addiction though increasing the availability of overdose-reversing drugs, drug substitution programs, and safe injection sites. The Trump administration is currently directing federal funding away from existing state and local harm reduction programs under grounds of enabling addiction. However, harm reduction approaches have already been proven to decrease overdose deaths, slow the spread of diseases such as HIV/AIDS, and can increase the chances of rehabilitation. Moreover, harm reduction has been proven to be more cost-effective than traditional approaches. While the optics of harm reduction can be unpalatable, they can greatly reduce the impact of nitazenes that do make it into the United States.
While the US is not completely defenseless, delaying further action against nitazenes could put the U.S. at greater risk. Further diplomatic engagement with China, improved postal security, and harm reduction strategies can mitigate that risk by preventing TCOs from profiting at the U.S.’s expense.
