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Who is responsible for the United States’ opioid epidemic? According to the US secretary of state, Antony Blinken, the culprits are “transnational criminal enterprises” who need to be tackled via international law enforcement operations. But according to Chinese state media, “the fentanyl crisis in the United States is demand-driven”, primarily by “the users themselves”. Blinken was speaking at the launch of a US-led coalition to address synthetic drug threats, which gathered virtually last week. China, which many US lawmakers blame for the crisis, declined to participate. (Opioid crisis: US and China at odds over influx of fentanyl).
[Secretary Blinken] underscored the importance of working together to disrupt the global flow of synthetic drugs and their precursor chemicals into the United States, which fuels the fentanyl crisis. (Secretary Blinken’s Visit to the People’s Republic of China (PRC))
The flow of fentanyl into the United States in 2019 is more diverse compared to the start of the fentanyl crisis in 2014, with new source countries and new transit countries emerging as significant trafficking nodes. This is exacerbating the already multi-faceted fentanyl crisis by introducing additional source countries into the global supply chain of fentanyl, fentanyl-related substances, and fentanyl precursors. Further, this complicates law enforcement operations and policy efforts to stem the flow of fentanyl into the United States. While Mexico and China are the primary source countries for fentanyl and fentanyl-related substances trafficked directly into the United States, India is emerging as a source for finished fentanyl powder and fentanyl precursor chemicals. (DEA Intelligence Report 2020)
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The management of flows of fentanyl has become an important element of the cluster of policies meant to control markets for suppressed goods, or to suppress markets for interdicted goods. The friction between the United States and China has complicated at least one facet of this global effort.
One has a fairly good sense of the position of the United States. It is always useful to gain a greater knowledge of the development of thinking from China. In aid of that effort it may be worth considering a short essay recently published by ZHA Daojiong (查道炯), Professor School of International Studies, Institute of South-South Cooperation and Development, at Peking University. The essay follows below in the original English and a crude English translation.
As one reads this it may be worth noting his four point proposal. It may provide a window on at least one approach to managing the issue from the Chinese side.
First is the argument from the position of rhetoric. Zha first suggests to turn the US rhetoric of China and fentanyl on its head. Rather than attack statements that China is a prime supplier of the drug or its components, China should embrace the position precisely because fentanyl is legitimately used virtually everywhere. Since there is a legitimate market for the product there is no need to pretend that its manufacture is implicitly illicit.
Second is the argument from self-interest. Zha argues that although the U.S. response to the fentanyl crisis does have elements of exporting its demand driven drug crisis outward, it is in China's interest to pursue functional cooperation and seeking the greatest common denominator of cooperation. Indeed, the drug fueled dissipation that marked American drug society may serve usefully as an offshore laboratory to study its effects on society with lessened threat to the Chinese homeland with the object to prevent a large-scale drug abuse crisis in this country.
Third is the argument from the position of win-win internationalism. Cooperation can be fashioned to align with global interdiction campaigns and Chinese interests in protecting its own social order. Cooperation, in this case is not merely with the US, but aligned with multilateral efforts tied to the UN systems.
The fourth is from the perspective of the protection of China's image on the global stage. It may be useful to reduce the narrative power of the American position by recasting it as a reflection of its internal politics and fractures. to reduce its effects on the way that China is regarded in the international community. Cooperation may be a useful means of advancing that objective.
中美关系︱芬太尼问题：坚持功能性合作的国际道义性
查道炯
2023-08-07 18:13
来源：澎湃新闻 ∙ 澎湃研究所 >
近几年，“芬太尼”从一个不常见甚至陌生的名词变成了中美关系中绕不开的议题之一。基本态势是美方主动，从指责中方在国际打击毒品合作中不力转向采取针对中国实体和个人诉讼、逮捕、制裁等措施。在舆论层面，越来越多的关注双边政治关系的美国学者认为，如果中美在芬太尼的跨国流动领域若是合作更为顺畅，将有利于降低美国政界对中国的敌意。
在情绪弥漫的社交媒体时代，基于事实描述去讨论双边关系和跨国性议题，对两国的研究者来说，尤为重要。而从了解芬太尼是什么入手，或许是一个不错的开始。
芬太尼是什么
芬太尼是一种合成阿片类药物，最初是作为手术镇痛剂或止痛药而开发的。其效力比海洛因强大约50倍，比吗啡强100倍。
自二十世纪五十年代末问世后，含有芬太尼成分的药物1963年在英国、1968年在美国、1974年在中国获准上市销售。 2017年世界卫生组织将芬太尼增列入其《基本药物标准清单》，供成员国选用。
药用（合法）芬太尼剂型齐全，包括粉末、片剂、注射剂、胶囊、溶液、贴剂、鼻腔喷雾剂等。它适用于成人和儿童，特别是在医院手术治疗过程中，是控制剧烈疼痛的良药。在遵守医嘱的情形下，晚期癌症患者也可通过服用芬太尼而减轻病痛。兽用芬太尼的效力是吗啡的一万倍，不能用于人类临床，且仅可用于大型动物。
非法（生产和销售）芬太尼也是合成品，形态多样，无色无味，其作用类似大麻、海洛因。非法芬太尼可以添加到其他药物中，使它们更便宜、更有欺骗性、更容易导致上瘾。芬太尼与任何（合法与非法）药物混合都会增加因过量吸入而致命的可能性。例如，卡芬太尼（一种从芬太尼中提取的类似物），其药效是芬太尼的100倍，仅需 0.02 毫克（相当于几粒盐）就有可能导致呼吸抑制和骤停、失去意识、昏迷和死亡。
就了解芬太尼的跨国流通所涉及的话题而言，有几个概念至关重要。
一是芬太尼衍生物（derivatives）。芬太尼这种化合物具有特定的化学结构，其药效变化可以通过修改一个或多个区域来实现。从理论上讲，通过微小的化学结构改变即可形成一个新的可能效力更强、毒性更大的化合物，而这种改变所产生新化合物是没有穷尽的。
二是芬太尼类似物（analogs）。特别是在非法流通过程中，存在多种化学结构上类似但不易检测的芬太尼类物质。对从事海关和药品市场监管的一线人员而言，这是一个极大的挑战，如果不使用芬太尼试纸或试剂，几乎不可能判断某种申报为药物的材料或药品是否含有芬太尼。事实上，试纸或试剂也可能无法检测到快速翻新的芬太尼类药物。
三是芬太尼前体（precursors）。这个概念主要指用于合成芬太尼的原料性质的化合物，由于芬太尼及其类似物可以通过多种方法合成，所以涉及的化学原料众多。一方面，这些材料为医疗、工业或商业用途所需，是合法的。另一方面，自芬太尼问世以来，预防干预其滥用以及打击非法制造和贩运，便一直是国际合作努力的方向。
在联合国框架下，《麻醉品单一公约》（1961年）和《禁止非法贩运麻醉药品和精神药物公约》（1988年）提供了将芬太尼前体及其衍生物列入成员国都有义务管制清单的法律机制。一种芬太尼前体从发现、报告到列入国际管制，需要经历一个专业判断的过程——2016年管制清单上的芬太尼前体为十六种，2017年增加两种，2022年又增加三种。
简而言之，“芬太尼”是一个基于实物和场景所指而多元、内涵复杂的名词。合法使用的芬太尼属麻醉药品和精神药品，在有效监管使用的场合，对适用的患者来说是“天使”；但在不当或非法使用场合，特别是毒品市场，芬太尼则是“魔鬼”。各国对于芬太尼的成药、衍生品和前体，都有合法的需求；但在这些合法需求之外，芬太尼则是人类公敌，存在成熟的国际机制，以谋求对其实施有效监管和流通阻断。
芬太尼与中美功能性合作
禁毒是中美功能性合作的领域之一。在国际关系研究文献中，“功能性合作”是指政府间就双方关切的社会性和跨国性议题采取的合作，鉴于相关议题超越政治之外的意涵，双方在互动过程中往往淡化外交分歧，以求达成共识。
中美1985年开始双边禁毒合作。两年后签订的《中美禁毒合作备忘录》为建立和维持功能性合作提供了框架，两国的公共卫生、司法和海关等业务部门参与其中。2003 年，双方建立禁毒合作情报交流会机制，从2018年第九届中美禁毒情报交流会如期举行看，机制的运行没有受到美国对华政策转向竞争与对抗态势的影响。
多年来，就芬太尼进行管制与合作是中美双方业务部门探讨的内容之一。还是在两国政治外交态势发生巨变的背景下，2019 年 9 月，美国白宫国家禁毒政策办公室主任到访北京，与中方就毒品溯源分析技术、防范寄递物流涉毒犯罪以及芬太尼类物质管控等问题深入交换了意见，两国在情报交流与数据共享方面的合作进一步加强。
中美在毒品打击领域合作的内容还包括：加强联合执法和办案力度，共同承诺打击非法芬太尼类物质。2019年11月，两国联合成功破获首起走私芬太尼案件，中国公安部禁毒局与美国国土安全部移民海关执法局共享情报信息与交换证据材料，全链条摧毁了一个非法加工、贩卖、走私芬太尼等毒品的犯罪团伙。
在中国，合法生产的芬太尼类药品从未发生流弊，社会面并不存在芬太尼类物质滥用问题。不过，公安部、国家卫生健康委员会和国家药品监督管理局仍于2019年4月发布公告，将芬太尼类物质列入非药用类麻醉药品和精神药品管制品种增补目录。这意味着此后可能出现的所有芬太尼类物质在中国均被视为非药用类麻醉药品和精神药品而受到严格管制，包括生产和合法出口。这在联合国禁毒委员会成员国中属首创。
在美国，芬太尼的滥用和非法使用已造成重大的公共健康危机。根据美国疾控中心的统计，2021年有八万美国人死于药物滥用，主要是对芬太尼的滥用。美国缉毒署等机构认为，中国是美国毒品市场上芬太尼的主要供应者，来自中国的芬太尼类物质，以及生产芬太尼所需的压片机和其他机械，或是直接进入美国，或是经由墨西哥进入美国。
拜登政府执政期间，美方升级了针对中方实体和个人的单边司法行为。例如，2020年5月美国商务部将中国公安部物证鉴定中心、国家毒品实验室列入出口管制实体清单。而这两个实体却是中国打击芬太尼非法流通的重要机构，负责鉴定和监测芬太尼及其类似物，并向联合国提供数据。
2023年6月，中国国家药监局和美国食品药品管理局恢复接触，就2023年以及未来合作等内容进行交流。打击毒品是药监工作的一部分。也就是说，中美间的毒品打击合作开始回到功能性合作轨道。
中方的选项
“芬太尼”，不论其具体所指为何，仅仅是美国治理其阿片类药物滥用现象中被突出应对的物质之一。美国政府“反毒品战争”（war on drugs）早于1971年就开始了，其教训表明，美国需要采取更全面的方法来管理其药物使用不当而导致的公共健康危机，而不仅仅是依靠对国外供应来源的控制。然而，尽管在政策设计、政策措施上都饱受争议，这场战争一直是，将来也会继续是，美国国内公共健康治理及治理政治向外交领域外溢的基本面。
面临美方对华政策总体态势短期不会改变的局面，在芬太尼的跨国流通议题上，如何应对才有利于中方的利益？
首先，对“中国是全球芬太尼的主要来源国”一类的说辞，中方没有必要将之定性为恶意相向。这是因为作为一种物质和产品，芬太尼，包括其前体和衍生物，在全世界都有合法使用的需求。至于非法生产而出现的芬太尼类似物，问题出在药物监管等公共健康治理环节，而在国际间公共健康治理的权限范畴是以国家为单位的辖区划界的。这些都是常识。
其次，尽管美国的芬太尼危机应对确有“内病外治”的成分，但这并不应改变中方坚持以功能性合作的精神继续与美方交流、谋求合作的最大公约数的基本价值取向。而且，任何一种药物在任何一个社会发生滥用都是另一个社会的前车之鉴的认知，中方的专业人员、研究机构、公共健康和司法等部门从与美方交流中所得到的是有用的知识和警示，对防范本国也出现大规模药物滥用危机是有益无害的。
第三，非法药物的跨国流通是人类历史上的持久性现象，也是各国药物监管和司法部门所必须常规性应对的议题。对任何一个政府的药物监管和司法部门而言，面对挑战，“计划赶不上变化”是常见的现象。特别是在互联网中的“暗网”等渠道常被不法分子和犯罪分子所用的情形下，通过与美国等其他国家、以及联合国等多边机制的交流，有利于中方打击自身社会也难免存在的违法行为。
第四，美国的政界人士将“芬太尼危机”与“中国”挂钩，有其自身的动力和逻辑，是美国国内政治生态的一部分。中方不能低估此类言辞在美国国内乃至更广泛的国际社会煽动性力量。美方是否改变或撤销对相关中国实体所实施的制裁措施，也有可能与未来中方的实际举措关联不紧密甚至无关。即便如此，维护中美禁毒情报合作交流会等机制的功能性合作性质，依然有价值，也有必要性。
总而言之，在“芬太尼”等禁毒事业上，中方坚持专业性、功能性合作方向，与包括美国在内的所有国家以及国际组织交流、合作，是否能像一些美国学者所预测的那样降低美国政界对中国的敌意，并不重要。重要的是，我们通过国际禁毒交流与合作，在当今和未来世界上守住道义高地，也同时为中国自身谋得与其他国家在毒品流通领域（包括流入中国的场合）的合作创造更为有利的条件。如是，才能做到“有理、有利、有节”。
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查道炯，系北京大学国际关系学院、南南合作与发展学院教授。
Sino-US Relations︱The Fentanyl Issue: Adhere to the International Morality of Functional Cooperation
ZHA Daojiong
2023-08-07 18:13
Source: The Paper
∙ The Paper Institute >
In recent years, "fentanyl" has changed from an uncommon or even unfamiliar term to one of the unavoidable issues in Sino-US relations. The basic situation is that the United States took the initiative, shifting from blaming China for its ineffective international anti-drug cooperation to adopting measures such as lawsuits, arrests, and sanctions against Chinese entities and individuals. At the level of public opinion, more and more American scholars who pay attention to bilateral political relations believe that if China and the United States cooperate more smoothly in the field of transnational flow of fentanyl, it will help reduce the hostility of American political circles towards China.
In the age of emotional social media, it is especially important for researchers from both countries to discuss bilateral relations and transnational issues based on factual descriptions. It may be a good start to start by understanding what fentanyl is.
what is fentanyl
Fentanyl is a synthetic opioid that was originally developed as a surgical analgesic, or pain reliever. It is approximately 50 times more potent than heroin and 100 times more potent than morphine.
Since its introduction in the late 1950s, drugs containing fentanyl were approved for marketing in the UK in 1963, the US in 1968, and China in 1974. In 2017, the World Health Organization added fentanyl to its "Model List of Essential Medicines" for selection by member states.
Medicinal (legal) fentanyl comes in a wide range of dosage forms, including powders, tablets, injections, capsules, solutions, patches, nasal sprays, and more. It is suitable for adults and children, especially during surgical treatment in the hospital, and is a good medicine for controlling severe pain. Patients with advanced cancer can also experience pain relief by taking fentanyl when prescribed by their doctor. Veterinary fentanyl is 10,000 times more potent than morphine, so it cannot be used clinically in humans, and it can only be used in large animals.
Illegal (produced and sold) fentanyl is also a synthetic product in various forms, colorless and odorless, and its effects are similar to marijuana and heroin. Illegal fentanyl can be added to other drugs to make them cheaper, more deceptive, and more addictive. Mixing fentanyl with any drug (legal and illegal) increases the likelihood of a fatal inhalational overdose. For example, carfentanil (an analog derived from fentanyl), which is 100 times more potent than fentanyl, can cause respiratory depression and seizures with as little as 0.02 mg (a few grains of salt). stop, loss of consciousness, coma and death.
Several concepts are critical to understanding the topics involved in the transnational movement of fentanyl.
One is fentanyl derivatives. Fentanyl, a compound with a specific chemical structure, can be altered by modifying one or more regions. Theoretically, there is no end to the number of new compounds that could be created with a small change in chemical structure to potentially be more potent and toxic.
The second is fentanyl analogs. Especially in the process of illegal circulation, there are a variety of fentanyl-like substances that are chemically similar but not easy to detect. This is a great challenge for front-line personnel engaged in customs and drug market supervision. Without the use of fentanyl test strips or reagents, it is almost impossible to determine whether a material or drug declared as a drug contains fentanyl. In fact, the quick-refurbished fentanyls may not be detected by the dipstick or reagent, either.
The third is fentanyl precursors (precursors). This concept mainly refers to the compounds used to synthesize fentanyl as raw materials. Since fentanyl and its analogs can be synthesized by various methods, there are many chemical raw materials involved. On the one hand, these materials are required for medical, industrial or commercial use and are legal. On the other hand, since the advent of fentanyl, the prevention and intervention of its abuse and the fight against illicit manufacturing and trafficking have been the direction of international cooperation efforts.
Under the framework of the United Nations, the "Single Convention on Narcotic Drugs" (1961) and the "Convention against Illicit Traffic in Narcotic Drugs and Psychotropic Substances" (1988) provide for the inclusion of fentanyl precursors and their derivatives. List of legal mechanisms. A fentanyl precursor needs to go through a process of professional judgment from discovery, reporting to inclusion in international control-there are 16 fentanyl precursors on the control list in 2016, two more in 2017, and 2022 Add three more.
In short, "Fentanyl" is a term with multiple and complex connotations based on objects and scenarios. Legally used fentanyl is a narcotic drug and psychotropic substance, and it is an "angel" to applicable patients when it is effectively regulated; but it is an "angel" when it is inappropriate or illegal, especially in the drug market. devil". All countries have legal needs for fentanyl's finished medicines, derivatives and precursors; but beyond these legal needs, fentanyl is the public enemy of mankind, and there is a mature international mechanism to seek effective supervision and protection against it. Circulation blocked.
Fentanyl and functional cooperation between China and the United States
Drug control is one of the areas of functional cooperation between China and the United States. In international relations research literature, "functional cooperation" refers to cooperation between governments on social and transnational issues of concern to both parties. Given that the relevant issues have implications beyond politics, the two sides often downplay diplomatic differences during the interaction process , in order to reach a consensus.
China and the United States began bilateral drug control cooperation in 1985. The U.S.-China Memorandum of Understanding on Narcotics Cooperation, signed two years later, provided the framework for establishing and maintaining functional cooperation, involving the public health, justice, and customs sectors of the two countries. In 2003, the two sides established the anti-drug cooperation intelligence exchange meeting mechanism. Judging from the 9th Sino-US anti-drug information exchange meeting held as scheduled in 2018, the operation of the mechanism has not been affected by the US policy toward China turning to competition and confrontation.
Over the years, the control and cooperation on fentanyl has been one of the contents of discussions between the business departments of China and the United States. Still in the context of dramatic changes in the political and diplomatic situation of the two countries, in September 2019, the director of the Office of National Narcotics Policy of the White House visited Beijing to discuss with the Chinese side on drug traceability analysis technology, prevention of drug-related crimes in delivery logistics, and control of fentanyl-related substances. They exchanged in-depth views on issues such as these, and the cooperation between the two countries in intelligence exchange and data sharing has been further strengthened.
The cooperation between China and the United States in the field of drug crackdown also includes: strengthening joint law enforcement and case handling, and jointly committing to crack down on illegal fentanyl-like substances. In November 2019, the two countries jointly successfully cracked the first case of smuggling fentanyl. The Narcotics Control Bureau of the Ministry of Public Security of China and the Immigration and Customs Enforcement Bureau of the Department of Homeland Security of the United States shared intelligence information and exchanged evidence materials, destroying a whole chain of illegal processing, trafficking, Criminal gangs that smuggle drugs such as fentanyl.
In China, legally produced fentanyl drugs have never been abused, and there is no problem of fentanyl abuse in society. However, the Ministry of Public Security, the National Health Commission and the State Drug Administration still issued an announcement in April 2019 to include fentanyl-like substances in the Supplementary Catalog of Controlled Varieties of Non-medicinal Narcotic Drugs and Psychotropic Substances. This means that all fentanyl-like substances that may appear since then are regarded as non-medicinal narcotic drugs and psychotropic substances in China and are subject to strict control, including production and legal export. This is the first of its kind among member states of the United Nations Narcotics Control Commission.
The abuse and illicit use of fentanyl has created a major public health crisis in the United States. According to statistics from the US Centers for Disease Control and Prevention, 80,000 Americans will die from drug abuse in 2021, mainly fentanyl. The U.S. Drug Enforcement Administration and other agencies believe that China is the main supplier of fentanyl in the U.S. drug market. Fentanyl-like substances from China, as well as tablet presses and other machinery needed to produce fentanyl, or directly enter the U.S. , or enter the United States via Mexico.
During the Biden administration, the United States has escalated its unilateral judicial actions against Chinese entities and individuals. For example, in May 2020, the U.S. Department of Commerce included the Physical Evidence Identification Center of the Ministry of Public Security of China and the National Narcotics Laboratory in the list of export control entities. These two entities are important agencies in China to combat the illegal circulation of fentanyl, responsible for identifying and monitoring fentanyl and its analogues, and providing data to the United Nations.
In June 2023, the State Food and Drug Administration of China and the US Food and Drug Administration resumed contact and exchanged views on 2023 and future cooperation. Combating drugs is part of the work of drug supervision. That is to say, the cooperation in drug fight between China and the United States has begun to return to the track of functional cooperation.
Chinese option
"Fentanyl," whatever its specific designation, is just one of the substances that has been highlighted in America's fight against its opioid abuse phenomenon. Lessons from the U.S. government's "war on drugs," which began as early as 1971, show that the U.S. needs to take a more holistic approach to managing its public health crisis from inappropriate drug use, not just relying on Control of foreign sources of supply. However, despite the controversy over policy design and policy measures, this war has always been, and will continue to be, the fundamental aspect of US domestic public health governance and the spillover of governance politics to the diplomatic sphere.
Facing the situation that the overall situation of the US policy toward China will not change in the short term, how to deal with the issue of cross-border circulation of fentanyl is in the interests of China?
First of all, there is no need for China to characterize the rhetoric that "China is the main source of fentanyl in the world" as malicious. This is because, as a substance and product, fentanyl, including its precursors and derivatives, is in demand for legal use throughout the world. As for the fentanyl analogues produced illegally, the problem lies in public health governance such as drug regulation, and the scope of international public health governance is demarcated by the jurisdiction of the country as a unit. These are common sense.
Second, although the U.S. response to the fentanyl crisis does have elements of "internal disease and external treatment", this should not change China's basic value orientation of continuing to communicate with the U.S. in the spirit of functional cooperation and seeking the greatest common denominator of cooperation . Moreover, the abuse of any drug in any society is a lesson learned by another society. What Chinese professionals, research institutions, public health and judicial departments have gained from exchanges with the United States is useful knowledge and knowledge. Warning, it is helpful and harmless to prevent a large-scale drug abuse crisis in this country.
Third, the cross-border circulation of illicit drugs is a persistent phenomenon in human history, and it is also an issue that must be routinely dealt with by drug regulatory and judicial departments in various countries. It is common for any government's drug regulatory and judicial departments to "slip plans" in the face of challenges. Especially when channels such as the "dark net" in the Internet are often used by criminals and criminals, exchanges with other countries such as the United States and multilateral mechanisms such as the United Nations will help China crack down on illegal behaviors and activities that inevitably exist in its own society.
Fourth, American politicians link the "fentanyl crisis" with "China", which has its own motivation and logic, and is part of the domestic political ecology of the United States. China cannot underestimate the inflammatory power of such rhetoric in the United States and the wider international community. Whether the United States changes or revokes the sanctions imposed on relevant Chinese entities may not be closely related or even irrelevant to China's actual actions in the future. Even so, it is still valuable and necessary to maintain the functional cooperation nature of mechanisms such as the China-US Anti-Drug Intelligence Cooperation and Exchange Conference.
All in all, in the anti-drug cause such as "fentanyl", China adheres to the direction of professional and functional cooperation, and communicates and cooperates with all countries and international organizations including the United States. Will it reduce the United States as some American scholars predict? Political hostility towards China is not important. What is important is that we maintain the moral high ground in the current and future world through international exchanges and cooperation in drug control, and at the same time create more favorable conditions for China to seek cooperation with other countries in the field of drug circulation (including occasions when it flows into China). condition. Only in this way can we achieve "reasonable, beneficial and restrained".
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Zha Daojiong is a professor at the School of International Relations and the School of South-South Cooperation and Development, Peking University.
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