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CNA Explains: What to know about etomidate, the drug Singapore plans to make illegal
CNA Explains: What to know about etomidate, the drug Singapore plans to make illegal

CNA

time2 days ago

  • Health
  • CNA

CNA Explains: What to know about etomidate, the drug Singapore plans to make illegal

SINGAPORE: An anaesthetic agent that has been found in vapes will soon be listed by Singapore as a Class C drug under the Misuse of Drugs Act, Health Minister Ong Ye Kung said on Sunday (Jul 20). The substance, called etomidate, was found during recent random testing in a third of the more than 100 vapes seized by the authorities. Vape products laced with etomidates are called K-pods. The use of vapes, especially those that are laced with etomidate, is increasing, Mr Ong said. E-vaporisers are banned and controlled under the Tobacco (Control of Advertisements and Sales) Act. "But today, e-vaporisers are no longer just used for the delivery of nicotine, Mr Ong added. "They are being used to deliver a range of substances and what we are seeing is the delivery of etomidate. That is a serious problem." The minister warned that consuming etomidate is "very damaging" and urged those consuming etomidate-laced vapes to give it up before the "law catches up" with them. What is etomidate, exactly? Etomidate is a short-acting agent administered intravenously to induce sedation for patients in surgery. It can also be used in certain medical processes such as intubation. Adjunct Associate Professor Puah Ser Hon from Tan Tock Seng Hospital explained: "It has a very fast onset. It doesn't affect the blood pressure too much and it is quite a stable agent." However, this is within the medical context, when etomidate is used in calculated doses and is monitored by doctors and nurses who are trained to use it, the senior consultant added. Adj Assoc Prof Puah is the head of the hospital's department of respiratory and critical care medicine. What are its effects? Used outside a controlled medical environment, etomidate is "extremely dangerous". Dr Lee Chuen Peng, a respiratory specialist from private clinic The Respiratory Practice, said that vaping in general can lead to a condition known as Evali, short for E-cigarette or vaping product use-associated lung injury. For those who are asthmatic, a single exposure can cause them to have an asthma attack, which can be life-threatening. Most commonly, however, etomidate is known for its suppression of adrenal glands, Dr Lee added. "It can shut down your adrenal glands that are critical for producing certain stress hormones like cortisol. This suppression can last for a few days and leave your body unable to handle stress." Assistant Professor Sewa Duu Wen, a senior consultant specialising in respiratory and critical care medicine at Singapore General Hospital, said that inhaling etomidate can reduce anxiety levels for a short period of time but the feeling passes quickly. "They will need to use it several times to achieve the same level of sensation," he added, pointing to its addictive property. When its effects start to wear off, users may deal with withdrawals such as increased anxiety and agitation. They may also get hallucinations and fall into a dissociative state. "This disassociated state can be quite disturbing and can sometimes lead to certain actions that the user didn't intend to do, and that's where the potential of them causing self-harm may occur," Asst Prof Sewa said. Dr Tan Sheng Neng, a senior consultant psychiatrist from The Safety Net, a private psychiatric practice, agreed that the fast-acting nature of etomidate can give users a "good feeling", leading users to rely on it as a coping mechanism. What are the long-term dangers? Prolonged use of etomidate can affect the adrenal gland's production of hormones released in response to stress. "It becomes a vicious circle," Dr Tan said, adding that users may be more susceptible to depression or anxiety. Adj Assoc Prof Puah, who also leads the National Healthcare Group's Respiratory Health Steering Committee Smoking Cessation Workgroup, said that it is still early to be certain about the effects of the long-term use of etomidate, but what they are seeing now is "already worrying". Even without etomidate, vapes and nicotine can stunt brain growth and cause attention issues. "You add etomidate to that, you add all sorts of illegal substances to these pods, you can imagine that the effects are double, triple, even 10 times," he added. "Why do we want to wait till we have information and act when it's too late?" Giving an example of another negative effect, Asst Prof Sewa said that the prolonged use of etomidate can suppress the vape user's ability to produce hormones essential in preventing low blood pressure or low sugar count. "It can lead to an adrenal crisis, where the patient may go into seizures or even coma," he warned, adding that there have been reports of such cases in patients who have abused the drug for a long time and in large doses. How can one overcome addiction to etomidate? Dr Munidasa Winslow, a senior consultant psychiatrist at private clinic Promises Healthcare, said that people who use etomidate should know that they can get help and recover. "Substance use is rarely just about the drug. It is often tied to deeper emotional or psychological roots," he said. Users who find themselves wanting to seek help should start by talking to someone they trust. After that, they should speak to a qualified healthcare professional. "Avoid the instinct to quit abruptly on your own," he advised. Etomidate is a potent sedative and its misuse can have unpredictable and potentially dangerous effects. Depending on how often it is used, stopping suddenly might lead to withdrawal symptoms and may increase the risk of relapse. Dr Winslow also said that recovery must be approached with a plan, for example, through therapy or a support group. "What is more important is understanding why it became a crutch in the first place, and how to replace that with healthier, more sustainable ways to cope." What are other jurisdictions doing about it? Across Asia, some governments have stepped up regulation on etomidate. The authorities in China officially placed etomidate under control in October 2023, the Office of China National Narcotics Control Commission stated. More recently, Hong Kong classified etomidate – known commonly as "space oil" there – under the Dangerous Drugs Ordinance in February. Under the ordinace, anyone found in possession or consumption of the substance is subject to a maximum penalty of seven years' jail and a fine of HK$1 million (S$163,400). How does Singapore's move fit with its overall approach to vaping and drug use? Assistant Professor Yvette van der Eijk from the National University of Singapore Saw Swee Hock School of Public Health said that classifying etomidate as an illegal drug will give the authorities greater leverage to curb its misuse in vaping devices. In Singapore, all offenders caught for the purchase, use and possession of vapes, or e-vaporisers, are now referred to the Health Science Authority and subject to a fine of up to S$2,000 (about US$1,560). Etomidate is a controlled substance under the Poisons Act. However, once it is listed under the Misuse of Drugs Act, people who consume it will be treated "no differently" from those who consume hard drugs and narcotics such as cannabis and cocaine, Mr Ong said. This means that anyone caught using etomidate will be subject to supervision, have to undergo mandatory rehabilitation and may also be committed to a drug rehabilitation centre. Repeat offenders will be prosecuted and may be jailed for at least a year. Asst Prof van der Eijk said: "This move not only disrupts the supply and demand for K-pods, but also reinforces Singapore's zero-tolerance approach to emerging forms of substance abuse." She also said that the move will raise awareness on the significant health risks associated with drug-containing vapes.

Singapore plans to list etomidate in vapes as illegal drug
Singapore plans to list etomidate in vapes as illegal drug

South China Morning Post

time3 days ago

  • Health
  • South China Morning Post

Singapore plans to list etomidate in vapes as illegal drug

Singapore is working to list etomidate, an anaesthetic that has been found in vapes, as a Class C drug under the Misuse of Drugs Act, Health Minister Ong Ye Kung said on Sunday. 'Vaping, especially those that are laced with etomidate, is increasing. It is causing quite serious concern among agencies, including the Ministry of Home Affairs [MHA] and Ministry of Health [MOH],' he told reporters. Recently, authorities randomly tested more than 100 vapes that were seized, and one-third were found to contain etomidate. Pods that contain vape juice mixed with etomidate are also known as K-pods. Ong also noted that there had also been some deaths, including those arising from traffic accidents as well as unnatural ones, where etomidate was implicated, and investigations were ongoing. Vapes, or e-vaporisers, are banned in Singapore. They are controlled and enforced under the Tobacco (Control of Advertisements and Sales) Act. Etomidate is a controlled substance under the Poisons Act. Under these Acts, users of drug-laced pods may be fined, but that will change when etomidate is listed under the Misuse of Drugs Act (MDA).

Singapore working to list etomidate as illegal drug; one-third of vapes seized found to contain it
Singapore working to list etomidate as illegal drug; one-third of vapes seized found to contain it

CNA

time3 days ago

  • Health
  • CNA

Singapore working to list etomidate as illegal drug; one-third of vapes seized found to contain it

SINGAPORE: Singapore is working to list etomidate, an anaesthetic that has been found in vapes, as a Class C drug under the Misuse of Drugs Act, Health Minister Ong Ye Kung said on Sunday (Jul 20). "Vaping, especially those that are laced with etomidate, is increasing. It is causing quite serious concern amongst agencies, including the Ministry of Home Affairs (MHA) and Ministry of Health (MOH)," he told reporters. Recently, authorities randomly tested more than 100 vapes that were seized, and one-third were found to contain etomidate. Pods that contain vape juice mixed with etomidate are also known as K-pods. Mr Ong also noted that there have also been some deaths, including those arising from traffic accidents as well as unnatural ones, where etomidate was implicated. Vapes, or e-vaporisers, are banned in Singapore. They are controlled and enforced under the Tobacco (Control of Advertisements and Sales) Act. Etomidate is a controlled substance under the Poisons Act. Under these Acts, users of drug-laced pods may be fined, but that will change when etomidate is listed under the Misuse of Drugs Act (MDA). "But under the MDA, they will be treated no differently from those who consume hard drugs and narcotics, such as cannabis or cocaine," said Mr Ong. This means they will be subject to supervision, have to undergo mandatory rehabilitation and may also be committed to a drug rehabilitation centre. Repeat offenders will be prosecuted and may be jailed for at least a year. "We will take a few weeks to put this into effect," said the health minister, calling the listing of etomidate an "interim measure". While vapes started off mainly as a device to deliver nicotine, Mr Ong noted that it is now a delivery device for a range of substances, from nicotine to psychoactive substances such as etomidate, to hardcore drugs that are illegal. "When that is the situation, it requires a whole-of-government effort to enforce against this," Mr Ong said. He added that several other agencies, such as the National Parks Board, National Environment Agency and Land Transport Authority, are already enforcing against vaping, in addition to the police and the Health Sciences Authority. "When they catch them, the vapes come to MOH and we test them. If it is just nicotine, we will process and fine them. "If it is something serious, other agencies will have to come in. In the most serious cases involving drugs, the Central Narcotics Bureau will have to come in, so it will have to be a concerted effort," said the minister. Mr Ong warned that it can be "very damaging" to consume etomidate through vapes, as it can cause permanent organ failure and hallucinations. He urged those who are using K-pods to give them up now. When asked about the situation in schools, Mr Ong said: "I do not want to assume it is fine. In an earlier exercise, when we tested the vapes we had seized from schools, we did not detect any etomidate. "But that was a couple of months ago. In the latest, when we randomly tested vapes (seized from the public), one third had etomidate, so I will not assume that etomidate has not made (its) way to schools."

The deadly drug that's complicating US-China trade
The deadly drug that's complicating US-China trade

Yahoo

time13-07-2025

  • Health
  • Yahoo

The deadly drug that's complicating US-China trade

Since US President Donald Trump – just days into his second term – began imposing tariffs on China for its role in the flow of deadly opioids like fentanyl into the United States, Beijing's message has been clear. The fentanyl crisis is the 'US's problem,' Chinese officials have repeatedly said, and China has already done 'tremendous work' to address the issue. 'We stand ready for practical cooperation with the US based on equality and mutual respect. That said, we firmly oppose the US pressuring, threatening and blackmailing China under the pretext of the fentanyl issue,' a spokesperson said in March, after Trump's fentanyl tariffs were raised to 20% on all Chinese imports into the US. But as those tariffs remain in place months later and, despite a truce de-escalating other duties, Beijing is signaling it's paying attention to the issue – and may be prepared to do more. China late last month announced it will add two more fentanyl precursors to its list of controlled substances – an expected step that brought it in line with international regulations, which its diplomats presented as a mark of 'active participation' in global drug control. Days earlier, Chinese authorities also extended control over another class of drug known as nitazenes – powerful synthetic opioids raising alarm among global health officials. The same day, Chinese Minister of Public Security Wang Xiaohong told US Ambassador to China David Perdue that Beijing was open to strengthening 'practical cooperation' on drug control. The Trump administration blames China for 'sustaining' the influx into the US of fentanyl, a lab-made, synthetic opioid dozens of times more potent than heroin. Abuse of the drug and its analogues has fueled a drug overdose crisis in the US, killing tens of thousands of Americans annually, though those numbers saw a significant drop last year. In Beijing's view, it's gone above and beyond international norms to stem the outflow of the drug and its component chemicals from its vast pharmaceuticals sector. In 2019 Beijing controlled fentanyl as a drug class – a significant move that drastically reduced the flow of the finished drug directly from China to the US, according to experts and US officials. It didn't take long for criminal networks to adapt, however. Chinese outfits shifted to selling precursor chemicals often to cartel-backed labs in Mexico, which then make and ship illegal fentanyl and similar drugs to the US. Chinese authorities have since controlled a number of these precursor chemicals. But experts and US officials say more could be done – as Beijing remains the largest source for products used to make illegal fentanyl and other synthetic drugs in Mexico and other countries. Chinese officials haven't explicitly linked their recent efforts at controlling two more of these substances to relations with the US, instead calling them another example of the 'goodwill China has shown,' and continuing to reject the premise of the US tariffs. But Beijing is likely expecting it will get credit for the latest moves in trade negotiations with the US. The question, however, is whether the steps will move the needle for Washington – and whether the two sides will be able to cooperate on the issue if their overall relations remain rocky. 'If Washington does not publicly recognize Chinese steps and show responsiveness to Beijing's own concerns, then bilateral law enforcement cooperation likely will falter going forward,' said Ryan Hass, director of the John L. Thornton China Center at the Brookings Institution. As US-China ties have chafed on everything from technology to China's militarization of the South China Sea, few issues have appeared more personal to American leaders than China's role as a producer of the drugs and chemicals fueling an opioid crisis in the US. During his first term, Trump hailed Chinese leader Xi Jinping's 'wonderful humanitarian gesture' of designating fentanyl a controlled substance in China. Some six years later, however, Trump began his second term accusing China of 'actively sustaining and expanding the business of poisoning our citizens' – an accusation vehemently denied by China. That message also contrasts with assessments from the US Drug Enforcement Agency which, in an annual report released in May, said fentanyl purity declined throughout 2024, consistent with indications that fentanyl cooks in Mexico were having trouble obtaining key precursor chemicals. That was as some China-based suppliers were 'wary of supplying controlled precursors … demonstrating an awareness on their part that the Chinese government is controlling more fentanyl precursors,' it said. Beijing's latest moves to control the two additional fentanyl precursors and nitazenes are positive actions that could have an impact on illicit drug supply chains, experts say. But they are also 'clever maneuvering' from China, according to Vanda Felbab-Brown, a senior fellow at the Strobe Talbott Center for Security, Strategy, and Technology at the Brookings Institution. A UN convention on illicit drugs added the two fentanyl precursors to its list of controlled substances last year, meaning signatory countries such as China must follow suit. China controlled a number of nitazenes in 2024 and the latest step, which expands those controls, was already in the works last fall, Felbab-Brown said. 'The Trump administration just reset the clock, did not recognize what China had already done and had committed to do, did not give China any credit for that. As a result, it also now is in a position where China can be promising to do exactly the same actions that it had promised to the Biden administration and use that as part of the bargaining,' Felbab-Brown said. A 'more effective posture' would have been to embrace China's efforts in 2024 and then ask it to fill in the 'substantial and impactful' holes in its drug control program, she added. Beijing has fiercely defended its record when it comes to controlling fentanyl and other synthetic drugs, releasing a 7,000-word white paper outlining its efforts in March, days after Trump imposed his second raft of fentanyl-linked tariffs. It has also balked at a Congressional report released last year accusing the ruling Chinese Communist Party of directly subsidizing the manufacture and export of illicit fentanyl materials and other synthetic narcotics through tax rebates. In China, where the Communist Party keeps a tight grip on all aspects of society, there's comparatively limited opioid abuse, according to official data – a situation Beijing uses to suggest the problem is about American appetite for the drug, not Chinese supply. That also means Chinese officials feel they've gone out of their way to work with Washington on a US domestic issue – efforts they see as being greeted first by a lack of American appreciation, and then by tariffs. Scientists in China on the front lines of identifying new precursors being used by criminal groups also point to reducing demand in the US as a key factor, given the challenges of controlling chemicals involved in synthesizing opioids. 'You really can't solve the fentanyl problem through control alone… the most fundamental issue is still reducing demand,' Hua Zhendong, deputy director of a drug analysis division at a counternarcotics laboratory under China's Ministry of Public Security, told CNN in an interview last September. He pointed to how some chemicals have widespread use in legitimate products, making them impractical to control, while chemicals used to make fentanyl can be easily adjusted to evade rules but still produce the product. 'It's always been like a cat-and-mouse game, because there could be thousands of potential substances for synthesizing fentanyl, we can't proactively control them all – we can only passively follow behind,' said Hua, whose lab was working regularly with US counterparts at the time of the interview to share information on emerging chemicals. Outside observers agree that US efforts to curb demand are critical for mitigating the opioid crisis. They note too that even if no chemicals came from China, fentanyl makers would look to other countries with large pharmaceuticals and chemicals industries, such as India. Des pite the challenges of enforcement in a vast sector where goods are often shipped in covert ways by busy air and sea routes, observers also say that more can be done in China. That includes tightening regulations to enable tougher punishments for people who sell controlled precursors to criminal groups or their middlemen unknowingly. Experts also say more could also be done to enforce existing regulations, especially in terms of how central government edicts are enforced by local authorities across China. 'Scheduling drugs and precursors that lead to the production of illegal drugs is one step of many needed in China,' said David Luckey, a senior international and defense researcher at RAND, a US-based think tank. 'I would suggest better still would be actually preventing Chinese companies from selling and distributing these harmful chemicals and drugs to criminal organizations in Mexico.' In addition to China, Trump placed tariffs on Mexico and Canada earlier this year, accusing them of not doing enough to curb migration and fentanyl trafficking, but carved out significant exemptions to those tariff rates. The US earlier this year designated Mexican cartels it alleges are involved in fentanyl trafficking as foreign terrorist organizations. 'China is a command economy with extreme control of its population – I think if the Chinese Communist Party didn't want Chinese companies doing this, the CCP could do more to stop it, and be more effective in stopping it,' Luckey said. An annual US State Department report on narcotics controls released in March described China's 'significant steps' working with the US last year to reduce precursor exports, which it said included cracking down on online platforms and companies selling them, making arrests, and adding 55 synthetic drugs and precursor chemicals to control lists. China's Ministry of Public Security last month said it had seized more than 1,400 tons of various precursor chemicals, and 151 related criminal cases were resolved in 2024. But authorities in China also acknowledge the scope of the problem, with a recent report noting that channels and means for smuggling chemicals out of the country 'were increasing' and 'constantly being updated,' creating 'greater challenges.' Beijing – which seeks to present itself as a responsible global player – has its own reasons for not wanting to be seen as an international purveyor of illicit drugs. But Chinese officials have long linked cooperation with the US on the issue to the health of the broader relationship. China cut off drug control cooperation completely in August 2022 in retaliation for then House Speaker Nancy Pelosi's visit to Taiwan. It then took a friendly summit between Xi and former US President Joe Biden in late 2023 to get collaboration back on track. This time around, China has bristled at the Trump administration's off-the-bat imposition of tariffs, saying it 'undermines' cooperation. The White House did not respond to a CNN request for comment on China's latest control steps. 'If the US truly wants to cooperate with China, it should face up to the objective facts, correct its wrongdoing, and seek dialogue with China,' a Chinese foreign ministry spokesperson said last month when asked whether those measures were done in cooperation with the US or at its behest. But Beijing is also keenly aware that the current tariffs are hitting at a time when China's economy has already been struggling with domestic challenges – and there's no certainty those duties couldn't rise again under Trump's capricious trade policy. 'Since the 20% tariff is specifically linked to cooperation on fentanyl, the Chinese might be hoping for a package deal that includes trade, counternarcotics, among other things,' said Yun Sun, director of the China program at the Stimson Center think tank in Washington. 'The Chinese hope to remove the 20% tariff … (and are) eager to get President Trump to visit China this year, so they need to work out good progress,' she said.

The deadly drug that's complicating US-China trade
The deadly drug that's complicating US-China trade

CNN

time13-07-2025

  • Health
  • CNN

The deadly drug that's complicating US-China trade

Since US President Donald Trump – just days into his second term – began imposing tariffs on China for its role in the flow of deadly opioids like fentanyl into the United States, Beijing's message has been clear. The fentanyl crisis is the 'US's problem,' Chinese officials have repeatedly said, and China has already done 'tremendous work' to address the issue. 'We stand ready for practical cooperation with the US based on equality and mutual respect. That said, we firmly oppose the US pressuring, threatening and blackmailing China under the pretext of the fentanyl issue,' a spokesperson said in March, after Trump's fentanyl tariffs were raised to 20% on all Chinese imports into the US. But as those tariffs remain in place months later and, despite a truce de-escalating other duties, Beijing is signaling it's paying attention to the issue – and may be prepared to do more. China late last month announced it will add two more fentanyl precursors to its list of controlled substances – an expected step that brought it in line with international regulations, which its diplomats presented as a mark of 'active participation' in global drug control. Days earlier, Chinese authorities also extended control over another class of drug known as nitazenes – powerful synthetic opioids raising alarm among global health officials. The same day, Chinese Minister of Public Security Wang Xiaohong told US Ambassador to China David Perdue that Beijing was open to strengthening 'practical cooperation' on drug control. The Trump administration blames China for 'sustaining' the influx into the US of fentanyl, a lab-made, synthetic opioid dozens of times more potent than heroin. Abuse of the drug and its analogues has fueled a drug overdose crisis in the US, killing tens of thousands of Americans annually, though those numbers saw a significant drop last year. In Beijing's view, it's gone above and beyond international norms to stem the outflow of the drug and its component chemicals from its vast pharmaceuticals sector. In 2019 Beijing controlled fentanyl as a drug class – a significant move that drastically reduced the flow of the finished drug directly from China to the US, according to experts and US officials. It didn't take long for criminal networks to adapt, however. Chinese outfits shifted to selling precursor chemicals often to cartel-backed labs in Mexico, which then make and ship illegal fentanyl and similar drugs to the US. Chinese authorities have since controlled a number of these precursor chemicals. But experts and US officials say more could be done – as Beijing remains the largest source for products used to make illegal fentanyl and other synthetic drugs in Mexico and other countries. Chinese officials haven't explicitly linked their recent efforts at controlling two more of these substances to relations with the US, instead calling them another example of the 'goodwill China has shown,' and continuing to reject the premise of the US tariffs. But Beijing is likely expecting it will get credit for the latest moves in trade negotiations with the US. The question, however, is whether the steps will move the needle for Washington – and whether the two sides will be able to cooperate on the issue if their overall relations remain rocky. 'If Washington does not publicly recognize Chinese steps and show responsiveness to Beijing's own concerns, then bilateral law enforcement cooperation likely will falter going forward,' said Ryan Hass, director of the John L. Thornton China Center at the Brookings Institution. As US-China ties have chafed on everything from technology to China's militarization of the South China Sea, few issues have appeared more personal to American leaders than China's role as a producer of the drugs and chemicals fueling an opioid crisis in the US. During his first term, Trump hailed Chinese leader Xi Jinping's 'wonderful humanitarian gesture' of designating fentanyl a controlled substance in China. Some six years later, however, Trump began his second term accusing China of 'actively sustaining and expanding the business of poisoning our citizens' – an accusation vehemently denied by China. That message also contrasts with assessments from the US Drug Enforcement Agency which, in an annual report released in May, said fentanyl purity declined throughout 2024, consistent with indications that fentanyl cooks in Mexico were having trouble obtaining key precursor chemicals. That was as some China-based suppliers were 'wary of supplying controlled precursors … demonstrating an awareness on their part that the Chinese government is controlling more fentanyl precursors,' it said. Beijing's latest moves to control the two additional fentanyl precursors and nitazenes are positive actions that could have an impact on illicit drug supply chains, experts say. But they are also 'clever maneuvering' from China, according to Vanda Felbab-Brown, a senior fellow at the Strobe Talbott Center for Security, Strategy, and Technology at the Brookings Institution. A UN convention on illicit drugs added the two fentanyl precursors to its list of controlled substances last year, meaning signatory countries such as China must follow suit. China controlled a number of nitazenes in 2024 and the latest step, which expands those controls, was already in the works last fall, Felbab-Brown said. 'The Trump administration just reset the clock, did not recognize what China had already done and had committed to do, did not give China any credit for that. As a result, it also now is in a position where China can be promising to do exactly the same actions that it had promised to the Biden administration and use that as part of the bargaining,' Felbab-Brown said. A 'more effective posture' would have been to embrace China's efforts in 2024 and then ask it to fill in the 'substantial and impactful' holes in its drug control program, she added. Beijing has fiercely defended its record when it comes to controlling fentanyl and other synthetic drugs, releasing a 7,000-word white paper outlining its efforts in March, days after Trump imposed his second raft of fentanyl-linked tariffs. It has also balked at a Congressional report released last year accusing the ruling Chinese Communist Party of directly subsidizing the manufacture and export of illicit fentanyl materials and other synthetic narcotics through tax rebates. In China, where the Communist Party keeps a tight grip on all aspects of society, there's comparatively limited opioid abuse, according to official data – a situation Beijing uses to suggest the problem is about American appetite for the drug, not Chinese supply. That also means Chinese officials feel they've gone out of their way to work with Washington on a US domestic issue – efforts they see as being greeted first by a lack of American appreciation, and then by tariffs. Scientists in China on the front lines of identifying new precursors being used by criminal groups also point to reducing demand in the US as a key factor, given the challenges of controlling chemicals involved in synthesizing opioids. 'You really can't solve the fentanyl problem through control alone… the most fundamental issue is still reducing demand,' Hua Zhendong, deputy director of a drug analysis division at a counternarcotics laboratory under China's Ministry of Public Security, told CNN in an interview last September. He pointed to how some chemicals have widespread use in legitimate products, making them impractical to control, while chemicals used to make fentanyl can be easily adjusted to evade rules but still produce the product. 'It's always been like a cat-and-mouse game, because there could be thousands of potential substances for synthesizing fentanyl, we can't proactively control them all – we can only passively follow behind,' said Hua, whose lab was working regularly with US counterparts at the time of the interview to share information on emerging chemicals. Outside observers agree that US efforts to curb demand are critical for mitigating the opioid crisis. They note too that even if no chemicals came from China, fentanyl makers would look to other countries with large pharmaceuticals and chemicals industries, such as India. Despite the challenges of enforcement in a vast sector where goods are often shipped in covert ways by busy air and sea routes, observers also say that more can be done in China. That includes tightening regulations to enable tougher punishments for people who sell controlled precursors to criminal groups or their middlemen unknowingly. Experts also say more could also be done to enforce existing regulations, especially in terms of how central government edicts are enforced by local authorities across China. 'Scheduling drugs and precursors that lead to the production of illegal drugs is one step of many needed in China,' said David Luckey, a senior international and defense researcher at RAND, a US-based think tank. 'I would suggest better still would be actually preventing Chinese companies from selling and distributing these harmful chemicals and drugs to criminal organizations in Mexico.' In addition to China, Trump placed tariffs on Mexico and Canada earlier this year, accusing them of not doing enough to curb migration and fentanyl trafficking, but carved out significant exemptions to those tariff rates. The US earlier this year designated Mexican cartels it alleges are involved in fentanyl trafficking as foreign terrorist organizations. 'China is a command economy with extreme control of its population – I think if the Chinese Communist Party didn't want Chinese companies doing this, the CCP could do more to stop it, and be more effective in stopping it,' Luckey said. An annual US State Department report on narcotics controls released in March described China's 'significant steps' working with the US last year to reduce precursor exports, which it said included cracking down on online platforms and companies selling them, making arrests, and adding 55 synthetic drugs and precursor chemicals to control lists. China's Ministry of Public Security last month said it had seized more than 1,400 tons of various precursor chemicals, and 151 related criminal cases were resolved in 2024. But authorities in China also acknowledge the scope of the problem, with a recent report noting that channels and means for smuggling chemicals out of the country 'were increasing' and 'constantly being updated,' creating 'greater challenges.' Beijing – which seeks to present itself as a responsible global player – has its own reasons for not wanting to be seen as an international purveyor of illicit drugs. But Chinese officials have long linked cooperation with the US on the issue to the health of the broader relationship. China cut off drug control cooperation completely in August 2022 in retaliation for then House Speaker Nancy Pelosi's visit to Taiwan. It then took a friendly summit between Xi and former US President Joe Biden in late 2023 to get collaboration back on track. This time around, China has bristled at the Trump administration's off-the-bat imposition of tariffs, saying it 'undermines' cooperation. The White House did not respond to a CNN request for comment on China's latest control steps. 'If the US truly wants to cooperate with China, it should face up to the objective facts, correct its wrongdoing, and seek dialogue with China,' a Chinese foreign ministry spokesperson said last month when asked whether those measures were done in cooperation with the US or at its behest. But Beijing is also keenly aware that the current tariffs are hitting at a time when China's economy has already been struggling with domestic challenges – and there's no certainty those duties couldn't rise again under Trump's capricious trade policy. 'Since the 20% tariff is specifically linked to cooperation on fentanyl, the Chinese might be hoping for a package deal that includes trade, counternarcotics, among other things,' said Yun Sun, director of the China program at the Stimson Center think tank in Washington. 'The Chinese hope to remove the 20% tariff … (and are) eager to get President Trump to visit China this year, so they need to work out good progress,' she said.

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