Why It Matters

Illicit fentanyl’s supply chain has shifted without ending the policy challenge described in the Congressional Research Service report China Primer: Illicit Fentanyl and China’s Role, which examines China’s role in trafficking and the U.S. opioid crisis. Synthetic opioids, primarily fentanyl-related substances, caused about 37,393 U.S. overdose deaths in 2025, although that count was 52 percent below the peak of 77,695 deaths recorded from July 2022 through June 2023.

The report places that public-health toll alongside a supply network in which China is a primary source of precursor chemicals used by transnational criminal organizations to synthesize fentanyl and its analogues in third countries, chiefly Mexico. For Congress, the tension is between measuring progress in reducing deaths and addressing a chemical supply chain that can adapt across borders. For the Trump administration, the record includes enforcement, trade, diplomatic, and national-security tools, while the public-facing outcome remains tied to overdose deaths and access to illicit substances.

The Big Picture

Fentanyl was first synthesized in 1959 and has been used medically as a painkiller and an anesthetic; the United Nations placed it under international control in 1964. The U.S. Drug Enforcement Administration regulates fentanyl under the Comprehensive Drug Abuse Prevention and Control Act of 1970, as amended, while international controls cover more than 30 fentanyl-related substances, including precursors, under the 1961 and 1988 United Nations drug-control conventions.

The U.S. Department of State identified China in 2017 as the main source of U.S.-bound fentanyl and fentanyl precursors, and China-sourced fentanyl accounted for 97 percent of high-purity fentanyl seized from U.S.-bound shipments in 2016 and 2017. The People’s Republic of China imposed domestic controls on fentanyl-related substances as a class in 2019, a step that curtailed almost all direct shipments of fentanyl from China to the United States. The March 2026 Annual Threat Assessment says that the U.S. intelligence community identifies China and India as primary source countries for illicit fentanyl precursor chemicals and pill-pressing equipment, and that China's chemical and pharmaceutical industries supply precursors for illicit methamphetamine, ketamine, and nitazenes.

As of April 2026, the International Narcotics Control Board reported 183 fentanyl-related substances with no known legitimate use, and the United Nations Office on Drugs and Crime estimates that laboratories could potentially synthesize thousands of fentanyl-related substances.

The Bottom Line

The policy record now spans classification, tariffs, import rules, prosecutions, international scheduling, and appropriations rather than a single response. Congress amended the definition of a major illicit drug-producing or drug-transit country in 2022 through P.L. 117-263 to include synthetic drugs and their precursors, and the President has designated China a major illicit drug-producing or drug-transit country since 2023.

Executive Order 14367 designated illicit fentanyl and its core precursor chemicals as Weapons of Mass Destruction in December 2025, while Executive Order 14195 expanded a national emergency on February 1, 2025, and imposed an additional 10 percent tariff on PRC products under authorities including the International Emergency Economic Powers Act. In February 2026, the Supreme Court invalidated tariffs imposed under IEEPA authorities, including tariffs on PRC products, and a 2025 suspension of duty-free de minimis treatment for low-value imports from China was later expanded globally.

The BUST Fentanyl Act, enacted as Title LXXXIII of the FY2026 National Defense Authorization Act (P.L. 119-60), requires the Secretary of State and Attorney General to report to Congress on efforts to address synthetic-opioid trafficking from China and other countries, while the FY2026 Consolidated Appropriations Act directs at least $150 million for countering trafficking in fentanyl, precursors, and other synthetic drugs, including flows from China and Mexico.

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