FENTANYL
1. Context
In the latest version of the Major’s List sent to the U.S. Congress, President Donald Trump listed 23 countries as being significant sources and/or sites of transit of illicit drugs — especially fentanyl — that he said threaten the U.S. The list of countries includes India, Pakistan, China, and Afghanistan.
2. What is Fentanyl?
- Fentanyl, a man-made opioid, has become the primary driver of drug overdose deaths in the United States. Originally created in the 1960s for medical use, it continues to be prescribed in tightly controlled doses to patients experiencing severe pain.
- Outside medical supervision, however, fentanyl is extremely dangerous — nearly 50 times stronger than heroin. As little as 2 milligrams can be lethal, since it acts as an agonist on the mu-opioid receptors found on nerve cells, which normally interact with the body’s natural pain-regulating chemicals.
- In high doses, fentanyl overstimulates these receptors, suppresses the brainstem’s respiratory centers that regulate automatic breathing, rapidly crosses the blood–brain barrier, and accumulates in the central nervous system. This leads to severely reduced breathing (hypoventilation) and life-threatening respiratory depression.
- Overdoses can be countered with naloxone, a competitive antagonist of the mu-opioid receptor. By displacing fentanyl and other opioids from the receptor, it helps restore normal breathing. But naloxone must be given quickly, as prolonged oxygen deprivation can cause brain damage or death within minutes.
- Between August 2023 and August 2024, over 57,000 Americans died from opioid overdoses, the majority linked to fentanyl. In 2022, the U.S. Drug Enforcement Administration (DEA) reported seizing 50.6 million fentanyl-laced pills along with enough powdered fentanyl to create an estimated 379 million potentially lethal doses — enough to kill the entire U.S. population
| The Major’s List is issued annually to identify regions where geography, trade, or industry plays a significant role in the movement of narcotics or the chemicals used to manufacture them into global markets. According to the U.S. State Department, inclusion on this list does not necessarily indicate how effective a country’s anti-narcotics measures are. Instead, it reflects whether substantial amounts of drugs or precursor chemicals are being produced or trafficked through that nation. However, certain countries — including Afghanistan, Bolivia, Myanmar, Colombia, and Venezuela — have been singled out as having “failed demonstrably” in meeting their responsibilities under international drug-control treaties |
3. Why is it hard to regulate fentanyl?
- Unlike heroin or cocaine, which are extracted from plants, fentanyl is entirely synthetic and produced in laboratories from chemical compounds known as precursors. The most significant of these are N-phenethyl-4-piperidone (NPP) and 4-anilino-N-phenethylpiperidine (4-ANPP). While these chemicals have legitimate industrial and pharmaceutical applications, they can also be diverted into illegal production networks.
- In illicit labs, these precursors are chemically transformed into fentanyl powder through standard organic chemistry reactions. The process can be carried out using common glassware, basic solvents, and moderate heat.
- This means that once traffickers acquire the precursor chemicals, converting them into fentanyl is relatively straightforward.
- Moreover, because only minimal amounts of precursors are needed to produce large volumes of fentanyl, and they can be shipped covertly, regulating the trade has proven extremely challenging
4. How is Fentanyl Supplied?
- The global fentanyl supply chain involves numerous players. China and India are key sources of precursor chemicals, some of which are illegally diverted. Mexican cartels are primarily responsible for converting these precursors into fentanyl powder.
- The finished product is then either pressed into counterfeit pills or mixed with other drugs and trafficked into the U.S., mainly via the Mexico–U.S. border.
- To combat this, the U.S. has used criminal prosecutions, trade sanctions, diplomatic engagement, and strengthened law enforcement measures. In January 2025, two Indian firms, Raxuter Chemicals and Athos Chemicals, were charged with conspiring to export fentanyl precursors to the U.S. and Mexico.
- A senior executive at Raxuter, Bhavesh Lathiya, was arrested in New York on smuggling charges.
- Following these developments, the U.S. Embassy in New Delhi revoked or denied visas for certain business executives linked to the illicit fentanyl trade
