Whenever U.S. President Donald Trump talks about the U.S. fentanyl crisis, he will especially blame China for causing it. That rhetoric does not hold up to scrutiny.

At the beginning of this century, almost 800 Americans died from a fentanyl overdose. Fast forward to 2021, and more than 107,000 deaths were traced to the drug in that year alone. How is it possible that in roughly 20 years, the number of deaths had spiked over 13,000 percent?

The answer is a complex one: Politicians are not interested in delivering such answers. Instead, they live in a world in which deflection and blame generate headlines. And we know anytime a politician blames China that news coverage is soon to follow.

So, what is the complex answer?

Let's begin with this: Fentanyl is cheap. According to one estimate, a gram can cost as little as $150. Other drugs cost much more. That means those people facing homelessness or economic uncertainty are often able to get their hands on the drug.

Doctors also have to be blamed. Beginning roughly 30 years ago, they began prescribing more and more pain medications to counter the discomforts described by their patients. By 2012, doctors in the U.S. had prescribed opioids more than 255 million times. Once patients became addicted to one form of an opioid, they were very likely to seize the opportunity to obtain a less expensive one.

Next, unsavory activities from pharmaceutical companies must be factored into the conversation. Pressure from such companies ensured that, in some cases, people who did not need highly addictive medicines were given them by their doctors. U.S. Department of Justice described what unfolded in one 2017 case as a "conspiracy" that included efforts "to mislead and defraud insurers" so that people who did not have cancer were prescribed medications.

Americans are also not likely to know that drug-related crimes in China are dealt with severely. The reality is that the country's businesses and individuals know that if found guilty of creating or selling illegal drugs, harsh penalties will follow. On top of that, a 2020 report from the Drug Enforcement Administration noted that China had implemented measures to counteract the creation of fentanyl. One action included "investigations of known fentanyl manufacturing areas, stricter control of online sites advertising fentanyl, stricter enforcement of shipping regulations, and the creation of special teams to investigate leads on fentanyl trafficking."

The bi-monthly Missouri Medicine journal in 2017 published a stinging rebuke directed at everyone who had refused to admit the obvious: The U.S. fentanyl crisis began as and continues to be a domestic problem. The doctor who authored the piece stated: "I will start with physicians. We overprescribe opioids, just as we overprescribe antibiotics. But it is generally well meaning; we don't want our patients to experience pain. But then we prescribe 30 or 60 pills when five or 20 would have been adequate."

The doctor then criticized Purdue Pharmaceuticals, an American privately held pharmaceutical company that filed for bankruptcy in 2019, for manufacturing the highly addictive oxycontin. He also chastised the American Pain Society and the Veterans Health Administration for latching onto pain management strategies that deserved more scrutiny. Soon, he reached the inevitable conclusion: "Blame must be placed; it is the American way."

But nowhere in his argument will you find mention of China. Likewise, you will not find Canada or Mexico, two other nations that Trump claims to be deserving of adding to the fentanyl crisis. Imposing tariffs and other economic sanctions against those nations could easily be interpreted as a president getting tough and holding other governments to account. Instead, such policy choices exacerbate tensions between the U.S. and those countries and require them to issue their own tariffs against the U.S. Moreover, the root of the problem is not being handled.

Fentanyl abuse and the thousands upon thousands of deaths resulting from it are an American problem created by American doctors, the American public, American pharmaceutical companies and unscrupulous individuals. BR

The author is an associate professor of politics, sports and media at the School of Informatics, Humanities and Social Sciences at Robert Morris University, the U.S. This article was first published on the China Focus website

Copyedited by Elsbeth van Paridon

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