Get Help & Answers Now

How can we help?

I'm ready to sign up! I have a few questions I want to refer someone Quiz: is Suboxone for me?

Where Does Fentanyl Come From? China, Mexico & Beyond

Danny Nieves-Kim, MD profile image
By Danny Nieves-Kim, MD • Updated Oct 15, 2023 • 6 cited sources

In 2022 alone, the United States Drug Enforcement Agency (DEA) seized more than 58.3 million pills laced with fentanyl and more than 13,000 pounds of powdered fentanyl.[1] All of these doses could be lethal, but American consumers may never know that fentanyl is present in these drugs until it’s too late. 

Dealers add fentanyl to their drugs to make them more potent.[2] And since fentanyl is powerful at tiny doses, they don’t need to smuggle very much to make products they can sell for big profits on the black market. 

Because illicit drugs come with no official oversight or quality control measures, they often contain lethal fentanyl doses.[2] One tiny pill, even if it’s marked as something else, could have enough fentanyl in it to cause a fatal overdose. 

How is Fentanyl Made?

Most illicit fentanyl is created with precursor drugs. These substances aren’t narcotics, but if they’re combined with other ingredients, they can make fentanyl. 

Most precursor substances come from China.[3] Dealers in countries like Mexico and India mix these substances with other ingredients in very large, industrial-scale laboratories.[3]

Making fentanyl from precursors can be complicated. While dealers often have industrial laboratories, quality control measures are weak or missing. The substances made in these facilities often have varying potency levels. 

The DEA has captured pills with fentanyl ranging from doses as low as 0.02 mg to as high as 5.1 mg.[2] About 2 mg of fentanyl is typically considered a lethal dose.[2]

How Does Fentanyl Get Into the United States? 

With fentanyl pressed into pills or powders, cartels are ready to ship their products. Most distribute fentanyl by the kilogram, which is enough fentanyl to kill about 500,000 people.[2]

Cartels in Mexico typically smuggle drugs across the southwestern border via commercial or passenger vehicles. Sometimes, they smuggle drugs through tunnels they’ve dug underground.[4]

While drugs could enter via any port in the United States, experts say most fentanyl is seized by officials in San Diego.[3] It’s not clear if this makes California a top point of entry for drugs or if the officials there are just exceptional at spotting and stopping deadly drugs. 

Fentanyl’s Top Suppliers 

No one wants fentanyl inside the United States. Understanding where it comes from can help policymakers craft rules to reduce the flow and keep people safe. But the traffic into the United States is complicated, and it often involves people from multiple countries working together. 

These are some of the top suppliers of fentanyl:

Fentanyl From China 

Experts say China is the primary source of fentanyl products that come into the country via international mail and consignments.[5] People who buy fentanyl products through websites or social media accounts are often supporting Chinese cartels. 

Most fentanyl seized from China weighs less than a kilogram, but it’s very pure. In laboratory tests, chemists find that the products contain a 90% concentration of pure fentanyl.[5]

Before 2019, most of the fentanyl in the United States came directly from China. But due to international pressure, the government changed rules and regulations, making export more challenging.[4]

Now, China produces most of the precursors needed to make fentanyl.[4] Legislators vow to change the rules and make exporting these dangerous substances harder. But so far, that hasn’t happened. 

Fentanyl From Mexico 

Mexican cartels have sophisticated laboratories with pharmaceutical-grade equipment and industrial-size capacity. 

Typically, products are pressed into pills for sale. Those products are smuggled in low-concentration, high-volume loads. Most kilogram seizures contain products with a less than 10% concentration of fentanyl.[5]

Two large criminal groups in Mexico are primarily responsible for fentanyl. But the business model requires plenty of smaller subcontractors that specialize in importing fentanyl precursors, producing the drugs and transporting them across the border.[6]

Since so many people are responsible for drugs entering the country, it’s difficult to crack down and stop the illicit drug trade. Eliminating one primary player often just creates an opening for someone new to step in. 

Fentanyl From India 

Chinese laws are changing, making it harder for groups to export fentanyl and its precursors. India could step into this rule. 

Experts say some Indian crime organizations are working with China-based traffickers to export precursors to labs in other countries.[5] A link between India and Mexico, supported by China, could keep these labs in business, making drugs to sell to American consumers. 

Indian officials are working to change their laws, making exports of precursors difficult.[5] Until that happens, this country is poised to take a larger role in the fentanyl crisis in this country.

What Can Americans Do? 

As long as Americans are willing to buy drugs, dealers will make them. If you or someone you love is misusing any kind of opioid, get help. Your treatment means one less customer for cartels. With enough momentum, this could encourage them to move on to another (more lucrative) business model.

By Danny Nieves-Kim, MD

... Read More

  1. DEA recognizes National Fentanyl Prevention and Awareness Day with extended hours for the Faces of Fentanyl exhibit. Drug Enforcement Administration. Published August 17, 2023. Accessed August 21, 2023. 
  2. Facts about fentanyl. United States Drug Enforcement Administration. Accessed August 21, 2023.
  3. Fentanyl seizures at border continue to spike, making San Diego a national epicenter for fentanyl trafficking; U.S. Attorney’s Office prioritizes prosecutions and prevention programs. United States Attorney’s Office, Southern District of California. Published August 11, 2022. Accessed August 21, 2023. 
  4. Klobucista C, Martinez A. Fentanyl and the U.S. opioid epidemic. Council on Foreign Relations. Published April 19, 2023. Accessed August 21, 2023. 
  5. Fentanyl flow to the United States. Drug Enforcement Administration. Published January 2020. Accessed August 21, 2023. 
  6. Dudley S, Bonello D, Lopez-Aranda J, etc. Mexico’s role in the deadly rise of fentanyl. Wilson Center. Published February 2019. Accessed August 21, 2023. 

Download Our Free Program Guide

Learn about our program, its effectiveness and what to expect

Safe, effective Suboxone treatment from home. Learn More

Imagine what’s possible on the other side of opioid use disorder.

Our science-backed approach boasts 95% of patients reporting no withdrawal symptoms at 7 days. We can help you achieve easier days and a happier future.