Tuesday, November 14, 2023

A BIG DEAL
Biden, Xi to Announce China’s Crackdown on Fentanyl Trade

Jenny Leonard
Tue, November 14, 2023



(Bloomberg) -- Joe Biden and his Chinese counterpart, Xi Jinping, are set to announce an agreement that would see Beijing crack down on the manufacture and export of fentanyl, according to people familiar with the matter, potentially delivering the US president a major victory.

Under the deal — which is still being finalized — China would go after chemical companies to stem the flow of both fentanyl and the source material used to make the deadly synthetic opioid, according to the people, who spoke on condition of anonymity to discuss the agreement.

In return, the Biden administration would lift restrictions on China’s forensic police institute, the people said, an entity the US alleges is responsible for human-rights abuses.

The agreement, set to be announced Wednesday when Biden and Xi meet in San Francisco on the sidelines of the Asia-Pacific Economic Cooperation summit, would mark a win for the White House on an issue voters say is a priority for the 2024 election.

How Fentanyl Made the US Opioid Crisis So Much Worse: QuickTake

Republicans have assailed the administration over its handling of fentanyl trafficking, turning it into a liability for Biden’s chances of winning a second term.

A White House National Security Council spokeswoman declined to comment. China’s Ministry of Foreign Affairs said the country is willing to carry out anti-drug cooperation with the US on the basis of “equality and mutual respect.”

“The US should work with China in two directions to remove obstacles on the road to cooperation between the two sides,” the Chinese foreign ministry said in a response to questions.

National Security Advisor Jake Sullivan told reporters Monday that the US hopes to see some progress on the fentanyl issue this week. “That could then open the door to further cooperation on other issues where we aren’t just managing things but we’re actually delivering tangible results.”

Senate Majority Leader Chuck Schumer said Xi “seemed receptive to our concerns” in October when lawmakers raised the issue with the leader during a visit to China.

US officials consider the deal a potential breakthrough but caution stringent enforcement is necessary to produce results. Officials said it will take time to assess whether Beijing follows through.

Any deal could be vulnerable to collapse if fragile ties between Beijing and Washington deteriorate over critical comments from the Biden administration, some China experts warned.

“China’s agreements have an unstated condition: Void if you criticize Xi and the Communist Party,” said Derek Scissors, senior fellow at the conservative American Enterprise Institute. “If the Biden administration isn’t pro-China in 2024, enforcement of a fentanyl deal will fade away.”

Health Crisis

Mexican cartels are largely responsible for the export of fentanyl, a synthetic opioid 50 times more powerful than heroin and 100 times more powerful than morphine. The cartels often use Chinese components to make the drug.

The problem has dogged multiple US presidents, as overdose deaths have spiked across the country. Former President Donald Trump in 2018 announced an agreement with Xi, under which Beijing vowed to designate fentanyl as a controlled substance.

The public-health crisis fueled by the drug has only intensified since then.

More than 150 people in the US die each day from overdoses related to synthetic opioids like fentanyl, according to the Centers for Disease Control and Prevention. Such overdoses increased more than seven-fold between 2015 and 2021, according to the National Center for Health Statistics.

San Francisco, the host for this week’s APEC summit, is one of many municipalities grappling with the fallout from a surge in addiction and overdose deaths.

“Fentanyl has really devastated our city, like no other drug we’ve ever experienced within my lifetime,” San Francisco Mayor London Breed said Monday in a Bloomberg News roundtable.

Breed urged Xi to cooperate to stop the flow of fentanyl, saying it had strained US-China ties.

“I would ask him to work with the US and to ensure that the resources that are being sent out of China, that come into either the US or Mexico, are cut off to the fullest extent possible,” she said during a separate interview with Bloomberg TV.

Lifting Sanctions

China has for months pressured the US to take the Institution of Forensic Science of the Ministry of Public Security off its blacklist. The Commerce Department in 2020 restricted those agencies from accessing US technology over allegations they are involved in repression of ethnic Uyghurs in China’s Xinjiang region.

“The US sanctions against Chinese companies and citizens will add more obstacles to China-US counter-narcotics cooperation,” a Chinese embassy spokesperson in Washington said in May.

The Biden administration this year took steps to stem the crisis but is limited in what it can achieve without Beijing’s help.

The Justice Department has investigated and prosecuted companies in China that ship precursor chemicals to Mexico. The Treasury Department has designated more than two dozen people and entities allegedly involved in the fentanyl trade. The White House has asked Congress for roughly $1.2 billion to target drug traffickers.

Republican presidential hopefuls have vowed to take even more drastic measures.

Trump, the 2024 GOP frontrunner, has threatened a full naval embargo on drug cartels and said he would deploy the US military to fight them. He has also called for drug dealers to get the death penalty.

Florida Governor Ron DeSantis has also said he would use the US military against Mexican drug operations. Former UN Ambassador Nikki Haley said the US should end normal trade relations with China until “they stop murdering Americans.”

--With assistance from Riley Griffin, Chris Strohm, Hadriana Lowenkron, Colum Murphy, Annmarie Hordern and James Mayger.

 Bloomberg Businessweek

US set to take action to win China's cooperation on fentanyl

MICHAEL MARTINA
November 14, 2023 



SAN FRANCISCO (Reuters) - U.S. President Joe Biden's administration is set to remove restrictions on China's Institute of Forensic Science in a bid to step up cooperation with Beijing to halt the flow of the synthetic opioid fentanyl in the United States.

Blocking fentanyl "precursor" chemicals has been a priority for Washington as the rate of overdose deaths involving the drug more than tripled from 2016 through 2021, according to the U.S. Centers for Disease Control and Prevention (CDC).

Biden will discuss the issue with China's President Xi Jinping on Wednesday in San Francisco on the margins of the Asia-Pacific Economic Cooperation (APEC) forum.

U.S. National Security Advisor Jake Sullivan said on Tuesday that Washington hoped the summit would result in action to help combat the fentanyl trade. A source familiar with plans said the U.S. was ready to remove restrictions on the Institute of Forensic Science, part of China's Ministry of Public Security.

Washington put the institute on the Commerce Department's "entity list" in 2020 over alleged abuses toward Uyghurs and other minority groups - effectively barring it from receiving U.S. exports. China has long questioned why the U.S. would expect cooperation on fentanyl while targeting the institute.

China's embassy in Washington did not respond immediately to a request for comment on the fentanyl issue.

Fentanyl is up to 50 times stronger than heroin and is increasingly mixed with other illicit drugs, often with lethal results. U.S. drug-related overdose deaths surpassed 100,000 in 2021, according to government estimates.

(Reporting by Michael Martina; Writing by Michelle Nichols; Editing by Jonathan Oatis)

PSA

You can't overdose on fentanyl just by touching it. Experts explain why.

KERRY BREEN
Updated November 11, 2023 


Fentanyl, a strong opioid about 50 times more powerful than heroin, has become increasingly present in the U.S. drug supply and has caused a wave of overdose deaths among people who consume it or use drugs they didn't realize were tainted with the substance.

On Nov. 8, 2023, several county elections offices in Washington state were evacuated after they received envelopes containing suspicious powder — including two that field-tested positive for fentanyl — while workers were processing ballots from the election the day before. A senior U.S. official familiar with the investigation told CBS News that roughly a dozen letters were sent to addresses in California, Georgia, Nevada and Oregon as well as Washington state.

The substance found on an unspecified number of the letters — not all of them, just some — included traces of fentanyl, the official said, adding that the substance overall was described as "nonharmful." The substance was identified using preliminary field tests, not more rigorous lab tests at FBI facilities, the official said.

The FBI warned all people to exercise care in handling mail, especially from senders they don't recognize.

However, experts in the fields of toxicology and public health have told CBS News that just touching or being near fentanyl won't cause an overdose. Here's what to know about fentanyl contact overdoses.

Can you overdose by touching fentanyl?

Experts told CBS News that touching fentanyl powder will not cause an overdose. In powder form, the way it's almost always found in the illicit drug supply, the drug cannot absorb through the skin, said Ryan Marino, a medical toxicologist, emergency physician and addiction medicine specialist at the Cleveland Medical Center. Just being near the substance also won't cause an overdose.

"Fentanyl as a dry powder is not going to cross through your skin. It's the same reason you can touch sugar without your blood sugar going up," said Marino. "Solids don't cross through your skin."

Fentanyl can resemble a white powder. / Credit: Bill Oxford / Getty Images

Major medical groups have also issued statements about the risk — or lack thereof — from touching fentanyl. In 2017, the American College of Medical Toxicology and the American Academy of Clinical Toxicology issued a joint position statement stating that "incidental dermal absorption is unlikely to cause opioid toxicity." One video, created by harm reductionist Chad Sabora, shows Sabora holding fentanyl and not having any adverse effects as he tests the substance.

If you do get fentanyl powder on your skin, Dr. Andrew Stolbach, a toxicologist and emergency medicine physician at Johns Hopkins Hospital in Baltimore, Maryland, said the treatment is simple: Just wash it off.

"If you see some powder on you, just wash it off, brush it off," said Stolbach. "After that, I wouldn't worry about it at all."

It's important to note that fentanyl found in the illicit drug supply is different from medical-grade fentanyl patches. These do adhere to the skin, but are formulated differently, are slow-releasing, and are primarily used in medical settings. Stolbach described the patches as "specially engineered medical devices" that "just barely delivers some clinically relevant amount of fentanyl." The patch includes fentanyl hydrochloride, a kind of salt that allows the medication in the patch to dissolve through the skin and enter the bloodstream.

A woman holds a fentanyl patch. / Credit: / Getty Images

"Even at peak absorption, if you covered both palms with fentanyl patches, it would take about 15 minutes to deliver just a standard dose," said Stolbach, who is also on the board of directors at the American College of Medical Toxicology. With powder fentanyl, "it's not fentanyl hydrochloride. It's not being held against your skin. It's just going to brush away when someone touches it. Everything's working against it. It's just a totally different scenario than the fentanyl patch."

Brandon del Pozo, a former police officer turned public health researcher who focuses on public health and substance use, compared it to a nicotine patch and a cigarette: "You can't just tape a cigarette to your arm instead of using a nicotine patch."

Can you overdose by ingesting or breathing in fentanyl?

Stolbach said that powder fentanyl can be absorbed by inhaling it, but it doesn't "spontaneously go up into the air," or volatilize, easily.

"Even if powder gets blown into the air, it quickly settles down," he said.

If you have fentanyl on your hands and then touch your eyes, nose or mouth, it could be possible to ingest the substance and bring it into your bloodstream, Marino and Stolbach said. To prevent accidentally ingesting fentanyl, Stolbach recommended taking reasonable precautions like "wearing gloves" and "washing powder off hands" if you come in contact with the substance.

"I always say that if fentanyl was so easily absorbed by other routes, why would people choose to use it by injection?" Stolbach said. "Why don't the dealers and transport people drop dead left and right from breathing or touching it?"

Where did the myth of fentanyl touch overdoses start?

It's hard to tell when exactly people started worrying about overdosing from touching fentanyl, but Dr. Jennifer Carroll, a medical anthropologist and research scientist who studies substance use and public health, told CBS News that fears grew after the Drug Enforcement Administration issued a news release and video warning law enforcement about the "dangers of handling fentanyl and its deadly consequences." In a news release from the Department of Justice, Deputy Attorney General Rod Rosenstein warned that "any fentanyl exposure can kill innocent law enforcement, first responders and the public." The press release and video have since been removed.

At the time, Carroll was a contractor at the Centers for Disease Control and Prevention, and the agency immediately began researching the claims made in the video, taking it "very seriously." However, Carroll said they sound found the claims "totally bogus."

Experts question video of deputy who purportedly "almost died" from substance said to be fentanyl

"I'm deeply frustrated that this myth is still out there, like, just in general," Carroll said. "I'm very angry that we have people who are still encouraging officers to believe this, because I think that's just a horrible thing to do to someone, to make them believe that their life is genuinely in the balance, but it's absolutely not."

In most instances, it's police officers reporting these contact overdoses. Del Pozo said that fentanyl is not "cop kryptonite."

The DEA video was later taken down, and guidelines from the CDC and the position statements from the American College of Medical Toxicology and the American Academy of Clinical Toxicology aimed to set the record straight. However, the myth continues to circulate.

Sheila Vakharia, the deputy director of the department of research and academic engagement at the Drug Policy Alliance, said that there are several reasons why the myth of contact overdoses continues to circulate. Partly, it's because fentanyl is a dangerous drug and people have limited information on how it works. It's also because the people spreading the myth are "people without the appropriate medical training" who are sharing what Vakharia called "well-intentioned" but incorrect information.

Why do people who touch fentanyl have symptoms?

In many cases where touch fentanyl overdoses are reported, the people who believe they are overdosing do report symptoms. A video of a San Diego deputy passing out after he was told the drugs he was seizing were "super dangerous" went viral in 2021. The deputy also reported gasping for air. In 2022, a Kentucky woman said she started feeling her arms tingle and lost the ability to speak before passing out after picking up a dollar bill that she said was tainted with fentanyl. Officers did not test the bill. However, these symptoms and others reported in similar incidents aren't usually associated with opioid toxicity.

"I can say very definitively and confidently that these are not fentanyl overdoses. My best guess would be that these are an anxiety or fear reaction," said Marino. "The symptoms that are always reported are very consistent with that, and that makes sense ... If people tell you every day that if you encounter fentanyl, you could overdose just from being near it, you believe it so strongly that you will have real symptoms."

Del Pozo said that when first responders blame every sudden symptom on fentanyl, it can cause them to miss the signs of what's actually going on.

"One of my officers in Burlington fainted at the scene of a drug arrest, and he assumed — everybody assumed — it was fentanyl," said Del Pozo, who was the chief of police in Burlington, Vermont, at the time. "I did not put it in the news, I did not write a press release, because back then (in 2019), I did not think that was true, and it turns out, it wasn't. It was an unrelated health issue."

What does it mean when officials say a seizure of fentanyl is "enough to kill a million people"?

When officers announce a seizure of fentanyl, it's not unusual for the drug to be quantified as enough to kill a large number of people.

Experts scoffed at this way of measuring how much was found for two reasons. There's no set lethal dose for how much fentanyl is going to kill a person: People who use it regularly will have a much higher tolerance than people who have never taken an opiate. Quantifying fentanyl this way also makes it seem like just by existing, it's dangerous — but in its inert form, that's not the case. Someone would have to consume the fentanyl to make it have an impact, Vakharia said.

Multiple experts compared this phrasing to saying that a body of water holds enough water to drown a state's worth of people.

"When you say there's enough water in the ocean to kill everybody in the world 10 times ... what does that mean? To me, it doesn't seem like a helpful statistic," Stolbach said. "It seems like an intentionally alarmist statistic."


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