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AILSA CHANG, HOST:

One of the outcomes of President Biden's meeting with Chinese leader Xi Jinping yesterday was an agreement over fentanyl. The agreement is to curb the flow of the precursor chemicals that are used to make synthetic opioids like fentanyl, which originate in China. Realistically, what would it take for China to seriously constrain this? Well, to discuss that, let's bring in Ben Westhoff. He's an investigative journalist and the author of "Fentanyl, Inc.: How Rogue Chemists Are Creating The Deadliest Wave Of The Opioid Epidemic." Welcome.

BEN WESTHOFF: Thanks for having me, Ailsa.

CHANG: Well, thanks for being with us. So this agreement between Presidents Biden and Xi to curb fentanyl production, it isn't the first of its kind, right? Like, there was an agreement back in 2019 between former President Trump and Xi on this very same issue. But is there something that stands out to you now that makes this announcement any different and makes you believe that the results we will see will be different?

WESTHOFF: The 2019 agreement was widely heralded and it was to ban fentanyl analogs, which are types of fentanyl and they're drugs themselves. People take those, overdose and die. This agreement focuses on the ingredients to make those chemicals. And so the 2019 agreement actually did work.

CHANG: Oh.

WESTHOFF: We saw less of these chemicals on the street. But what happened was these Chinese chemical companies just shifted to making these fentanyl precursors...

CHANG: Ah.

WESTHOFF: ...Aka fentanyl ingredients. And so now that's the problem.

CHANG: And do you think that this new agreement between President Biden and Xi Jinping will produce a more effective result - that is, we will see a noticeable difference in the amount of fentanyl flowing in the U.S.?

WESTHOFF: I think there could be a short-term difference. What happens is that these Chinese chemical companies sell the precursors to Mexican cartels, who finish them and send them north of the border. And we might see less of that for a while. But the problem is that Mexican cartels are very adaptable.

CHANG: I see. Well, let's talk about your reporting from China. You're one of the only, if not the only, reporter to get access to one of the fentanyl manufacturing labs in China. What was your main takeaway from that?

WESTHOFF: I couldn't believe how this was being done on such a huge scale. You know that only two grains of rice worth of fentanyl is enough for someone to overdose and die. But in these labs and companies where I visited, I saw these huge quantities being made - you know, kilos and kilos and kilos. And these were some small labs, too. And so I think the problem is just much bigger worldwide than we even really realize.

CHANG: Is there one metric that you will be looking to to assess if this particular plan, at least between the U.S. and China, is at all effective in the upcoming months or years?

WESTHOFF: If China really does curb the flow of these fentanyl precursors, what might happen is that fentanyl might start becoming more expensive on the streets of the United States. So if that happens, then that will show that this is effective. And for what it's worth, I actually do think that this agreement could be effective. The strange thing about drug traffickers operating out of China is that they actually want to follow the law. You know, the companies that are producing these chemicals tend to pay taxes. They fear the government. I just don't think in the long term it's really going to help the problem here at home with so many overdose deaths.

CHANG: Right. Well, given that you think that fentanyl production would just be overtaken by actors in other countries if Chinese factories play a lesser role, how would you advise President Biden in terms of how to limit the production side of fentanyl?

WESTHOFF: Unfortunately, I just think that when it comes to the supply of fentanyl, there's really no way to make a dent in it. You know, we've spent tens of billions of dollars trying to stop drugs from getting into this country, but none of this has really had any effect. The only thing that really will work to curb this epidemic, I believe, is to focus on people here, try to help people who are addicted have access to treatment.

CHANG: That is Ben Westhoff, investigative journalist and author of "Fentanyl, Inc." Thank you very much.

WESTHOFF: You're welcome. Thank you for having me. Transcript provided by NPR, Copyright NPR.

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