Fentanyl is a nasty synthetic opioid. It is 100 times more potent than heroin and 50 times more potent than morphine. It is, not surprisingly, also many times more addictive.

In 2023 an estimated 75,000 Americans died of fentanyl overdoses. As little as two milligrams of fentanyl—roughly equivalent to a few grains of salt—can kill you. A large number of the 2.5 million US opioid addicts are fentanyl users.

Because it is highly addictive, Fentanyl is replacing—some say has replaced—cocaine and heroin as the product of choice of the drug cartels. Heroin exports are also being laced with a grain or two of fentanyl to increase the user’s dependence on the drugs.

All of the above goes some of the way to explaining why President-elect Donald Trump has linked the totally separate issues of immigration and fentanyl exports and threatened to slap a 25 percent tariff on imports from Mexico and Canada and a 10 percent tariff on Chinese imports unless they close down the fentanyl-producing laboratories and the smuggling operations. Of course, life is never that simple.

Let’s start with Mexico. The Mexican drug cartels are the major culprits. In the first nine months of this year, US Customs seized 16,000 pounds of fentanyl at America’s southern border. That is 7.24 billion lethal doses.

The illicit trade is dominated by the Sinalo and Jalisco New Generation cartels. They have taken the billions they have earned from drugs to invest in mining, agriculture and, of course, political respectability. They have become an integral part of the Mexican business and political establishment with legal and illegal operations in 40 countries. They will be difficult to root out. To complicate matters they operate a franchise system so that each production and smuggling operation functions separately from the centre.

The Chinese were targeted by the Biden Administration, and since 2019 illegal exports of fentanyl to the US and to Mexico for transhipment to the US have dropped dramatically. But the chemical components that comprise the synthetic drug are still being shipped to Mexican Laboratories for assembly. As each of the components is completely legal it is difficult to prevent their production and export.

It is a bit of a mystery as to why Trump has included Canada on his list. In the first nine months of 2024 US Customs sized just 40 pounds of fentanyl heading south from America’s northern neighbour. It is also an enigma as to why Trump included Canada in his target list for illegal aliens. In 2023, US border control stopped 12,200 illegal aliens from crossing the US-Canada border. This compares to 2.48 million from Mexico. It is more likely that Trump is trying to undermine liberal icon Justin Trudeau before next year’s federal elections.

There is a further twist to the fentanyl and the general opioid story. It is an American-created problem. Fentanyl was first developed in 1960 in Belgium, by the pharmacologist Dr Paul Janssen. He quickly licensed production to American pharmaceutical companies. One of the big financial beneficiaries was the multinational Johnson and Johnson. Woody Johnson, the heir to the Johnson and Johnson fortune, is a big contributor to Donald Trump and was his ambassador in London from 2017 to 2021.

But the ones who won and lost the most as a result of the opioid crisis are the Sackler Family. Their company Purdue Pharma produced an opioid called oxycontin which they marketed as a painkiller with low risk of addiction. This was a lie and they knew it. Oxycontin earned Purdue and the Sacklers tens of billions of dollars. It also resulted in thousands of law suits which have to date cost the Sacklers $6 billion and bankrupted Purdue Pharma.

Fentanyl was developed as a painkiller for cancer patients suffering chronic pain and for those recovering from difficult and painful surgery. It is still prescribed.

But by the end of the 1990s it was being over-prescribed alongside other opioids such as morphine, oxycontin, oxycodeine, hydrocodone, buprenorphine and hydromorphine. If you went to the doctor and complained of a backache they wrote you out a prescription for an opioid. When the backache returned they wrote you another and another….

By the turn of the century America was in the midst of a full-blown opioid epidemic. The government and medical profession responded by imposing strict guidelines on the issuing of prescriptions for opioid drugs. But it was too late. When the opioids were withdrawn from the millions of medically-created addicts, the drug cartels rushed in to fill the vacuum.

In 2023, 350,000 opioid addicts—most of whom became addicted through prescription use—were being treated, mainly with methadone. But an estimated two million-plus are still addicted and obtaining fentanyl and other opioid drugs from street vendors.

* Tom Arms is foreign editor of Liberal Democrat Voice and author of “The Encyclopaedia of the Cold War” and “America Made in Britain".