A recent development: In the latest “Major’s List” presented to the U.S. Congress, former President Donald Trump identified 23 nations as major sources or transit points for illicit drugs, particularly fentanyl, which he stated pose a threat to the U.S. and its citizens. This list includes countries like India, Pakistan, China, and Afghanistan.
What is the Major’s List?
The Major’s List is an annual compilation that highlights regions whose geographical location, trade activities, or industrial output contribute to the global flow of narcotics or their precursor chemicals. The U.S. State Department clarifies that a country’s inclusion on this list doesn’t necessarily indicate a failure in its anti-narcotics efforts. Instead, the designation depends on whether significant quantities of drugs or their manufacturing chemicals are produced or transported through that nation. Notably, Afghanistan, Bolivia, Myanmar, Colombia, and Venezuela were explicitly cited for “demonstrably failing” to meet their international drug-control obligations.
Understanding Fentanyl
Fentanyl, a synthetic opioid, is the primary cause of drug overdose fatalities in the United States. Initially developed in the 1960s for medical purposes, it’s prescribed in precise, regulated doses for patients experiencing severe pain. However, in illegal markets, fentanyl is approximately 50 times more potent than heroin. A mere 2 milligrams can be lethal because it acts as an agonist on the mu-opioid receptor, a protein in nerve cells that typically responds to the body’s natural pain-modulating chemicals. When fentanyl binds to these receptors in high enough concentrations, it suppresses the brainstem’s respiratory centers, which control automatic breathing. It also readily crosses the blood-brain barrier, accumulating in the central nervous system. This ultimately leads to hypoventilation and severe respiratory depression.
Naloxone, a competitive mu-opioid receptor antagonist, can reverse opioid overdoses by displacing opioids from the receptors and restoring normal breathing. However, swift administration is crucial, as untreated respiratory failure can result in brain damage and death within minutes.
U.S. statistics show that from August 2023 to August 2024, over 57,000 Americans died from opioid overdoses, with most cases involving fentanyl. In 2022, the U.S. Drug Enforcement Administration (DEA) reported seizing 50.6 million fentanyl-laced pills and enough powdered fentanyl to create 379 million potentially deadly doses—an amount sufficient to kill the entire U.S. population.
Why is Fentanyl So Difficult to Regulate?
Unlike heroin or cocaine, which are plant-derived, fentanyl is manufactured in laboratories using specific chemical compounds known as precursors. The most critical of these are N-phenethyl-4-piperidone (NPP) and 4-anilino-N-phenethylpiperidine (4-ANPP). While these substances have legitimate applications in industry and pharmaceuticals, they can easily be diverted into illegal supply chains.
In illicit labs, these precursors are transformed into fentanyl powder through standard organic chemistry reactions. First, NPP is converted into 4-ANPP via a reductive amination reaction, where a nitrogen-containing fragment is attached to the NPP ring and stabilized by a mild reducing agent. Subsequently, 4-ANPP undergoes an acylation reaction, adding an acyl group (R–C(=O)) to the nitrogen atom, which then produces fentanyl. These processes require only basic laboratory equipment, solvents, and moderate heat. Consequently, once traffickers acquire the precursor compounds, manufacturing fentanyl becomes straightforward. The difficulty in regulation is compounded by the fact that only tiny quantities of precursors are needed to produce large amounts of fentanyl, and these substances can be shipped discreetly.
The Fentanyl Supply Chain Explained
The global fentanyl supply chain involves numerous players. China and India are key contributors to the production of precursor chemicals, with some being diverted into illegal channels. Mexican cartels play a central role in processing these precursors into fentanyl powder. Once manufactured, the powder is either pressed into fake pills or mixed with other illicit narcotics, then smuggled into the U.S., particularly across its southwestern border with Mexico. In response, the U.S. government has employed various strategies, including criminal prosecutions of companies and their executives, imposing trade penalties, applying diplomatic pressure, and enhancing law enforcement efforts. For instance, in January 2025, two Indian firms, Raxuter Chemicals and Athos Chemicals, were accused of conspiring to export fentanyl precursors to the U.S. and Mexico. Bhavesh Lathiya, a senior executive at Raxuter Chemicals, was arrested in New York on smuggling charges. Following these incidents, the U.S. Embassy in New Delhi revoked and denied visas for several business executives and their families linked to fentanyl precursor trafficking.
In February 2025, the Trump administration levied 25% tariffs on Canadian and Mexican imports and an additional 10% on Chinese imports, explicitly citing fentanyl trafficking as a key reason. While the tariffs on Canada and Mexico were later lifted after agreements to strengthen border enforcement, those on China remained in effect.
Domestically, the DEA has stepped up operations to seize fentanyl shipments, dismantle trafficking networks, and intercept counterfeit pills designed to look like legitimate drugs such as oxycodone. Simultaneously, naloxone distribution has increased, and public awareness campaigns are educating consumers about the risk of lethal amounts of fentanyl in fake pills. Furthermore, treatment programs for opioid dependence are being strengthened to reduce demand and offer support to individuals battling addiction.