I know firsthand what it is like to get a call from the Medical Examiner’s Office saying your loved one’s body was picked up today from a street corner filled with fentanyl addicts. And then to wait a year before the overwhelmed Medical Examiner’s Office sent an official death certificate and autopsy report confirming her death was due to an overdose of fentanyl. She was a person with potential; an artist, a singer, rebellious, creative, curious, big-hearted, and in need of help for mental health issues, and to this system, her life was worth exactly nothing. The last straw that drove her to seek fentanyl was the systematic violent destruction by the authorities of homeless encampments and networks that provided her with at least some shelter, resources, community and an element of peer supervision that kept her away from the most dangerous drugs.

Multiply the pain of that phone call from the Medical Examiner by millions, and you get a feel for the impact of this terrible plague on the victims of this virulently dangerous drug, and their loved ones. From the abandoned cities and towns of the “Rust Belt,” to the Native American reservations… from the wealthy cities facing budget crises that have slashed social services, to the desperate inner cities long devoid of hope… there is an epidemic of fentanyl deaths in this country.

Statistics on fentanyl deaths are very incomplete. Reporting varies greatly by state. Medical examiners are stretched past the breaking point. And the role of fentanyl is often not identified in many deaths (for example, fatal heart attacks can be induced by fentanyl use, but those deaths often are not counted). With all that, in 2021 the U.S. Centers for Disease Control and Prevention reported over 71,000 deaths from fentanyl overdoses, a huge increase from the previous year. And fentanyl has become the leading cause of death among adults ages 18-45.

And here’s the kick in the gut, the spit in the face, or as the 1960s revolutionary George Jackson used to say, the blood in my eye: as I am about to get into, the same system that is responsible for all this misery is using the anger and anguish it has caused. Using it to incite xenophobic and violent hatred against other victims of their system, the desperate millions being brutalized at the Mexican border. Those people, driven to risk (and so often lose) their lives trying to escape poverty and violence that are a product of U.S. capitalism-imperialism. But this system is aiming to enlist you and people like you behind the inhuman brutality being unleashed against those human beings.

And both the Republi-fascists and the Democrats are working to play people in this country for fools and blame China. The rulers of this country see China encroaching on their “turf” atop a world of sweatshops, slums, oppression and war. And they are using the fentanyl epidemic to incite rabid, idiotic, patriotic allegiance to the “USA.”

The Evolution of a Plague

The evolutionary roots of the fentanyl epidemic go way back. Capitalism-imperialism has a long history of pushing mind-numbing and deadly drugs on the oppressed around the world and flooding the inner cities of this country with addictive and deadly crack cocaine and opioids (like heroin). (See box, “Capitalism-Imperialism: The World’s Most Depraved and Murderous Drug Pusher.”)

On another track, starting in the 1990s, big pharmaceutical companies in this country like Purdue Pharma pushed doctors to over-prescribe a synthetic (chemically manufactured) opioid, OxyContin. The owners of Purdue Pharma made over $12 billion during that time. They covered up and lied about how dangerously addictive it was. The result was a wave of addiction that spread across the country, far beyond the inner cities. And as people’s money or prescriptions for legal OxyContin ran out, they turned to heroin in huge numbers (see The Opioid Epidemic and the System Responsible at revcom.us).

Fentanyl is a newer, more powerful synthetic opioid. It is up to 50 times stronger than heroin and 100 times stronger than morphine. It is sometimes sold as heroin, because it is cheaper to produce.

The Victims

The victims of the fentanyl epidemic are increasingly disproportionately people locked down on Native American reservations. These are people without access to jobs, education, healthcare or resources to develop their communities. And, increasingly, they are impoverished young Black people for whom this system has no future.

In March to August of 2021, for example, according to a report at JAMA (Journal of the American Medical Association) Network Open, 30 out of every 100,000 young Native American and Native Alaskan (AIAN) men died of a fentanyl overdose, as did 19 of every 100,000 AIAN women. And 21 out of every 100,000 young Black men died of a fentanyl overdose, as did 10 out of every 100,000 young Black women (see Racial and Ethnic Disparities in Drug Overdose Deaths in the US During the COVID-19 Pandemic).

And the death rate is increasing. In the year 2020, during the period when large-scale production and distribution of fentanyl shifted from China to Mexico (for reasons I’ll explain shortly), the overdose death rate increased by 44 percent among Black people and by 39 percent among American Indian and Alaska Native people. At the same time, there was a 22 percent increase among white people.

Statistics are hardest to come by for other sections of outcast and dehumanized sections of society, but there are studies identifying terrible rates of fentanyl overdose among women driven into prostitution (so-called “sex workers”) and homeless and mentally ill people.

While fentanyl deaths are rising disproportionately among Native American and Black people, the plague has also had a terrible impact among sections of white people. This is especially the case in regions of the country where the exodus of factory jobs has had the greatest impact, leaving behind despair, depression, and huge numbers of people without access to social and medical services. A 2021 study reported people in 80 percent of counties in the U.S. lack adequate access to medical care.

And as I’m about to get into, all this suffering, misery, and death that has been so profitable to U.S. capitalism is now being twisted by shameless demagogic operatives of—and apologists for—this system into inciting hatred for… Mexicans.

Biden Invokes Fentanyl to Uphold Border Brutality, and Repubi-Fascists Demand Much Worse

In his 2023 State of the Union (SOTU) Address, Biden declared, “We now have a record number of personnel working to secure the border, arresting 8,000 human smugglers and seizing over 23,000 pounds of fentanyl in just the last several months.” He went on to frame that in the context of plans for further intensification of repression at the Mexican border.

“Progressives” within the Democratic Party might have murmured something under their breaths about let’s not demonize all immigrants. If so, I can’t find a record of that. Republi-fascists in Congress, on the other hand, broke longstanding rules of SOTU protocol and disrupted Biden’s speech. Fascist lunatic Marjorie Taylor Greene shouted, “It’s coming from China!” Another Republi-fascist shouted at Biden, “It’s your fault!” It’s your fault!”

Both sides in the death-match conflict within the U.S. ruling class are posing as champions of white victims of fentanyl. To give a sense of how this is playing out: In his recent successful campaign for the U.S. Senate (from Ohio), Republican J.D. Vance promoted and incited fascist conspiracy theories that Democrats are deliberately allowing Mexican drug cartels to smuggle fentanyl. He claimed, "If you wanted to kill a bunch of MAGA voters in the middle of the heartland, how better than to target them and their kids with this deadly fentanyl ... and it does look intentional."

Did Vance’s Democratic opponent, Tim Ryan, tell people that it is loony to think that fentanyl overdoses are a plot by Mexican cartels and the Democrats to kill MAGA voters (and point out that Black and Native American people are by far the hardest hit)? Did he insist that both immigrants and victims of drug overdoses are human beings? Did he even make an issue out of the fact that people, including “MAGA voters” are driven to use fentanyl because they don’t have access to real medical care? No, no, and no. Ryan introduced a bill in Congress classifying fentanyl as a “weapon of mass destruction.” And Ryan declared in a debate with Vance that the solution was “more Border Patrol” and building a “barrier” (Trump’s Wall, but branded a bit differently) on the Mexican border.

The Role of Mexican Cartels

As a matter of fact, today there is a large influx of fentanyl into the U.S. produced and distributed by Mexican cartels. But the fentanyl plague is not an “invasion” or “weapon of mass destruction” from Mexico. It is a product of the oppressive “relationship” between U.S. capitalism-imperialism and Mexico. This letter cannot go into that in any depth, but if you want to understand this and how it fits into the big picture in the world today, read Imperialist Parasitism and Class-Social Recomposition in the U.S. From the 1970s to Today: An Exploration of Trends and Changes by Raymond Lotta. Lotta’s article identifies, for example, that “… in 2016 average hourly manufacturing compensation costs (wages and benefits received by workers) in Mexico was $3.91; in the U.S. it was $39.03—in other words, workers in Mexico were receiving 1/10th the pay of U.S. workers in manufacturing. All this enhances profitability and is essential to bolstering the competitiveness of U.S. capital on the world market.”

The cartels that manufacture and ship fentanyl into the U.S. are a major link in the chain in the oppressive relationship between the U.S. and Mexico and the super-exploitation that Raymond Lotta’s article gives an example of. The cartels are key to maintaining economic stability and enforcing the rule of the dependent Mexican ruling class, even as there can also be significant, even violent conflicts and contradictions among these forces. The economy of Mexico, and the official forces of violent repression of the Mexican state (army and police), are deeply intertwined with the cartels.

In REVOLUTIONARY HOPE: New Possibilities Are Opening Up for Liberatory Revolution In the Midst of Acute Crises and Upheavals of the Capitalist System—It Is Urgent to Organize the Fight For Revolution, the Revolutionary Communist Organization (OCR) in Mexico summarizes and quotes from important analysis that organization has made of this complex oppressive web:

[Mexico’s U.S.-backed “war on crime”] does not seek to put an end to drug trafficking but rather to put in order and control the illegal drug market and, above all, to prop up the state and its ability to protect the prevailing social order” with “major interpenetration between the cartels and the government at all levels” in which “both the government and the cartels commit horrible crimes against the people” with a huge toll of murders, disappearances and torture throughout the country.

In short, the manufacture of fentanyl by Mexican cartels and their role in the distribution of fentanyl in the U.S. are tightly bound up with the super-exploitation of the people of Mexico and structures—official and unofficial—that maintain and enforce that oppression.

One terrible impact of that growth of fentanyl production and distribution in Mexico has been the spread of this deadly epidemic into the massive and desperate slums of Mexican cities, particularly Tijuana.

From 2021 to 2023, fentanyl use tripled in Tijuana, and that number is based only on deaths recorded in hospitals, not the forsaken ones who die in the street. A Mexican reporter who has been exposing the extent of death among desperate and homeless people in Tijuana wrote, “Unfortunately the police and society don’t care about these people and we don’t really know who dies and how many have died.”

And again, this makes my blood boil: The depraved ghouls who rule this system and those who front for them are trying to incite people who have lost loved ones to fentanyl, or people who care about that, to get played into seeing people viciously exploited and oppressed by “our” rulers in Mexico as the “problem” and the “enemy.”

No. We—the masses of people in this country and the masses of people in Mexico and around the world—have a common problem and a common enemy: the rulers of this capitalist-imperialist system.

The “China Connection”

Along with scapegoating and demonizing Mexicans and immigrants, both the fascists and Democrats in the U.S. ruling class have been blaming China for the fentanyl epidemic. Let’s look at the reality here.

Americans have access to a wide range of legal pharmaceuticals more cheaply because they are made by lower-wage, super-exploited workers in China. (China was a revolutionary, socialist society until the death of Mao Zedong in 1976 when capitalism was restored there. For background see Revolution special issue You Don't Know What You Think You "Know" About... The Communist Revolution and the REAL Path to Emancipation: Its History and Our Future.)

In addition to producing fentanyl, Chinese pharmaceutical companies “have supplied more than 90 percent of U.S. antibiotics, vitamin C, ibuprofen and hydrocortisone, as well as 70 percent of acetaminophen and 40 to 45 percent of heparin in recent years.” (New York Times, 3/11/20) And Chinese manufacturing based on super-exploited labor has been a source of tremendous profit for U.S. corporations, including the pharmaceutical industry.

There is no evidence that Chinese manufacturers or authorities actually smuggle, or smuggled, fentanyl into the U.S. What U.S. officials charge is that orders placed from what appear to be legitimate U.S. pharmaceutical distributors for fentanyl are filled by Chinese manufacturers. Chinese manufacturers may have known, or not bothered to find out, if some of what was being shipped to the U.S. was being distributed illegally. But for the rulers of the U.S. to point a finger of blame at China is the pot calling the kettle black. Legal and illegal distribution of fentanyl has been a source of massive profits for major U.S. capitalist enterprises, including the leading drug manufacturers and distributors.

For example, Insys Therapeutics, a U.S. corporation whose founder was at the time worth over $3 billion, bribed doctors around the country with money, gifts and expenses-paid trips to strip clubs to write prescriptions for their SUBSYS fentanyl spray (see How a Drugmaker Bribed Doctors and Helped Fuel the Opioid Epidemic).

In recent years, the U.S. rulers have been on a mission to stabilize their global “supply chain” and break dependency on especially strategic Chinese imports. “Think tank” advisors to the U.S. ruling class are warning that reliance on imported Chinese medicines “can be used as a weapon of war against the United States.” Under both Trump and Biden, the U.S. has been seeking to discredit the safety, standards, and regulation of shipments from Chinese drug manufacturers, including fentanyl (see Fentanyl and geopolitics: Controlling opioid supply from China, Brookings Institution).

As a result, Chinese authorities clamped down on verification that orders for fentanyl from the U.S. are legitimate. That squeezed the “supply chain” of Chinese-manufactured fentanyl and created an “opportunity” for production to move to Mexico.

Chinese manufacturers who produced fentanyl did so under at least some government supervision to maintain dosage and quality consistency. That is not the case with fentanyl produced by the Mexican cartels. And, as noted earlier, because fentanyl is so concentrated, lack of consistent doses makes this drug much more dangerous.

None of this was a planned conspiracy. The shifting of the major supplier of illegal fentanyl from China to Mexico was a product of the blind, anarchic workings of capitalism driven by a do-or-die need of individual blocs of capitalists to beat out rivals and maximize profits. That is what it actually means to say that something is “systemic.” But this shift did move the source of fentanyl to the U.S.-Mexico border. And it put production and distribution in the hands of cartels with government connections and networks through which to pump massive amounts of cheap fentanyl into the U.S.

It Will Take a Revolution…

The fentanyl epidemic evolved out of a toxic stew of rabid competition to maximize profit in the pharmaceutical industry; the essential role the super-exploitation of the people of Mexico plays in the operation of U.S. capitalism-imperialism and its position as the world’s leading exploiter and oppressor; and the escalating clash between U.S. imperialism and their capitalist-imperialist rivals in China. In short, it is a product of a system that has no future for humanity and turns everything it touches into suffering and death.

Only a REAL revolution, that overthrows that system, will change that.