China has long maintained one of the most stringent drug control regimes globally, characterized by law enforcement, compulsory rehabilitation, and strict regulation of controlled substances. Domestically, China has experienced a significant shift in its drug market. Since around 2015, synthetic drugs have progressively become the predominant substances consumed, particularly among new users. By 2022, an estimated 620,000 people were registered as users of synthetic drugs (mainly methamphetamine and ketamine) representing approximately 55 percent of the total registered population of people who use drug nationwide.

This evolution has required Chinese authorities to adapt both enforcement and regulatory approaches, including through adjustments to scheduling practices. Internationally, attention has focused on China’s role in the production and export of chemical and pharmaceutical precursors used in the manufacture of fentanyl and other synthetic drugs. This has been particularly prominent in the context of U.S.-China relations, where U.S. authorities have criticized what they perceive as insufficient enforcement against precursor producers and limited prosecution of Chinese nationals involved in transnational trafficking. These concerns have been reflected in legislative initiatives in the U.S. Congress and in the designation of China, in September 2023, as a Major Drug Transit or Major Illicit Drug Producing Country.

Chinese authorities have consistently rejected these characterizations, emphasizing shortcomings in demand-reduction efforts in consumer countries and denouncing unilateral sanctions against Chinese companies and individuals as unlawful and politically motivated.

At the same time, China introduced class-wide scheduling of fentanyl-related substances and precursors in 2019 and nitazenes in 2025, marking a significant policy shift. These moves were widely welcomed, and the impact on illicit trafficking of fentanyl has been documented in the reduction of related mortality (in the U.S. and Canada), 2 despite taking time due to existing stockpiles, adaptive supply chains, and the speed with which illicit markets respond to regulatory changes.