China, US join hands to fight fentanyl

Strict supervision

Since the 18th Communist Party of China's National Congress in 2012, President Xi Jinping has attached great importance to the anti-drug campaign and ordered authorities to actively take part in global drug control to safeguard people's health, safety and the well-being of all mankind.

Last year, Xi said China would regulate all fentanyl-related drugs as controlled substances.

According to the National Health Commission, fentanyl is under the strictest supervision in the country.

Chen, from the National Medical Products Administration, said that in addition to strictly controlling fentanyl, authorities should scientifically define it to ensure they have full control over its use and that it is used legally for medical treatment, in industry and for scientific research.

In China, fentanyl can only be used as an anesthetic and a painkiller in hospitals. It is strictly controlled by laws and regulations covering its research, development, production, circulation and clinical use.

According to the NMPA, there are more than 70 known derivatives of fentanyl, but only four of them can be clinically used in China.

Wang, the HuanmanWell Healthcare Group chairman, said, "Only a few enterprises in China have permits to produce fentanyl, and the production of each company is planned by the top drug authority annually, based on demand for the drug."

Circulation of fentanyl is also strictly supervised, and only drug wholesalers are allowed to handle transactions to authorized medical institutions, he said.

Such institutions must obtain approval from the authorities, including health and public security, to get permits to buy the drug, and doctors require a special certificate to prescribe it, Wang said.

"At present, it can only be used in injections in China, and no oral products have been approved," he added.

Huang Yuguang, head of Peking Union Medical College Hospital's anesthesia department, said some types of fentanyl are used as effective painkillers in hospitals, but they also have serious side effects such as suppressing respiration.

All such drugs are under the strictest supervision in Chinese hospitals, he said.

For example, in hospitals, fentanyl is stored away from other drugs in locked cabinets, and doctors use a special prescription for it, Huang said.

A prescription must include detailed information about the patient, including name, gender, identification card number, employer's name and details of the quantity and specification of the drugs prescribed, Huang said.

The quantity of the drug allowed for each prescription is also strictly limited. A single prescription can only cover one injection, with the exception of patients with acute pain caused by cancer or other diseases, where each prescription can cover three days, he said.

Wang Shenghe, deputy director of the National Health Commission, said, "We should fully evaluate all kinds of substances related to fentanyl and their potential legal use."

Chen Shuaifeng, an associate professor of narcotics control at the People's Public Security University of China, said that in the past, once a drug derivative was included on the controlled list, illegal producers made a new derivative after slightly changing its chemical structure to evade legal supervision.

He said banning all substances related to fentanyl would help eliminate loopholes in illegal production, abuse and smuggling.

"When the new measure is in place, once a new derivative is produced in the laboratory it will immediately be considered to be a controlled drug, so it cannot be used or produced illegally," Chen Shuaifeng said.

He proposed that detailed laws or regulations be drawn up to more effectively hold those who violate the law covering new synthetic drugs, such as fentanyl, legally accountable.

The existing law clearly specifies penalties, such as the length of sentence for those who illegally produce, sell or abuse traditional drugs, such as heroin, Chen Shuaifeng said.

However, there is a lack of details for those who violate the law covering new synthetic drugs.