What's more interesting though is the inherent impedance mismatch between money and goods (which are highly mobile and flow everywhere) and people and laws (which are much less so).

The crux of the problem is Americans are negatively affected by things that China sells. But what is the remedy?

Should China's government take American citizens' interests directly into account when making its laws? Is that a reciprocal obligation? How far does it extend?

How is it different from the current scenario, where presumably the US State Department identifies the harm, brings it up with China, and negotiates a change to Chinese laws? Should there be a bureaucratic mechanism with quicker feedback? Would that lead to an inevitable loss of effective sovereignty for nations?

Are you saying that it's acceptable for Chinese companies and gangs to manufacture opiates and ship them off to the USA because Britain and the USA went to war with China 150 years ago to enforce the opium trade?

History suggests they will be. China happily exported and exports Ketamine, and are now dealing with a massive problem of heavy Ketamine addicts. It’s gotten so bad that they’ve lobbied internationally to sanction ketamine, which ran into a brick wall for good reasons.1

1 Ketamine is the only general anesthetic that doesn’t require loads of training and respiratory support to use, and as such is on the WHO lost of essentials.

It's not as addictive as some people would suggest. I have a prescription and it makes me sweat profusely and puke. Hardly enjoyable and I have no interest in dissociation because I want to live in the present.

Making Ketamine harder for patients to access is going to destroy a lot of lives. People with depression like myself are already being taken advantage of by Ketamine infusion clinics that charge exorbitant rates. These doctors, often not psychiatrists, could prescribe a lozenge for their patients to take at home if they were serious about helping depressed patients and not lining their pockets.

Even putting aside its use as a treatment for depression, restricting Ketamine was deemed unacceptable by the WHO, so don’t worry. It’s really really the only thing going if you need to intervene surgically and don’t have an OR.

Probably because it’s the death sentence.

There are real use cases for fentanyl (there's a report here locally of ambulance crews misappropriating fentanyl from the pain medication supplies.) I know there's media reports of "an opioid epidemic", but I'm suspicious about how much that's "real" and how much of it is "war on drugs" reporting pushed by law enforcement PR for the purposes of propping up the prison-industrial complex...

30,000 deaths per year in the US seems to be considered "acceptable" in the face of the benefits of 200-ish million people owning/driving cars. I wonder what the ratio of "people benefiting" vs "people dying" from opiates and fentanyl in particular is?

maybe, maybe not. often when someone overdoses, the dealer has customers lined up around the block the next day. addicts don't know whether that particular stuff was cut with fent or just stronger than usual, and they don't particularly care.

even if enough people were dying that it made a significant dent in sales, i doubt it would change anything for the suppliers. selling fentanyl as heroin is massively more profitable than just selling heroin, and there's no way to do it safely. low doses of heroin are in the tens of milligrams, while fentanyl can have a potent effect at doses less than one milligram. this makes it really hard to achieve a homogenous mixture; there's basically always going to be some potentially lethal hotspots.