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Last year, responding to pressure from the Trump administration, the Chinese government cracked down on direct shipments of fentanyl to American buyers.

Chinese chemical companies quickly adapted by selling their product to "middle man" drug cartels in Mexico.
"They're sending precursor chemicals directly to cartels in Mexico to produce the fentanyl along with the fentanyl in pills," Donahue said.

Once they got into the fentanyl trade, Mexican cartels used their existing drug routes and street markets in Western cities to push the new product. Their motives are simple: Fentanyl is deadly, but it's also cheap and easy to make and ship. It's also highly addictive, making it far more profitable than heroin or cocaine.