U.S. prosecutors have charged 10 more people in an international fentanyl trafficking operation they say led to overdose deaths in four states.

Authorities have now accused a total of 32 people of trafficking large amounts of the powerful opioid in the U.S. and Canada. Five are fugitive Chinese nationals.

Attorney General Jeff Sessions made the announcement Friday in North Dakota, where the first death occurred in 2015. Deaths have also been reported in North Carolina, New Jersey and Oregon.

Sessions says the Treasury Department also has sanctioned the five Chinese nationals, including the man alleged to be the conspiracy leader, along with his biotechnology company. Any assets in which they have an interest must be reported to the department.

It’s the first time the department has sanctioned an alleged fentanyl trafficker.

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