And he has caused more worry in Washington, DC, through his repudiation of ties with the US and seeming embrace of China — a move that has stirred concern among the Philippines' neighbors in the region and among US policymakers as they try to respond to China's growing influence and assertiveness in the South China Sea.
However, Duterte's initiatives — a brutal crackdown on the drug trade and an opening to Beijing — may come in conflict with each other if the Chinese role in the Philippines' drug scene becomes a sticking point.
Duterte has referred to the connection between China and drugs in the Philippines since mid-summer. After a July 12 international-court ruling dismissing China's claims in the South China Sea, Duterte suggested that many drug-related killings involved Chinese nationals.
"Those who die and the bodies are unclaimed, who will claim them? Most of them really are Chinese," he said on July 17. He also claimed that drug organizations cooked shabu, a name for the methamphetamine consumed in the Philippines, aboard ships originating from China.
Later that month he doubled down saying, "Where is the big fish [in illegal drugs]? If you want them, go to China. Look for them there."
In late August, Duterte's government again linked China to the country's drug trade. Foreign Secretary Perfecto Yasay told a Senate hearing that the Chinese ambassador had been summoned to respond to accusations that China was a major source of drugs and that Chinese triad gangs were involved in smuggling.
"(The ambassador) said that this is not true, and I told him these reports are based on intelligence information. They have been validated so far as we are concerned, so I wanted a clarification from him," Yasay told Reuters at the time.
China responded by requesting more information on allegations about Chinese involvement in the drug trade, with the country's ambassador to the Philippines saying it was "utterly wrong" to claim all the drug lords were Chinese.
“If you find there are Chinese nationals who got themselves involved in drug-related crimes, give us solid information before you say they are Chinese,” China's ambassador, Zhao Jianhua, said in late August. “These allegations or generalizations must be avoided.”
In recent weeks, Duterte has reaffirmed his desire to break with the US (though he said he would honor current treaties) and rebuked much of the world for criticizing his drug war, all while again signaling his willingness to engage with China.
In mid-September, Duterte announced his government was considering weapons purchases from China, and on September 26 said "we will open alliances with China" and Russia, and that he would open up the "other side of the ideological barrier."
But drugs still cast a shadow over the Philippines' ties with China, where the presence and seizures of methamphetamine have grown in recent years.
In August, an antinarcotics raid northwest of Manila reportedly seized more than $82.7 million worth of shabu in a warehouse allegedly belonging to a Chinese syndicate.
In early September, a raid on a pig farm north of the Philippine capital of Manila uncovered a drug lab and led to the arrests of seven Chinese citizens.
Also in early September, the chief of the PNP Anti-Illegal Drugs Special Operations Task Force said that China continued to be a major source of drugs in the Philippines.
“Most of those involved in smuggling shabu were mostly Chinese and West African drug syndicates,” Senior Supt. Bartolome Tobias told reporters at the time.
“This is why we will continue to launch operations against big-time Chinese drug lords operating in the country,” he said.
China, which has capital punishment for drug offenses, has affirmed its support for Duterte's crackdown on drugs, but Chinese officials and state media have at times denied Chinese involvement or downplayed China's role in the Philippines' drug trade.
Chinese citizens have both criticized the bloodshed in the Philippines and mocked Philippine anger over Chinese involvement in the drug trade, according to Quartz.
Positioned between two world powers — China and the US — in a strategically valuable spot in the South China Sea, the Philippines president has room to play both sides.
The US would likely be quiescent over the drug violence if Manila was firmly on its side in efforts to balance against Chinese power, and Beijing would likely be open to playing ball if the Philippines were willing to accede to some of China's interests in the Pacific.
But Duterte's saber-rattling against the US (though other Philippine officials have reaffirmed the relationship) has only stirred unease in Washington, while his focus on combatting drugs and drug dealers may antagonize Beijing.
Duterte, for his part, seems to be focused on drugs, perhaps to the detriment of other issues.
On September 20, noting that Hitler had murdered millions of Jews, he said: "There are 3 million drug addicts (in the Philippines). I'd be happy to slaughter them."
"If Germany had Hitler, the Philippines would have...," Duterte said, pausing and pointing to himself.
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