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The moral of the fentanyl overdose epidemic story is not that prescription opioids should never have been legally prescribed, nor that advertising should be prohibited, but that individual patients should be more vigilant as they consider which course of treatment to undergo.

https://libertarianinstitute.org/articles/lessons-from-fentanyl/

by Laurie Calhoun

The use of drugs is sometimes characterized as a victimless crime, since the person who ingests them will bear the negative consequences should something go awry. Supporters of prohibition, who wish for the government to regulate and limit sales and distribution, are typically concerned with not only the moral effects on individuals themselves but also what might be called the “collateral damage”: the family and community members affected by the user who succumbs and loses “the plot” of his life, so to speak. This concern with “collateral damage,” however, applies to drug (including alcohol) use more generally, whether or not the substance in question is illegal. In fact, as both Prohibition and the War on Drugs illustrate, the crimes committed by users and suppliers multiply in tandem with laws enacted to prevent people from obtaining the substances which they wish to ingest.

If no one in the United States who sold drugs was committing a crime, then there would be no witnesses to worry about and possibly eliminate. There would be no need for armed cadres of contract killers to deal with the rival gangsters attempting to control sales over makeshift domains. No one would be in prison for drug possession or sales, including the parents of children rendered homeless or wards of the state as a result. The purchase of drugs would be rendered safer for consumers themselves, who would no longer have to gamble in deciding which criminal to patronize, having no idea what the source of the substances was and whether and with what they may have been cut. When drug use is criminalized, addicts in search of a needed but expensive (because illegal) fix may be driven to commit other crimes, generating even more collateral damage, only because of the illegality of drug use. It may seem axiomatic to libertarians that laws create crimes, but all of these empirical hypotheses, previously tested by the Prohibition, have been more recently confirmed by Portugal in the years since 2001, when the government of that country decriminalized recreational drug use.

The drug scene has transformed significantly over the course of the past three decades, as a result of the sudden appearance and spread of synthetic substances. Throughout much of the twentieth century, most of the street drugs which people were peddling had natural origins: marijuana, hashish, cocaine, opium, morphine, heroin, et al., are all derived from plants. LSD (lysergic acid diethylamide) is a potent synthetic drug, but it is not addictive and, aside from the hippie era, it has never been as popular as any of the aforementioned natural drugs. Today, however, for reasons peculiar to the explosion of synthetic drug production in the late twentieth century, including the never-ending quest of pharmaceutical companies to discover and market profitable molecules, many popular street drugs, too, are synthetic. Drug trends come and go, but among the substances which have taken off in recent years, fentanyl stands in a class all its own. Fentanyl is not only inexpensive to produce but also highly addictive and so potent that even a tiny dose can be deadly. At first glance, it might seem to some that the fentanyl crisis itself constitutes a cogent argument for prohibition. Nothing could be farther from the truth, as an examination of the etiology of the current overdose epidemic reveals.

The use of fentanyl as a synthetic heroin surrogate became widespread after millions of people became addicted to prescription pain medications such as Vicodin, Hydrocodone, and Oxycontin, and turned to the streets for their needed fixes.

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