The use of the term “crisis” in public debates is often just a crude effort to raise social awareness about an issue of limited social importance. Not so with opioids. The term “opioid” refers to a class of drugs that includes illegal substances such as heroin and FDA-approved drugs such as fentanyl, OxyContin, Vicodin, Codeine, and morphine. This broad class of drugs is today in the public eye because of the large number of deaths and injuries that result from their misuse. In 2017, over 47,000 people died from the use of these compounds, and deaths from synthetic opioids have increased 45% since 2016. In 2018, more Americans died from opioid overdoses than were killed in car crashes. Injuries short of fatality were also immense: Perhaps up to 2.4 million people have suffered from substance abuse problems related to all classes of legal and illegal opioids.

Opioid abuse follows multiple paths. In some instances, patients to whom the drugs have been properly prescribed ingest excessive quantities or continue to take them after the period of prescribed medical use has ended. In other cases, persons with no medical conditions take them for recreational purposes. In about 4 to 6 percent of cases, persons who start on legal opioids transition to heroin. Further deaths are attributable to the illicit manufacture of fentanyl, far removed from recognized distribution channels organized and overseen by either private pharmaceutical companies or the FDA.