yyyyyyy

There's good reason for my harsh criticism, and I don't think most people truly realize how bad the situation is.

No. I'm saying, as someone that understands the nuances better than you that, focusing on the fentanyl statistic is misleading.

It alone is responsible for what is quickly becoming the deadliest drug epidemic of all time.

No it is not "alone" responsible. All the other stuff: oxy, hydro, tramadol, heroin, morphine is more responsible for the current mess. People didn't routinely end up with opioid addictions due to fentanyl as much as all these other medications (and illicit heroin, not all addictions are the doing of big pharma)

The fact that they are now seeking out illegal suppliers and that invariably these end up being fentanyl based due to the convenience for that organized criminal enterprise is why fentanyl shows up so much.

It's not the root cause though. And the forces that make it appealing in the illegal market would be present regardless of its legal status as a prescription medication.

I put some of the responsibility on the people who created it and promoted it's use in the first place.

While there was a little bit of questionable marketing around some forms of fentanyl it was mostly around for the ride - the real blockbuster drugs leading to the medical establishment opioid crisis were hydrocodone, oxycodone and tramadol. Making fentanyl a scapegoat is misplaced.

The opioid epidemic did not need a "super heroin".

It's naive to think we could make "super heroin" and it would stay restricted to safe, controlled medical environments

It's naive to think organized crime cartels would not have figured it out anyway.

An opioid that's more potent, more addictive, and more deadly than heroin should never have gone to market in the first place.

This is a little misplaced. Fentanyl is a medically useful drug. Fentanyl had years of use as an anesthetic agent (and still does - it is an essential ICU medication) before the idea of marketing it for other purposes occurred.

And without defending the pharma industry and their role one bit. The vast majority of fentanyl these days is not from big pharma, and it's arguable what relative role fentanyl played vs all the other drugs

Specifically, the demand for illegitimate fentanyl today was mostly driven due to addictions from other medications that were NOT fentanyl - such as oxy, hydrocodone and even the "safe" tramadol.

Having said that, it's going to be a hard sell that all opioids should be banned. There is some middle ground between reserving for palliative and acute critical illness and having PCPs prescribe for simple back pain.

heroin is safer

It is a smidge more complex. Fentanyl has some pharmacologic properties that make it safer for controlled use in sick patients. Heroin has similar metabolite related side effects as morphine.