Dina Fine Maron (2018) in “How Opioids kill” reports that it has long been a conventional wisdom now that the opioid epidemic started in the US at the pharmacy. Opioid prescription drugs are not considered dangerous drugs because they are prescribed by a doctor. Prescription drugs tend to be less stigmatizing in society than illicit drugs because painkillers are considered medically necessary for the treatment of pain. Synthetic overdose of opioids killed 20,000 people in 2016. The CDC team said that an important step is finding out which drugs killed people. So, they conducted blood tests on people who had died of overdose in 10 states of the US. They found a disturbing number of deaths from very powerful drugs, mainly fentanyl.Fentanyl is a drug that was originally designed to relieve the most extreme pain in people who die from cancer, for example. Analogs are even more powerful. With few exceptions, fentanyl analogues are produced illegally because they have no legal medical benefit in humans.Opioid painkillers can lead to dangerous addiction, not only to opioid prescription drugs, but also to heroin. Those struggling with opioid painkiller addiction may be left with few choices for maintaining their addiction once their prescription drug of choice is no longer affordable or accessible. The relatively low cost and availability of heroin make it an attractive and relatively easy substitute for opioids. Prescription opioids drug users are 19 times more likely to try heroin than those who used no previous opioid drugs along with the risk of switching to heroin is increased manifolds.The signs and symptoms of opioid dependence are excessive mood swings, strong feeling, particularly being energetic or sedated, nausea and vomiting, decreased breathing rate, dizziness, frequent and intermittent loss of consciousness, confusion, poor coordination, often contracted pupils, increased pain despite raising doses, changes in sleep patterns.Here’s how fentanyl kills you:When it binds to endorphin-releasing receptors in the brain it can spoil them. Because of this, your body can not respond to low oxygen levels or high levels of carbon dioxide. These are the two things that tell your brain (which controls your lungs) that you need to breathe. If the opioid is linked to these receptors, it cannot tell if the oxygen is low or the carbon dioxide is too high and you will eventually stop breathing and die. If you take an oral medication you swallow, it can take a long time before it gets absorbed into the body as opposed to if you inject it or take medication. It can happen a lot faster.