From prescriptions to street drugs: Opioids trajectory across America

Opioid prescription rates by states and counties

The origins of the US' ongoing opioid crisis are typically traced to the more than 1 billion prescription pain pills that flooded medicine cabinets between 2005 and 2019. This prescription opioid epidemic resulted in more than 210,000 fatal overdoses and set the stage for the ongoing crisis fueled by heroin and fentanyl.

The three waves of the opioid crisis: overprescription, heroin, and fentanyl

The US opioid crisis has unfurled in three distinct waves, each spiraling into an epidemic that's killed millions. The first crested in the 1990s with the overprescription of opioids for pain relief. The second manifested as heroin overdoses in the 2010s. The third began in 2013 with the rise of deaths related to tramadol and fentanyl.

Fast, cheap, and deadly: How fentanyl replaced heroin and hooked America

This interactive article details how fentanyl has largely replaced heroin in the drug trade, with fatal results. Fentanyl was first developed in 1959 as an anesthetic for pain relief, but the drug took hold in the US black market in 2014 and has since exploded in the intervening decade.

One person dies from opioids every 7 to 8 minutes

This collection of infographics by the National Institute for Health Care Management helps put the crisis into perspective. The opioid epidemic has had three waves. Opioid-related deaths increasingly involve synthetic versions of the drug class, contributing to 83 percent of all opioid-related deaths in 2020. Use these infographics to learn more about the crisis.

Synthetic opioids: a historical and clinical review

In the 19th century, researchers began synthesizing and isolating poppy plant alkaloids, leading to the invention of morphine, codeine, heroin, oxycodone, and others. These highly addictive variants eventually gave rise to illicit use and a widespread underground market, laying the foundation for the current opioid crisis.

Why is fentanyl poisoning street drugs?

A few grains of fentanyl, a synthetic opioid far more potent than heroin or morphine, is enough to kill a typical adult human. It's made its way into other, less lethal street drugs, where it may be used to increase the highs experienced by unknowing users, increasing their likelihood of addiction and overdose. This 39-minute podcast episode is the first half of a two-part series exploring fentanyl's rise.

The Cincinnati Enquirer's Pulitzer-winning look at the opioid epidemic

Synthetic opioids kill someone in the US every 16 minutes. Communities across the country have been ravaged by deaths, overdoses, jail time, and babies born with drug-related medical problems as opioid abuse became a typical feature of many American towns. This seven-part exposé provides an inside look at the effect in southern Ohio and northern Kentucky.

Learn about the US opioid crisis in this free course

Where did the US opioid crisis come from, and how did it spread? Learn this and more in this free, online Harvard University course. Learn about the disease model of addiction treatment and management, and get up-to-date with public health and law enforcement's current harm reduction practices. This free resource gives users a greater understanding of opioid addiction and the epidemic still haunting the US.

The story of the Sackler empire behind highly addictive OxyContin

This investigative report examines how the Sackler family built its fortune through Purdue Pharma’s aggressive marketing of OxyContin, a highly addictive painkiller. Through 2017, the drug had generated more than $30B in sales for Purdue Pharma, controlled by the Sacklers.

Opioid epidemic 101: lawsuits and settlements

State and local governments trying to address the opioid epidemic have sued organizations they believe started and supported the crisis. Companies that made, distributed, or contributed to sales of the highly addictive painkillers are expected to pay more than $50B in settlements. These settlements specifically state that at least 85% of settlement funds must be spent on addressing the epidemic, though where exactly the money is going is unclear.

See how DOJ prosecutors took down a pharmaceutical company's executives over the opioid crisis

This FRONTLINE documentary follows federal prosecutors as they used anti-racketeering laws to convict executives at Insys Therapeutics, a pharmaceutical company that bribed doctors to overprescribe a fentanyl painkiller.

Visualizing cause of death over time in America

As people age, their life expectancy decreases, but the timing and speed of this decline have evolved over the years. Check out this chart which shows the shift in various causes of death of Americans over the last few decades. Data from the...

The US war on drugs, explained

The United States has been fighting a global war on drugs for decades. By making drugs more expensive and less available, the US has sought to reduce drug use and inhibit the international drug trade. However, increasing prison populations,...

Drugs 101: An interactive guide

What's the difference between opioids and psychedelics? This guide details specific drugs and their various associated effects. Drugs in this wheel fall into seven categories: stimulants, depressants, empathogens, psychedelics, dissociatives, cannabinoids, and opioids.

How America's cocaine habit fueled its migrant crisis

The United States has been facing a migration crisis along its southern border. Thousands of people have been fleeing their homes in Central America, traveling north through Mexico, and claiming asylum in the USA. Much of this crisis can be traced...

Look up where your generic prescription drugs are made

This project from investigative journalism outlet ProPublica compiled source data for most generic prescription drugs in the US. Roughly 90% of drugs on the market are generic, and in rare cases investigators have noted issues with compliance or safety at some plants. Using your drug's name and the company on the label, find out any issues with your drugs here.

Narcan is an opioid antagonist that can rapidly reverse overdoses

Naloxone, also known by the brand name Narcan, is an opioid-overdose reversal medication that typically begins working within a few minutes. An opioid antagonist, the treatment attaches to opioid receptors without activating them, forcing opioid molecules out of their respective receptors and allowing users' breathing rates to normalize.

How drug trafficking undermines West Africa

The rise of drug trafficking is undermining institutions, public health, and development efforts in West Africa. According to the West African Commission on Drugs, civil wars have receded, democracy has gained ground, and economies are growing in...

The potential for weight loss drugs to transform the economy

In 2023, Americans spent more than $50B on weight loss drugs, a number expected to triple by the end of the decade. However, because of the wide range of obesity-linked health issues, widespread adoption of the treatments could transform the wider economy.

Trauma is a primary risk factor for substance use disorder later in life

Studies indicate 75% of people with substance use disorder have experienced at least one traumatic experience in their life. These experiences alter brain function, leading to heightened stress and emotional pain. Substances offer temporary relief, but this often results in dependency.

America doesn't have enough estradiol patches for menopause and perimenopause demand

Fueled in part by the lifting of the FDA's black box warning about HRT risks, sales of estradiol patches in the US have shot upward. More than 142 million units of the patches were sold in 2025 versus 46.5 million in 2020. Suppliers are failing to keep up with demand—11 patch products were in short supply in early 2026. (Some users may experience a paywall.)

Explore a timeline of US dependence on crude oil from 1850 to 2023

Oil dependence began with the rise of oil as a commodity, followed by an era of geopolitical competition for the resource after World War II. The domestic fracking boom, which started around 2006, was driven by a desire to reduce the nation's dependence on international adversaries for energy.

The story of Olympian Ryan Wedding's rise and fall as drug kingpin

After a disappointing finish representing Canada in the slalom at the 2002 Winter Olympics, Wedding turned to growing cannabis and selling cocaine. After serving prison time, he upped his game and came to control major drug routes in North America, finding himself on the FBI's 10 Most Wanted List. He was captured in Mexico City in January 2026.

How Kurt Cobain's suicide changed the media

Public health experts feared that the suicide of a high-profile figure, especially for young people, would lead to a rise in suicides across the country. The opposite turned out to be true: Suicide rates decreased. Specialists suggest that's due to the way Cobain's death was covered, with news organizations largely avoiding glorification and including crisis hotline information.

COVID accelerated antibiotic resistance

The COVID-19 pandemic was caused by a virus, and viruses can’t be treated with antibiotics. But recent research finds that COVID patients were given a tremendous amount of antibiotics, contributing to the problem of antibiotic-resistant bacteria. Why? This NPR feature sheds light on an unexpected side effect of the pandemic.

Fireworks-related ER visits are on the rise—in 2024, they increased by 52% as compared to the prior year.

Telehealth demand for GLP-1s for weight loss is booming as consumers seek easier access.

US consumers collectively owe more than $1T to credit card companies—almost as much as they owe in auto loans.

This real-time tracking of the hantavirus cruise ship outbreak in May 2026 offers a unique glimpse into the global reach of the outbreak and whether the virus sickened passengers and their communities around the world.

Listen to an in-depth conversation on the links between Parkinson's disease and herbicide exposure and the challenging pace of scientific investigation.

View the ten deadliest tornadoes in US history.

The hormonal disorder PCOS was renamed PMOS in 2026, a move designed to improve care and research by shifting the focus to the hormonal causes of this condition that affects 1 in 8 women.

About 12.5% of US adults experience a phobia in their lifetime, a diagnosis that hinges on the intense fear interfering with daily life and persisting for at least six months.

At the beginning of the 20th century, a group of young men ate standard American food—replete with food additives like borax and formaldehyde—as part of government research to better understand food safety.

The US dollar is the most widely circulated currency in the world, and is involved in nearly 90% of global transactions

Cultural norms about how to handle the bodies of loved ones in communities in West Africa have hampered Ebola responses.

Hear 50 years of iconic hip-hop samples, the genre's foundational looped tracks

US housing costs have risen by roughly 175% between 1991 and 2026—but a growing number of Gen Zers are becoming homeowners anyway. In 2025, 4% of homebuyers were Gen Z, up from 3% the year before.

Louisiana's 'Cancer Alley' is infamous for having some of the highest industrial pollution, toxic air emissions, and cancer risks in the US.

20,000 letters to the advice columnist 'Dear Abby' provide insight into prevailing sex, religion, and LGBTQ fears, anxieties, and concerns from the 1950s onward.

Explore an interactive map built from more than 100,000 survey responses on where people find joy in their lives

Between 10 million and 50 million people in the US develop rashes from poison ivy, poison sumac, and poison oak each year.

About 2,000 US babies are born annually without some portion of their limbs, potentially leading to a lifetime of pricey prosthetics.

Calculate how much of your tax dollars go to each federal program based on your income, filing status, and number of children

The story of Dollree Mapp, whose legal challenge over her 1957 conviction for possessing "obscene material" led to a major strengthening of the Fourth Amendment

Explore fun facts from the USPS, including unique post office buildings, a stamp that traveled past Pluto, and more.

Domino's Pizza's 30-minute delivery guarantee was responsible for the chain's 1980s surge, but it was discontinued after the company was found liable for delivery driver accidents.

For centuries, it was common to sleep in two shifts: a few hours at the beginning of the night, and a longer period beginning around midnight

The Russia-Ukraine conflict is the largest ground war in Europe since World War II in casualties, forces mobilized, and displacement of civilians.