Fentanyl is 100 times more potent than morphine, and just 2 milligrams can be lethal for humans, depending on a person's body size, tolerance, and past usage.

A synthetic opioid, fentanyl is highly addictive and incredibly fast-acting—a fatal dose is equal to a few grains of table salt. Once it enters the body, fentanyl floods naturally occurring opioid receptors, which can cause the body to shut down its breathing reflex, leading to a fatal overdose.

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.

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.

Among opioids, fentanyl is uniquely adept at crossing the blood-brain barrier—the brain's security fence against harmful substances. This enables a lightning-fast high. It ends just as quickly, sometimes within minutes (where a heroin high lasts hours), and still results in the same withdrawal symptoms.

Exclusive data obtained by The Washington Post from the Centers for Disease Control and Prevention shows how individual counties moved through three waves of the opioid crisis, each wave paving the way for the next. Between 2011 and 2017, the drug responsible for the majority of overdose deaths shifted from prescription pills to heroin to fentanyl. Together, oxycodone, hydrocodone, heroin, and fentanyl have been major drivers in declining life expectancy in the US.

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.

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.

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.

Opium reached the US at about the time early colonists were itching for ways to soothe aches and pains. The active ingredient in the substance was isolated in the early 19th century, eventually leading to the manufacture and commercial sale of morphine, heroin, and other opium-based drugs.

It's been used for ages to reduce pain and induce euphoria, both of which are side effects of the plant's alkaloids—nitrogen-based compounds with pronounced physical effects. Isolating and synthesizing derivatives of these naturally occurring chemicals enabled the invention of morphine, heroin, and other opioids.

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.

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.

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.

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.

Los Chapitos are the four sons of El Chapo, the infamous leader of Mexico’s Sinaloa Cartel. Once dismissed as “narco brats,” the Chapitos are now key figures in the Sinaloa Cartel, accused by the US Drug Enforcement Administration (DEA) of pioneering the “manufacture and trafficking of the deadliest drug [the USA] has ever faced.” Read Reuters’ special report to chronicle the rapid rise of the Sinaloa Cartel’s new generation.

Archaeological evidence shows the use of the poppy plant for its pain-killing properties likely originated in the Mediterranean before making its way to the East and West via trade. It has since inspired two eponymous wars, and highly addictive derivatives of the naturally occurring substance have led to an ongoing overdose crisis.

Religious or medical use of opium was present across Europe and Asia as early as 5000 BCE. By the 16th century, humanity had come to see opium as more than medicine: It was a marketable product. This perspective also defines today's relationship with opioids, highly addictive painkillers at the heart of an ongoing drug crisis.

When opioids enter the brain, they dock in receptors, blocking electrical pulses such as those that communicate pain. They also trigger the release of dopamine, a neurotransmitter tied to motivation and associated with stress relief.

According to the UN, Myanmar remains the world’s second-largest producer of heroin. Inside Myanmar, almost all the drugs come from one place: Shan state in the Golden Triangle region, south of China, where Myanmar meets Thailand and Laos. The...

GLP-1 drugs popularity for weight loss and treating diabetes, led to a significant supply shortage and the rise of compound pharmacies, which produce customized drug formulations but lack formal approval from regulators. The drugs are ostensibly the same, but manufacturing methods lead to variations in concentration, filler compounds, and more.

Based on tests with mice, the lethal dose of chocolate is estimated to be no more than 1,000 mg/kg. This means that the lethal dose of dark chocolate for the average US adult is about 6.5 kilograms (14.33 pounds), or about 8,300 Hershey's kisses, in one sitting.

The music legend was found dead in an elevator at his Paisley Park residence on April 21, 2016. The cause of death was an accidental overdose from taking pills he believed to be Vicodin, but were actually counterfeit pills laced with fentanyl. Law enforcement was unable to determine who provided him with those pills. He was 57 at the time of his death.

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.

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.

The war on drugs has forced cartels to be increasingly creative when it comes to smuggling drugs. As police develop methods to catch smugglers, drug traffickers come up with new ways to get their products from producer to seller to buyer. This cycle...

In 2006, the Mexican government launched a war on the drug cartels. The cartels and the drug trade fuel rampant corruption and violence in Mexico, contributing to tens of thousands of homicides in the country each year. Mexican drug cartels are also...

The Middle East and North Africa is a major source, transit point, and consumer of illicit drugs. Despite having some of the harshest penalties for drug-related crimes, the region both influences and is negatively impacted by illicit substance abuse...

The Death Cap, also known as amanita phalloides, is the most fatal mushroom on the planet, responsible for roughly 90% of the world's mushroom deaths per year. Ingestion of the mushroom wreaks havoc on the liver and kidneys, frequently leading to...

This five-part podcast series, produced by Serial Productions, focuses on the experiences of women undergoing fertility treatments at a Yale clinic where a nurse secretly replaced pain medication with saline solution. This led to women experiencing excruciating pain during procedures, but the clinic downplayed or ignored their complaints.

Counterfeit operations are often controlled by rogue governments, drug cartels, and more. These organized crime rings often sell counterfeit bills wholesale, for anywhere between 40 and 70 cents per dollar.

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,...

Within seconds of inhaling a high dose of vaporized synthetic 5-MeO-DMT—a lab-produced substance that otherwise is naturally derived from the glands of the Colorado River toad—it induced slow brain waves. Such waves are typically associated with unconsciousness due to a coma or anesthesia, perhaps explaining why users describe feeling like everything falls away. The compound is currently in clinical trials for treating depression.

A typical gummy vitamin contains about the same amount of sugar in a single serving as one Sour Patch candy. It's linked to the increase in pediatric overdoses for products including multivitamins and melatonin. Gummy formulations also degrade quickly, so they often include much higher levels of the product in each serving than the label advertises—boosting overdose risks due to this unchecked variability.

The drug was popular with several Seattle acts in the early 1990s, with artists like Hole's Courtney Love even publicizing her use in a magazine profile. A 1992 New York Times story on Seattle said the city's principal drugs were "espresso, beer, and heroin."

The worldwide illegal drug trade continues to flourish. Accounting for almost 1% of the world’s financial revenue, the cocaine trade alone boasts an annual turnover of an estimated $85 billion. This infographic, from Around the World: An Atlas for...

The global cocaine trade is worth an estimated $100B a year. But, where does that money go, who is spending it, and who is making it? Vice follows the money to understand why the cocaine business functions the way it does. From illicitly growing...