Hacker News

Purdue Pharmaceuticals paid off the FDA to allow a very addictive form of opioid into mainstream medical use. They then used pharma reps to push it on patients, falsely citing low addiction. This caused a massive addiction epidemic in the US. Once all of this came to light, doctors stopped overprescribing the opioids, and many people turned to the streets.

There’s a Netflix series called “Painkiller” that’s based on the Sackler family, who controls Purdue Pharma and is responsible for all of this.

Afaik subscription opioids cause addiction, leading people to seek more of them from pill mills after their subscription runs out. But pills are expensive, so as money runs out people look for alternatives and fentanyl is the cheapest and most easily smuggled.

Same reason the prohibition lead to American hard liquor culture. If alcohol is prohibited you aren't going to smuggle beer, as whisky is more abv.