For years, the opioid crisis has been explained as a three-wave disaster: pills, heroin, and fentanyl. This narrative is repeated by public health agencies, journalists, policymakers, and prosecutors. In this framework, the first wave of fatalities began with prescription opioids, the second with heroin around 2010, and the third with illicit fentanyl beginning around 2013—with some now adding a fourth wave of fentanyl mixed with stimulants. Whi…
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