There are real use cases for fentanyl (there's a report here locally of ambulance crews misappropriating fentanyl from the pain medication supplies.) I know there's media reports of "an opioid epidemic", but I'm suspicious about how much that's "real" and how much of it is "war on drugs" reporting pushed by law enforcement PR for the purposes of propping up the prison-industrial complex...

30,000 deaths per year in the US seems to be considered "acceptable" in the face of the benefits of 200-ish million people owning/driving cars. I wonder what the ratio of "people benefiting" vs "people dying" from opiates and fentanyl in particular is?

maybe, maybe not. often when someone overdoses, the dealer has customers lined up around the block the next day. addicts don't know whether that particular stuff was cut with fent or just stronger than usual, and they don't particularly care.

even if enough people were dying that it made a significant dent in sales, i doubt it would change anything for the suppliers. selling fentanyl as heroin is massively more profitable than just selling heroin, and there's no way to do it safely. low doses of heroin are in the tens of milligrams, while fentanyl can have a potent effect at doses less than one milligram. this makes it really hard to achieve a homogenous mixture; there's basically always going to be some potentially lethal hotspots.