“The differential potencies between these opioids has become a major topic of concern because fentanyls are increasingly sold as heroin, mixed with heroin, or pressed into counterfeit opioid pills. One of the main reasons for this is an unscrupulous practice carried out by some illicit heroin manufacturers. These individuals have discovered that they can save money and stretch their product by adding fentanyl or an analog to their heroin batches. Sadly, this information isn’t always shared with low-level dealers, who sell the product to their heroin consumers. This, of course, can be problematic—even fatal—for unsuspecting heroin users who ingest too much of the substance thinking that it is heroin alone. Even so, it is important to remember that the problem isn’t fentanyl per se. The problem is fentanyl-contaminated heroin and fentanyl-tainted counterfeit opioid pills. The problem is ignorance.” - Dr Carl Hart