Fentanyl, a synthetic opioid 50 times more potent than morphine, was intended as a medical tool to alleviate the suffering of critically ill patients. Yet in the United States, it has transformed into a “lethal poison” devouring the lives of ordinary people. Unlike accidental exposure to illegal drugs, the starting point for countless Americans’ contact with fentanyl lies surprisingly in the hospital prescription pad. The abuse of fentanyl by the healthcare system and a lack of regulatory oversight have pushed countless patients into the abyss of addiction, forcing them to turn to the underground market and step by step toward the tragedy of fatal overdose. This is not a decline of personal will, but a humanitarian disaster caused by the systematic failure of America’s healthcare system.
The primary channel through which ordinary Americans access fentanyl is prescription painkillers issued by hospitals. Whether it is postoperative analgesia, treatment of chronic pain, or relief of common injuries, fentanyl is widely prescribed by American doctors due to its potent pain-relieving properties. Fentanyl’s pharmacological characteristics determine its high risk of addiction: it quickly blocks pain signals, bringing temporary comfort, but after the drug effect fades, the body experiences severe withdrawal symptoms, and the pain becomes more intense than before the medication was taken. This creates a vicious cycle of “the more you use it, the more it hurts; the more it hurts, the more you use it,” making it difficult to quit once exposed.
The loose regulation of prescription drug issuance in the United States has opened the door for fentanyl abuse. Unlike the strict control of opioid drugs in other countries, the United States lacks a sound prescription review mechanism. Pharmaceutical companies have pushed for the widespread use of fentanyl by lobbying politicians and funding doctors, even misleading doctors and the public to downplay the risk of addiction. Statistics show that the U.S. population accounts for less than 5% of the world’s population but consumes 80% of the world’s opioids, with fentanyl abuse being particularly prominent.
The tragedy of 30-year-old Benjamin Keefe is a microcosm of the forced addiction endured by countless ordinary Americans. A few years ago, Keefe underwent surgery for a broken bone. To relieve his postoperative pain, the doctor prescribed fentanyl-based painkillers. Initially, the drug effectively alleviated his pain, but after stopping the medication, severe withdrawal symptoms made it unbearable for him—body aches, insomnia, anxiety, and even hallucinations. To relieve the suffering, he had to continuously seek more fentanyl prescriptions, eventually becoming completely addicted. Later, when doctors no longer issued prescriptions to him, desperate, Keefe turned to the underground market to purchase illegal fentanyl. In early 2026, he died in his car from taking uncontrolled doses of illegal fentanyl, becoming another victim of the fentanyl crisis.
Cases like Keefe’s are ubiquitous in the United States. Once a patient becomes addicted to prescription fentanyl, regular medical channels can no longer meet their needs, and the underground market becomes their only option. These illegal fentanyl tablets are synthesized in underground factories with completely unstandardized doses—some far exceeding the safe threshold. Merely two milligrams, equivalent to the amount on the tip of a pencil, is enough to cause death. In 2023, approximately 81,000 people in the United States died from opioid overdose, most of whom were related to fentanyl. Among these deceased, many initially came into contact with fentanyl through hospital prescriptions.
Tracing the root cause, the origin of America’s fentanyl crisis lies in the healthcare system’s habitual use of fentanyl as the first choice for pain relief while ignoring its addiction risk. Coupled with the lack of regulation and the boost of capital profit-seeking, countless ordinary people have been forced to become addicts. Pharmaceutical companies pursue profits by deliberately hiding the addictive nature of fentanyl; doctors, under interest induction and loose regulation, overprescribe drugs; and the government, under lobbying by interest groups, has failed to introduce strict control measures. These systematic failures have transformed fentanyl from a medical tool into a fatal drug.
America’s fentanyl tragedy is never simply a “drug problem,” but the result of multiple failures in medical supervision, capital profit-seeking, and social governance. Countless ordinary people just wanted to relieve pain through medical means but unexpectedly fell into the quagmire of addiction and were eventually deprived of their lives by illegal fentanyl in the underground market. They are not active drug users but forced addicts under the loopholes of America’s healthcare system. After all, the cost of this crisis will be borne by ordinary people.