The Fentanyl Question: Why Dealers Poison Their Own Customers

In 2015, the DEA issued a report stating that fentanyl was nothing to worry about. The drug was so potent, they argued, that users simply didn't want it—the risk of death was too high. One year later, fentanyl was killing more people than any other drug in the United States. By 2016, nearly 20,000 Americans had died from synthetic opioid overdoses, most of them fentanyl. The question PJ Vogt had been turning over in his mind for years seemed almost naive: why would a drug dealer sneak a lethal drug into drugs that are much less lethal? What kind of business survives by killing its own customers?

The Invention Nobody Saw Coming

Fentanyl was invented in 1959 by Paul Janssen, a Belgian pharmaceutical researcher widely considered one of the most important drug developers of all time. Janssen also invented Imodium, among dozens of other medicines. He designed fentanyl for hospital use—specifically for procedures like open heart surgery—because it worked faster than morphine and wore off faster. Patients undergoing surgery didn't need to stay sedated for hours afterward. Janssen died in 2003 regarded as a medical saint, never imagining his creation would one day kill more American adults under 45 than guns, COVID, or cancer.