The rise of fentanyl trafficking is largely a result of prohibition. Imagine you are a drug smuggler. Now would you rather have truck load worth $100k or a briefcase worth $100k?
Fentanyl solution for injection that hospitals get is a lot less potent than the hydromorphone solutions for injection that they can stock.
(50mcg/mL vs 10, 20, 50 or 100mg/mL).
As for the actual dosing... fentanyl is a lot more forgiving than morphine or hydromorphone, as measured by therapeutic index.
The ODs are mainly because people don’t know what they are buying.
For instance, cocaine costs ~2k/kg in backcountry Columbia, but ~20k/kg in US cities [0] (at least at the time the article was researched). And when your transport costs dominate that much, almost every way to reduce volume and weight is justified.
0: https://www.businessinsider.com/from-colombia-to-new-york-ci...
The total cost of risk-free (i.e. fully insured) delivery of a truckful of goods is trivial compared to even quite cheap products; while that briefcase would pretty much have to double in value after that long trip to make the transport profitable.
Specifically, in the US, 60% are suicides.
https://www.pewresearch.org/fact-tank/2019/08/16/what-the-da...
A completely black market for guns would lead to things that could blow up in your hand or explode at any time, the same as unregulated drugs
It's just everywhere else is even more outrageously restricted, which makes the US look liberal in comparison...
But to call guns unregulated in the states is to say that cars (among many other things) are completely unregulated too.
You can’t make a gun to sell without an ATF license. All guns must have serials numbers and customers pre-screened.
And that’s just federal law. Many states have even greater regulations.