Apparently the poor are most at-risk from this crisis according to a large study [1] - so maybe the fix isn't just harm reduction, but alleviating the existential crisis we put people of lower income in the US - making them more susceptible to drug addiction & death
[1] https://www.nhlbi.nih.gov/news/2020/large-study-links-lower-...
By comparison, shipping heroin across the Pacific is costly risky business, because it's easier to detect and seize. Hence the need for fentanyl which is orders of magnitude stronger and can be created in impromptu labs.
This gets particularly dicey for every "party drug" users in the states, because a white powder that would be relatively harmless is subject to accidental cross-contamination. [edit based upon reading comments below: Yeah, if you live in the US and your friends take coke or ketamine, you should have Narcan.]
Opiate users are addicts but they're not stupid. Nearly all greatly prefer reliable heroin to the risk of OD'ing. Hence why fentanyl hasn't become a thing in Europe. A reputation for killing your customers is bad for business.
Bonus question: Why does Europe not have a methaphetamine crisis?
Because it has an amphetamine crisis?
I'm assuming most of crystal meth in the US comes from mexico and they don't bother to ship that much of it overseas as stuff like cocaine has higher profits and a bigger market.
Not enough free space. It takes a lot of room to make meth because anyone nearby can easily tell.
It is going to change soon because Afghanistan is starting to make it.
I've always thought that it was because all the precursors for meth get used to make MDMA.Though it's probably more of a culture/economic thing. Europe definitely has some meth in it.
And opioid overdoses are similar to the US per capita.
British Colombia had 2,306 deaths in 2022, and adjusted by population that's 132,000, so more than the US.