The ‘opioid epidemic’ in the US is the most recent drug-abuse challenge from the misuse of prescription medicines or the use of illicit drugs. It is a particularly difficult challenge because thousands of patients benefit from the prescription pain killers that originally fuelled the crisis. Ceasing production and use of such medications, then, is not the right answer. But the crisis has recently entered a more lethal phase, one that involves the use of illicit synthetic opioids which are both more addictive and more deadly.