The invention of the hypodermic needle and synthesis of heroin in the 19th century forever changed the opiate landscape. The arrival of cheap, accessible and mass-produced synthetic opioids might do the same.

Synthetic opioids such as fentanyl are driving drug overdose deaths in the United States and it is unlikely this will end soon. But unlike prescription pain relievers, the vast majority of synthetic opioid overdoses involve illicit imports from China and Mexico.

Federal law enforcement reports that increasing amounts of synthetic opioids arrive by mail or cargo from China, many from online vendors who offer a wide range of chemicals at very low prices.