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Fentanyl has become popular on the black market in part because it’s synthetic, and because it is so potent, it can be mailed around the world in tiny, concealable packages. (Photo: Shutterstock)

America’s opioid crisis has shifted. As Congress and the White House have dawdled, the overdose death toll has continued its steady climb — reaching more than 49,000 in 2017, an increase of nearly 7,000 over the previous year, itself a record-breaker. But the primary agent of death is no longer ordinary prescription painkillers. It’s illicit fentanyl, often mixed with heroin or some other street drug.

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