When the opioid epidemic first came about in the 1990s it was largely related to prescription drug medications for pain. From 1999 to 2021 nearly 280,000 people have died from overdose of these medications. However, as time has evolved so have the medications. Heroin is an illegal opioid that has killed 152,000 people in this same time frame. Its use rose in the 2010s, but its use is now actually declining in part due to the rise of Fentanyl. Fentanyl is a synthetic man made opioid that is extremely potent and is now being made illegally and can be mixed into other drugs. In 2021 alone it was responsible for 71,000 overdoses. It is now estimated that 60-70% of illicit pills contain fentanyl. Even more concerning is that Fentanyl is also being found in counterfeit prescription medications like Adderal and Xanax. For this show, host Dr. Justin Clark was joined by Coleman Cutchins, who is the lead pharmacist for the Alaska Department of Health and the office of substance abuse and misuse and Venus Woods, Director of HIV Prevention & Education for the Alaskan AIDS Assistance Association (Four A's).