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Almost all of the increases in overdose deaths are attributed to illicitly manufactured fentanyl, not pharmaceutical fentanyl that has been misused or diverted. And we know that because the number of prescriptions for pharmaceutical fentanyl has remained relatively stable over the past decade, whereas seizures of illicitly manufactured fentanyl has skyrocketed, so it really is due to illicitly manufactured fentanyl that is entering the market and that is essentially being mixed with heroin so that Lindsay LaSalle have an adulterated product that people aren't aware of, so their risk of overdose increases substantially.
In those parts of the country, you have a white powder heroin that you can mix fentanyl into pretty easily, whereas on the West Coast, you have a black tar heroin, which is very difficult to mix the white powder into. So you just don't see the same distribution of fentanyl on the West Coast as in these other places.
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