Purdue had created a generation of people who were addicted to opioids, through the careful and relentless cultivation of demand for the drug. When the reformulation happened, that demand did not go away: it just found another source of supply. The paper established that even the boom in illicit fentanyl, like the rise in heroin before it, “was driven by demand considerations existing years prior to the entry of fentanyl.” Synthetic opioid abuse was disproportionately high in states that had high rates of OxyContin misuse.
