Lots of people have covered the ‘inception’ part of the crisis really well. Just wanted to add the ‘continuation / proliferation’ part.
Supply / Substitution: illegal synthetic opioids that were hundreds or thousands times more potent were chemically engineered to meet the exploding demand that could not be fully served by the legal / prescription market. Drug manufacturers (mostly illegal) from overseas (in particular China) manufactured and exported large quantities of synthetic opioids or their precursor ingredients to North and Central America.
Distribution: driven by the profit on offer Mexican drug cartels expanded into the distribution of opioids just as they had expanded into distribution of Colombian cocaine in the 1970s and 1980s to serve the largest market for narcotics in the world: the United States.
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