Quality control. Stuff on the black market is ofc uncontrolled and therefore often cut with cheaper drugs (amphetamine, meth, caffeine…) or filler material. Also, harmful contamination is more likely.
Same with any other drug that’s used both in healthcare and as a recreational black-market drug. It’s basically moonshine vs. store-bought booze. The same if made properly, but one has more risk to not be up to standard.
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