It starts with drinking and heroin dealers are at the parties. Heroin is in pill form now so getting someone to take it is easy and very profitable for the dealer. Once or twice and the kid is hooked. Most kids are are open to this now as smoking pot and drinking is considered fine by the majority. Dealers are manipilative as they make good money selling. Once a kid is hooked, there is no going back. They were not that unhappy before, just going along with the crowd. Colleges are full of addicts now.
Death Penalty for Dealers.
Heroin is not active when taken orally. If it is distributed in capsule form, it must still be either snorted or injected (or maybe smoked). And realistically, it takes more than "once or twice" to get hooked.
In any event, the elevated risk is, of course, due to the black market status of the drug, where strength can vary greatly from dealer to dealer, or even from batch to batch.
Additionally, dealers are apparently using fentanyl as an additive in some cases, and since fentanyl dosage is measured in micrograms—not milligrams—it's even more likely that someone will measure something wrong, and thereby produce an even more deadly concoction.
Think about the people that are putting together these pill capsules. They're not exactly assistant pharmacists, as you can imagine.
Down here in South Florida recently, a 10-year-old boy died simply from coming into contact with fentanyl during the course of his daily activities. As far as I'm aware, somehow he merely touched a sample, and enough got in through his skin to kill him.
As problematic as pharmaceutical opiates may be with respect to addiction, in many cases "crackdowns" are leading addicts into acquiring street drugs such as heroin in lieu of the pharmaceuticals they can no longer obtain. Unintended consequences of the War on Drugs and Contraband Law.
I would suspect that most fatalities related to pharmaceutical opiates such as Oxcontin are actually suicides, or else the result of careless combinations with benzodiazepines (tranquilizers) such as Valium, Xanax, etc. You see jokes about Xanax and the like on sitcoms nowadays.
However, to die as a result of a pharmaceutical overdose, one must make a bona fide effort, or else be completely uneducated.
Contraband Law (prohibition) creates its own set of dangers, which is among the reasons I'm adamantly opposed to it. If addicts are maintaining their habits using pharmaceuticals, where they know what they're getting, the risk of accidental overdose is significantly reduced, and at least they are more likely to remain alive, with a chance to undergo rehabilitation, for example.
Draconian measures—including the failed experiment of alcohol (which is a drug) Prohibition—have been tried for 100 years with zero success, and have resulted in profound erosion of Constitutional rights, with the ever-expanding Police State apparatus necessary to enforce them. Education and rehabilitation are infinitely preferable. IMHO, addiction is a challenge that any free society must face without resorting to Authoritarian shortcuts...