What often happens is that they get clean and then try “one more time” at the same level they had worked up to... and that is what kills them. Or they quit too late and it has damaged their liver beyond repair. Once a person starts, it is very difficult to come off it because it plays with the pleasure centers of the brain. It starts a choice but ends a disease. I have had two friends who lost children to addiction in the past year. These were kids who were raised in Christian homes with good values. Drugs leave a devastating legacy.
I think what gets a lot when they relapse is the ever increasing amount and quantity of Fentanyl used as a cut. I listen to the scanner sometimes at work and I can always tell when a new batch of Heroin is in by the amount of OD calls the area rescue squads are dealing with and these are presumably experienced users. As a former EMT it astounds me. I’m in a very rural area and when a new batch hits it can be 50% of the calls for a few days. Unreal.