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Notes -
Alcohol is safer (at least in the short term) for various reasons, like the dose one can survive goes up with tolerance, and the difficulty of getting a fatal dose into you without working at it (though college students regularly manage). But I don't think those kinds of differences exist between the commonly-abused opioids. I'm not saying fentanyl would be as safe as alcohol if the dose was controlled, I'm saying it would probably be at least as safe as heroin. And that the massive increase in OD deaths that coincides with the introduction of fentanyl is primarily due to the inconsistency, not the inherent danger.
Also in the alcohol case, I suspect if instead of the common packaging for serious abusers being bum wine or some sort of standard-proof cheap liquor (which are easily distinguishable from each other), it was whatever the addict could get ranging between 5% and 90% alcohol, plus perhaps some isopropyl alcohol mixed in, and the addict couldn't immediately tell the difference by the taste/burn, we'd have a lot more overdoses.
I maintain that "I can imagine a product being adulterated by bad things" is not sufficient reasoning for population rates. One data point that would have to be explained in the chart I linked is the prevalence of prescription opioid deaths. Why aren't other illegal substances, which are presumably adulterated with rat poison, also off the charts in comparison?
My point isn't about adulteration with "bad things", my point was about uncertainty of dosage. I mentioned isopropyl alcohol because it might be considered analogous to fentanyl; it's a stronger alcohol than ethanol in some ways but not toxic in the way methanol is.
Really, the bigger problem for my theory of uncertainty of dosage caused by the introduction of illicit fentanyl into the recreational opiate trade being the main reason for the increase in overdose deaths is the fact that cocaine and meth went up (though not as much) at the same time. As far as I know nothing changed pharmacologically there, so your "inherent danger" theory can't explain it either.
Fentanyl is a colourless white powder and sometimes used to cut cocaine and meth by unscrupulous dealers. Terrible idea, but it will make people feel more fucked up... not to mention make a nice contribution to overdose death statistics.
Interesting, but it unfortunately doesn't distinguish between "inherent danger" and "uncertainty of dosage".
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Most definitely agreed. And now with xylazine, you've got straight methanol or rat poison or something in 1/a few hundred or so? of these bottles of "booze".
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