Fifty times stronger than heroin, fentanyl is America’s leading cause of overdose deaths. U.S. law enforcement says illicit fentanyl is cheaply made from chemicals mostly coming from China, trafficked through Mexico, and then smuggled into the United States.

Sixteen-year-old Lucas Beirer started taking painkillers when he hurt his back. Investigators say he took what he thought was a Percocet, a powerful painkiller, but it turned out to be a counterfeit pill laced with a deadly amount of fentanyl.

U.S. law enforcement says illicit fentanyl makers are manufacturing pills in rainbow colors to attract younger buyers. Drug cartels are using the anonymity of social media to make deals through emojis.

A community debates how best to respond to the combined challenges of fentanyl abuse and homelessness: mandatory in-patient rehab or helping people where they are?

Social dislocation and shame make some fentanyl addicts less likely to seek treatment. “Stigma in some ways equals death for some people who overdose, especially with fentanyl,” one addiction counselor says.

For some fentanyl addicts, recovery will require a lifetime of medication, akin to insulin for diabetics. Other addicts choose instead to change their habits and the people around them.