That leaves two options: Keep doing what we’re doing and let addicts keep dying as they’re dying, until the opioid epidemic burns itself out. Or start talking about ways to make safe, reliable doses of opiates available to addicts who aren’t ready to stop. That would mean opening more methadone clinics and making it less onerous for doctors to prescribe buprenorphine, a relatively mild opioid that’s difficult to overdose on. But lowering the death toll may well require a more drastic step: legalizing prescriptions of stronger opiates.

Prescription heroin? Remember, I said you might not like the solution. I don’t like it, either — and frankly, neither do the drug policy researchers who told me it may be necessary. But when fentanyl took over the U.S. illicit drug markets, it also got a lot of addicts as hostages. We’ll never be able to rescue them unless we can first keep them alive long enough to be saved.