Which wave includes synthetic opioids such as fentanyl?

• A. Wave 1
• B. Wave 2
• C. Wave 3
• D. Wave 1 and 2

Answer: (C)

This question tests how opioid trends have evolved in waves. The earliest period centered on misuse of prescription opioids, with a shift to heroin as those prescriptions became harder to obtain. The next major shift brought heroin to the forefront on a larger scale. The most recent period is defined by synthetic opioids—chief among them fentanyl and its analogs—that flood illicit markets and are often mixed with other drugs. Fentanyl is a lab-made, highly potent opioid, not derived from the poppy plant, which is why it marks the latest wave. That’s why the best answer points to the most recent wave, the one focused on synthetic opioids like fentanyl. The earlier waves do not fit because they revolve around natural/opioid derived from the poppy and heroin, not synthetic fentanyl.