Opioids in the US and UK; Laurie Taylor explores the changing nature of opioid use, from street heroin to synthetic prescription drugs. Helena Hansen Professor of Psychiatry and Anthropology at the University of California, Los Angeles, reveals the surprisingly white “new face” of the US opioid crisis. Although Black Americans are no more likely than whites to use illicit drugs, they are much more likely to be incarcerated for drug offenses. Meanwhile, a very different system for responding to the drug use of whites has emerged. White opioids – the synthetic opiates such as OxyContin - came to be at heart of epidemic prescription medication abuse among white, suburban and rural Americans. Why was the crisis so white? How did a century of structural racism in drug policy lead, counter intuitively, to mass white overdose deaths? Also, Alex Stevens, Professor of Criminal Justice at the University of Kent, provides a UK perspective, charting the rise of synthetic opioids which are much more potent than heroin. Heroin related deaths are concentrated in people over 40, who live in deindustrialised areas and are nine times higher in the most deprived decile of neighbourhoods in England. He argues that their increasing presence in the drug supply could dramatically increases the number of deaths as has been seen in the USA. This episode contains a clip from a TV programme Horizon recorded by Dr Michael Mosley in 2020 exploring painkiller use in Britain. Producer: Jayne Egerton