But a growing number of law enforcement agents, doctors, recovery providers, and drug users argue for malicious intent. They speculate that cartel leaders are using cocaine to expand the market of people addicted to opioids.
"People who were just using cocaine occasionally, now they're using cocaine every day," says Rafael, who buys cocaine and other illegal drugs, often several times a day, on the streets of Boston. (We've agreed to use just his first name.)
Rafael says dealers, high up, are intentionally adding fentanyl to cocaine because fentanyl is a more addictive drug.
"The opioid epidemic started in white suburbia but with the infiltration of fentanyl into the cocaine market we are definitely now seeing many more African-Americans dying of this problem," Gilson says.