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"They ended up liking it better." Alex Kral, a Berkeley, California-based epidemiologist who studies illicit drugs at the nonprofit research institute RTI International, said he's heard from users that once they start using fentanyl, it's very tough to go back to using heroin, because they dont get the same high

There is an initial barrier to entry thanks to the significant capital expense for not just equipment, but the buildout of extraction booths, and the requirement for highly skilled staff