The photo that flashed onto the courtroom screen showed a young man dead on his bedroom floor, bare feet poking from the cuffs of his rolled up jeans. Lurking on a trash can at the edge of the picture was what prosecutors said delivered this death: an ordinary, US Postal Service envelope. It had arrived with 10 round, blue pills inside, the markings of pharmaceutical-grade oxycodone stamped onto the surface. The young man took out two, crushed and snorted them. But the pills were poison, prosecutors said: counterfeits containing fatal grains of fentanyl, a potent synthetic opioid that has written a deadly new chapter in the American opioid epidemic. The envelope was postmarked from the suburbs of Salt Lake City. That’s where a clean-cut, 29-year-old college dropout and Eagle Scout named Aaron Shamo made himself a millionaire by building a fentanyl trafficking empire with not much more than his computer and the help of a few friends. For three weeks this summer, those suburban millennials climbed onto the witness stand at his federal trial and offered an unprecedented window into how fentanyl bought and sold online has transformed the global drug trade. There was no testimony of underground tunnels or gangland murders or anything that a wall at the southern border might stop. Shamo called himself a “white-collar drug dealer,” drew in co-workers from his time at eBay and peppered his messages to them with smiley-face emojis. His attorney called him a fool; his primary defense was that he isn’t smart enough to be a kingpin. How he and his friends managed to flood the country with a half-million fake oxycodone pills reveals the ease with which fentanyl now moves around the world, threatening to expand the epidemic beyond America’s borders. It is so potent, so easy to transport, experts say, large-scale traffickers no longer require sophisticated networks to send it to any corner of the globe. All they need is a mailbox, internet access and people with an appetite for opioids. And consumption rates are rising from Asia to Europe to Latin America as pharmaceutical companies promote painkillers abroad. The case against Shamo detailed how white powder up to 100 times stronger than morphine was bought online from a laboratory in China and arrived in Utah via international mail; it was shaped into perfect-looking replicas of oxycodone tablets in the press that thumped in Shamo’s basement and resold on the internet’s black markets. Then it was routed back into the postal system in thousands of packages addressed to homes across this country awash with prescription painkiller addiction. When Shamo took the stand to try to spare himself a lifetime in prison, he began with a nervous chuckle. He careened from one topic to the next in a monologue prosecutors would later describe as masterful manipulation to convince the jury he thought his drug-dealing was helping people. Customers wrote thank you notes because their doctors refused to prescribe more painkillers, he said. It felt like “a win-win situation” – he got rich and his customers got drugs. One of them was a struggling 21-year-old named Ruslan Klyuev who died in his bedroom in Daly City, California, the envelope from Utah at his feet. Shamo was charged in connection to that overdose alone, but when investigators scoured the list of customers they said they counted dozens more dead. The question before this jury is being debated all across America: Two decades into the opioid epidemic, is there such a thing as justice for 400,000 lost lives? The largest civil litigation in history is testing how the pharmaceutical industry should be held accountable for inundating the country with billions of addictive pain pills. Purdue Pharma, seen by many as the primary villain for deceptively pushing the blockbuster drug OxyContin, reached a tentative $12 billion settlement this week with about half the states and roughly 2,000 local governments. Attorneys general who didn’t sign on say the figure is far too low. A trial of other pharmaceutical companies is scheduled for next month, in which communities will contend that their mass marketing of prescription painkillers sparked an epidemic. This crisis began in the 1990s and has since has spiraled into waves, each worse than the one before: Prescription opioids spread addiction, then a crackdown on prescribing paved the road to heroin, which led to fentanyl – a synthetic opioid made entirely in a laboratory. Traffickers added it to heroin to boost its potency and profitability. That transition happened slowly at first, then with extraordinary ferocity. By 2017, deaths from synthetic opioids had increased more than 800 percent, to 28,466, dragging the United States’ overall life expectancy down for a third consecutive year for the first time in a century. Fentanyl deaths have been reported abroad, in Canada, Sweden, Estonia, the United Kingdom. Countries with surging prescription opioid addiction, like Australia, fear they are on the brink. “Fentanyl will be the bubonic plague,” said Mike Vigil, former chief of international operations for the Drug Enforcement Administration, warning that any country with a burgeoning prescription opioid problem could soon find itself following American footsteps. “It’s just a matter of time.” No one can say exactly how or why fentanyl, first synthesized in 1959 as a powerful painkiller, entered the modern illicit drug market, said Bryce Pardo, a researcher at the Rand Corporation. In 2013, people began overdosing on heroin laced with fentanyl in New England and Ohio, and it spread from there. Shabbir Safdar, the Partnership for Safe Medicines’ executive director, said the first known death from a fentanyl-laced pill was in San Francisco in October 2015. It was a frightening development: The DEA estimates 3.4 million Americans misuse prescription painkillers, compared to 475,000 heroin users – meaning the pool potentially exposed is 10 times bigger.