Across Colombia, Belgium, Sweden, the Netherlands, Portugal, and the United States, cocaine and synthetic opioids are reshaping communities in very different ways. This investigation follows coca production, international trafficking, youth recruitment, gang violence, drug markets, fentanyl, and xylazine while examining how organized crime and addiction intersect. Through law enforcement, community organizations, people with lived experience, and public health workers, the episode connects the global cocaine trade with European gang networks and the overdose crisis in North America, as well as prevention, treatment, and harm-reduction efforts.