Pima health officials warn potent carfentanil found in Tucson’s illicit pill supply

Carfentanil, a synthetic opioid far more potent than fentanyl, was recently found in a stash of blue “M30” pills seized by Tucson police officers, Pima County officials warned local health providers.

Tucson Police Department officers found pills containing carfentanil — an opioid originally made to sedate elephants and other large animals — made to appear identical to more common opioid pills, Pima County Health Department officials said in a recent alert.

While carfentanil has been linked to overdoses in the Midwest since 2016, this is the first time the drug has appeared in Pima County, officials said.

Officials warned tablets containing carfentanil were found among blue pills marked “M30” to appear to be oxycodone pills, and they warned the drug is 100 times more potent than fentanyl and 10,000 times more potent than morphine.

Many illegally manufactured fentanyl pills sold on the street are marked as M30s, to mimic authentic oxycodone pills.

“According to law enforcement, this is the first time carfentanil has been confirmed in our local illicit drug supply. They also warn that the tablets containing carfentanil are visually identical to the typical blue M30s making it impossible to distinguish between the two,” Pima County officials warned. “This poses extreme risk of overdose and death to individuals who may unknowingly use these pills.”

Neither Tucson police nor county officials provided details to the Sentinel about the number of pills found, nor the circumstances that led to their discovery by officers. The Health Department warning was issued last Friday, but not sent to the press.

For years, the Drug Enforcement Administration has warned that criminal drug networks are “flooding” the market with counterfeit pills made to look like prescription opioids such as Oxycontin, Percocet, Vicodin, or Xanax, as well as stimulants like Adderall, but are laced with fentanyl. 

Last year, the DEA said they seized more than 60 million fake pills and nearly 8,000 pounds of fentanyl powder. 

“The presence of carfentanil in illicit U.S. drug markets is cause for concern, as the relative strength of this drug could lead to an increase in overdoses and overdose-related deaths, even among opioid-tolerant users,” DEA officials said. 

Pima County Health officials said people should assume that any illicit substance, including powder, liquid, or tablets, may contain carfentanil.

They asked doctors and other medical professionals to tell people who use drugs that carfentanil is in the illicit drug supply and to use extreme caution, and insist on harm-reduction practices, including telling people never use alone, always carry naloxone or Narcan—a drug that can quickly reverse overdoses—and never use multiple drugs at the same time, including alcohol. 

Overdoses involving carfentanil “may require multiple doses of naloxone (Narcan) for reversal,” Pima County officials warned.  

People who unknowingly consume carfentanil are “at extreme risk of sudden death” officials said, adding that carfentanil can be fatal in “extremely small amounts, even via skin contact or inhalation,” they said. 

Health officials also warned that unlike fentanyl, which can be detected with test strips, carfentanil will only show through advanced laboratory testing and is “impossible to distinguish on the street.” 

“Fentanyl test strips should not be used to detect carfentanil in a substance,” they said. 

Carfentanil began appearing in several states as early as 2016 and helped drive overdose deaths in Ohio and Florida, according to the Centers for Disease Control and Prevention. In 2023, carfentanil was linked to at least 168 overdose deaths in 38 states—the largest number in West Virginia where 34 people died. 

In the U.S., nearly 82 percent of overdose deaths involved at least one opioid in 2023, and illegally-made fentanyl was the most commonly-involved drug, according to data from the State Unintentional Drug Overdose Reporting System, or SUDORS. 

In Arizona this year, 306 people have died from overdoses, including 150 deaths in Maricopa County and 74 deaths in Pima County. There were also 1,642 non-fatal opioid overdoses in Arizona this year, including more than 1,200 in Maricopa County, and 163 in Pima County, according to data from the Arizona Department of Health Services. 

As part of the Trump administration’s slash and burn effort through the federal budget, overdose prevention programs at the CDC were cut as well as Substance Abuse and Mental Health Services Administration, and the White House has moved to cut $56 million from the program that helps distribute Narcan.