Last Updated: July 26, 2022

By: Rachel Clark, DanceSafe Contractor

A round blue pill with “M” in a box on one side and “30” above a score line on the other was sold in Denver, CO as oxycodone, but actually contains acetaminophen, fentanyl, 4-ANPP, metamizole, and xylazine. The sample was submitted from Denver, CO. 

The sample did not react in the presence of the Marquis, Mecke, or Mandelin reagents.  

Acetaminophen (Tylenol) is a popular over-the-counter pain and fever relief medication. It is non-psychoactive. 

Fentanyl is active in minute quantities, which has made it a nationally-recognized contributor to the opioid crisis due to its concentrated (and often accidental) presence in pills and powders. It is popularly believed that fentanyl and its analogs are fatal when in contact with bare skin; this is a myth that has been repeatedly dispelled through scientific channels. If you suspect that someone is overdosing on an opioid, you are not at risk of intoxication simply by touching them  or breathing the same air as them. Fentanyl and its analogs are absorbed through mucous membranes – an added layer of protection can be achieved by washing your hands after administering CPR on a person who has overdosed. Skin absorption would require very large quantities of fentanyl to be in contact with the dermis for prolonged periods of time, or direct contact with a wound. 

Since fentanyl is typically (if not always) distributed unevenly throughout a sample, it is essential to use proper dilution techniques to dissolve the whole sample in water when testing it with a fentanyl test strip (this does not destroy the sample – after the test, the water can be left to evaporate out over a few days, leaving powder again). Symptoms of opioid overdose include slowed or stopped breathing and heart rate, blue-tinged extremities, loss of consciousness, and often vomiting. If you suspect that a person has overdosed on an opioid, call 911, administer Narcan whenever available, and place the person in the recovery position (if they are still breathing) to prevent asphyxiation on vomit. If a person is not breathing, perform CPR. 

4-ANPP is a manufacturing intermediate of fentanyl (specifically, an impurity).

Metamizole is a powerful painkiller and anti-inflammatory agent that was pulled from U.S. shelves in the late 70s due to its potential to cause severe, life-threatening immunosuppression. 

Xylazine is a sedative that is commonly used in veterinary medicine, and has been marked as an emerging drug of intentional abuse in Puerto Rico. It is thought to be primarily used as a bulking agent, often found in syringes containing speedballs (heroin and cocaine used in conjunction). Xylazine’s sedating and anesthetic properties lead to markedly lowered blood pressure and heart rate (hypotension and bradycardia). 

We urge our community to keep in mind that drug markets are expansive and that this adulterated oxycodone pill may appear in places other than its source and submission location. Using a reagent test kit can help provide a first line of defense as a presumptive (and not affirmative) process. Additionally, samples may be sent in to www.ecstasydata.org for in-depth laboratory testing. Test before you ingest to avoid taking misrepresented substances, and so you can adjust your intention, set, and setting appropriately to minimize risks. You can purchase fentanyl strips here.

The purpose of #TestIt Alerts is to alert the public to misrepresented substances circulating in their region. We neither condemn nor condone drug use, but rather want people to be aware of what they are ingesting so they can take steps to minimize risks.

Since 1998, DanceSafe has been keeping the electronic music and nightlife communities safe. As a 501(c)(3) nonprofit, we provide free harm reduction services at music festivals and nightlife events across the nation. All proceeds from the sales of our drug checking kits go back into the organization so we can continue to provide our services to our communities for free. By purchasing a kit, you are not only helping keep you and your friends safe, you are also contributing to the harm reduction movement. Thank you for your support!