“Blue 30s” is the common street name for a highly dangerous type of counterfeit pill driving the opioid crisis. These illicit tablets are designed to look exactly like legitimate prescription oxycodone pills, specifically the 30-milligram dose. They are illegally manufactured and contain a lethal amount of synthetic opioid. Users often believe they are taking a regulated medication, unknowingly consuming a substance that can be fatal in a single dose. The lack of quality control makes “Blue 30s” an urgent public health threat.
Visual Identification and Street Terminology
The physical appearance of “Blue 30s” is intentionally crafted to mimic a genuine oxycodone hydrochloride tablet. They are typically small, round, and light blue, often appearing slightly chalkier or grainy compared to pharmaceutical-grade pills. The most identifying feature is the stamping: a large letter “M” is pressed into one side, and the number “30” is pressed into the other, leading to the common nickname “M30s.”
This marking replicates the actual M30 oxycodone tablet, leading individuals to believe they are purchasing a regulated 30-milligram dose. Though the counterfeit pills may sometimes have slightly wider lines or imperfect imprints, they are frequently indistinguishable from the real medication. Common street names for these counterfeit pills include:
- M30s
- Blues
- Dirty 30s
- Mexican Blues
- Blue Devils
The Composition: Fentanyl and Counterfeit Status
The danger of “Blue 30s” stems from their chemical composition; they are not oxycodone but are pressed with fentanyl, a powerful synthetic opioid. Fentanyl is significantly more potent than many other opioids, estimated to be 50 to 100 times stronger than morphine. This high potency means that a microscopic amount, as small as two milligrams, is considered a potentially lethal dose.
These pills are produced in illicit labs with no quality control, creating an unpredictable risk. Analysis of seized pills shows that a significant percentage contain a lethal dose of fentanyl, meaning any single pill could be fatal. The fentanyl is often unevenly distributed throughout the tablet, resulting in “hotspots” where the drug concentration is high enough to cause an immediate overdose.
The pills are often manufactured outside of the U.S. and smuggled in, pressed to look like legitimate prescription medications to increase marketability. When consumed, the user is unknowingly taking a dangerously high dose of a fast-acting synthetic opioid. This lack of certainty regarding dosage and the drug’s strength is why “Blue 30s” are responsible for a large number of fatal overdoses.
Symptoms of Fentanyl Overdose
Recognizing the signs of a fentanyl overdose is important because the drug’s potency causes symptoms to appear rapidly. The primary sign is respiratory depression, which manifests as breathing that is extremely slow, shallow, or has stopped completely. This slowing of the respiratory system leads to death if not immediately addressed.
A person experiencing an overdose may become drowsy, disoriented, or lose consciousness, becoming unresponsive even to attempts to wake them. Their pupils will often constrict to a very small size, referred to as “pinpoint pupils.” Changes to skin color are also an indicator, with the lips and fingernails turning blue or gray due to a lack of oxygen, a condition known as cyanosis.
Other observable signs include cold and clammy skin, a limp body, and gurgling, choking, or snoring sounds, sometimes called the “death rattle.” The combination of unresponsiveness, pinpoint pupils, and depressed breathing strongly suggests an opioid overdose. Because fentanyl is fast-acting, any person exhibiting these symptoms requires immediate emergency intervention.
Emergency Response and Intervention
An overdose from a “Blue 30” is a medical emergency requiring immediate action. The first step is to call 911 immediately and clearly state that someone is unresponsive and not breathing. Providing the exact location ensures emergency medical services arrive quickly.
The most effective intervention is the administration of naloxone, an opioid antagonist medication that temporarily reverses the effects of an overdose. Naloxone, often known as Narcan, is safe to administer and only works if opioids are present. Because fentanyl is potent, multiple doses of naloxone may be necessary; be prepared to administer a second dose after two to three minutes if there is no response.
After administering naloxone, or while waiting for emergency services, rescue breathing should be performed since fentanyl causes severe respiratory depression. The person should be laid flat, the head tilted back to open the airway, and one breath delivered every five seconds until they begin breathing normally. Many jurisdictions have Good Samaritan laws that provide legal protection to individuals who call for help and administer aid during an overdose.
Resources for Treatment and Prevention
Preventing an overdose from “Blue 30s” requires never consuming any pill that was not prescribed by a licensed medical professional and dispensed by a registered pharmacy. Since these counterfeit pills are often sold online or through social media, avoiding purchasing any medication through unverified sources is a primary preventative measure.
For those at risk, having naloxone readily available is a practical harm reduction strategy. Training is available to learn how to recognize an overdose and properly administer the reversal medication. If substance use disorder is a concern, various national resources offer confidential support and treatment options.
The Substance Abuse and Mental Health Services Administration (SAMHSA) operates a National Helpline, which provides 24-hour treatment referral and information. SAMHSA also offers toolkits and resources focused on overdose prevention and response. These resources connect individuals to substance abuse treatment centers and other harm reduction services, including medication-assisted treatment programs.