“Blue 30s” is a street term for illicit, counterfeit pills that pose a severe public health threat. These tablets are designed to look exactly like legitimate 30-milligram oxycodone prescription painkillers, typically stamped with an “M” on one side and “30” on the other. They are not pharmaceuticals produced by a licensed manufacturer; they are illegally pressed tablets containing potent, unlisted substances. The widespread availability of these fake pills is a significant factor in the escalating number of accidental overdose deaths in the United States.
Identifying Counterfeit Blue 30s
Counterfeit “Blue 30s” are deliberately manufactured to closely resemble authentic oxycodone tablets, making visual inspection highly unreliable. The genuine prescription drug is a small, round, light-blue pill typically imprinted with an “M” on one side and the number “30” on the other, sometimes with a line separating the number and the “M.” The illicit versions mimic this appearance precisely, down to the powder-blue color and the specific stampings.
The differences are often subtle, sometimes involving slight variations in the pill’s size, the shade of the blue, or the quality of the imprint. Counterfeit pills may have a more chalky texture, or the “M” and “30” markings might appear wider, fuzzier, or less cleanly pressed than the legitimate pharmaceutical. Despite these minor potential flaws, the tablets are often indistinguishable from the real thing, even to experienced users, which makes their consumption a deadly gamble. The only way to ensure a pill is safe is to obtain it directly from a licensed pharmacy with a prescription.
The Primary Danger Fentanyl
The danger of “Blue 30s” comes from the presence of illicitly manufactured fentanyl, a synthetic opioid. Fentanyl is used because it is inexpensive to produce and is highly potent, allowing manufacturers to mimic the strong effects of prescription oxycodone. This synthetic compound is extraordinarily powerful, estimated to be 50 to 100 times stronger than morphine and up to 50 times more potent than heroin.
The amount of fentanyl required to cause a lethal overdose is microscopic, with a dose as small as two milligrams considered potentially fatal. Since there is no quality control in clandestine labs, the fentanyl is often mixed unevenly throughout a batch, creating “hot spots” where the concentration is far higher in one pill than in another. This means a person can take a pill from a batch that seemed safe, only to take a subsequent pill with a lethal dose, leading to accidental overdose. Laboratory testing of seized counterfeit pills has found that a significant percentage contain a potentially lethal dose of fentanyl.
Manufacturing and Distribution
The production of “Blue 30s” is a sophisticated, illicit enterprise driven by the profitability of using cheap fentanyl to replace expensive pharmaceutical-grade opioids. These counterfeit tablets are produced using pill press machines in clandestine labs, often located in Mexico or domestically within the United States. The raw materials, known as precursors, often originate from international sources, such as China, before being smuggled and assembled into the final product.
The process involves mixing powdered fentanyl with cutting agents, adding blue coloring, and then using a pill press equipped with dies to stamp the “M” and “30” markings. The ease of acquiring pill press equipment, sometimes shipped disassembled or mislabeled to avoid detection, enables the mass production. Distribution often occurs through social media platforms and e-commerce sites, allowing criminal networks to market these pills directly to a wide audience, including minors, who mistakenly believe they are purchasing authentic prescription medication.
Recognizing and Responding to Overdose
Recognizing the signs of an opioid overdose is crucial, as a rapid response is necessary to save a life. Signs of an overdose include unresponsiveness; the person cannot be woken up even with a firm shake or sternal rub. Breathing will be slow, shallow, or completely stopped, and the person may make gurgling or snoring sounds.
Physical signs include pale, clammy skin, and a blue or gray discoloration of the lips and fingernails, indicating a lack of oxygen. The immediate steps are to call emergency services (911) and administer the opioid antagonist Naloxone, known by the brand name Narcan. Naloxone works by temporarily blocking the effects of opioids in the brain, reversing the life-threatening respiratory depression caused by fentanyl.
If the person is not breathing, rescue breaths should be given after administering Naloxone. A second dose should be given if the person does not respond within two to three minutes. Because Naloxone’s effects can wear off before the fentanyl is fully metabolized, it is important to stay with the person and monitor them until professional medical help arrives. Many public health departments offer training and provide access to Naloxone.