If you pay attention to the recent news surrounding the opioid epidemic in the Midwest, you’ve likely heard the name “fentanyl” floating around. The Centers for Disease Control and Prevention (CDC) issued a warning regarding the prevalence of this drug, which has become the deadliest new facet in the opioid epidemic. And the scariest part? You might not even know you’re taking the drug.

Over the last few years, the Midwest has seen a huge resurgence in heroin overdoses. A new drug has emerged, and it’s cause for concern. Fentanyl is (now) famously 50 times stronger than morphine, and has become the cause of a huge influx of opioid overdoses. When heroin is laced with fentanyl, the potency of the drug means that a much smaller amount can cause an overdose, and that’s what’s been happening in shocking amounts, in places like Indiana and Ohio, and in increasing amounts.

When you overdose on an opioid, your breathing slows to the point of cessation, you may begin turning black and blue or your pupils appear very small, appear to be disoriented and confused, and even lose consciousness.

Naloxone, or Narcan, the life-saving medication to prevent overdose, is used in ‌instances of opioid overdose. However, because of the strength alone of fentanyl, overdoses now require larger and larger amounts of Narcan in order to use the life-saving opioid antidote properly. In some cases, Narcan has been used up to 4 times in order to successfully resuscitate someone from a fentanyl overdose.

Frighteningly, fentanyl has been popping up in prescription pills laced with the drug, meaning that fake pills, like Norco, OxyContin, Xanax and others, have become stronger than ever. Since prescription pills are abused in places far and wide, this means that the higher chance for opioid overdose has spread to those areas, as well.