Many of today’s biggest fentanyl busts don’t involve powder at all. They involve pills: thousands or even millions of tablets pressed to look like real prescription medicine. They are counterfeit, and they are one of the deadliest products in the illegal drug market.

What are “M30s”?

“M30” is street slang taken from the imprint on genuine 30 mg oxycodone tablets, which are small, round, and blue with “M” on one side and “30” on the other. Traffickers copy that look almost exactly. The fakes are often called “blues.” Counterfeiters also copy other pills, including Xanax (alprazolam) bars, Adderall, and Percocet.

The real pills are regulated prescription medicines. The fakes typically contain illicitly made fentanyl mixed with fillers, and sometimes other drugs like methamphetamine or xylazine.

How they’re made

Counterfeit pills are made with pill presses, machines that compress powder into tablets using dies stamped with the copied imprint. Traffickers mix fentanyl powder with binders and fillers, add dye, and press the mixture into pills.

The problem is mixing. Fentanyl is active in tiny amounts, and powders don’t blend evenly in clandestine operations. One pill from a batch might contain little fentanyl while the next contains a deadly amount. That uneven mixing is sometimes called the “chocolate chip cookie” problem: some cookies get more chips than others.

Pill presses themselves are legal to own in the U.S. but federally regulated. Sellers and importers must report sales and imports of tableting and encapsulating machines to DEA, and DEA treats illegal pill press activity as a key target.

What DEA lab tests have found

DEA tests seized fentanyl pills to measure how much fentanyl they contain. In 2023, DEA reported that about 7 in 10 fake pills it tested contained a potentially lethal dose of at least 2 milligrams. According to DEA data reported since then, that share fell to about half in 2024 and to 29% in fiscal year 2025, which DEA has attributed to pressure on the fentanyl supply chain.

Lower average purity is good news, but it doesn’t make fake pills safe. Nearly 3 in 10 still carried a potentially lethal amount in 2025, and there is no way for a buyer to know which ones. For why 2 mg matters, see fentanyl vs. heroin vs. carfentanil.

You can’t tell by looking

Many counterfeit pills look nearly identical to the real thing. Sometimes there are clues, like crumbling edges, uneven color, or slightly off imprints, but well-made fakes can fool pharmacists without lab testing. The only safe source of prescription medication is a licensed pharmacy, filling a prescription written for you.

Who buys them

Counterfeit pills reach people who believe they are buying a real painkiller, anxiety medication, or study aid, often through social media or messaging apps. Teens and young adults who have never used opioids have died after taking a single fake pill because they had no tolerance. That’s why public health and law enforcement campaigns repeat the message that one pill can kill.

Why busts are counted in pills

Because pills are the product, agencies report seizures by count: “50,000 fentanyl pills” or “4 million pills.” In July 2024, CBP officers at the Lukeville Port of Entry in Arizona seized about 4 million fentanyl pills weighing more than 1,000 pounds, described at the time as the largest fentanyl seizure in CBP history. See more record hauls in the biggest drug busts in U.S. history.

How fake pill cases are charged

Federal fentanyl penalties are based on weight, so pill counts are converted to grams of mixture. At roughly a tenth of a gram per pill, a few hundred pills can cross the 40-gram threshold for a 5-year federal minimum, and a few thousand can cross 400 grams for a 10-year minimum (see federal penalties by weight). Exact weights vary by pill, so the lab-measured weight is what counts in court. Cases involving overdose deaths can bring a 20-year minimum.

Staying safe

• Take only medicine prescribed to you and dispensed by a licensed pharmacy.
• Assume any pill bought online, on social media, or from a friend could contain fentanyl.
• Carry naloxone (Narcan), which is available without a prescription and can reverse an opioid overdose.
• Fentanyl test strips can detect fentanyl in drugs, though they can’t measure how much.

Frequently asked questions

What does an M30 pill look like?

Genuine M30s are small, round, blue 30 mg oxycodone tablets stamped “M” and “30.” Counterfeits copy that look closely, which is why they are hard to spot.

Do fentanyl test strips work on pills?

Test strips can detect whether fentanyl is present in a sample, but they cannot tell how much is in a pill.

If you or someone you know is struggling with substance use, the SAMHSA National Helpline is free, confidential, and available 24/7 at 1-800-662-4357. In an emergency, call 911.