TYLER, Texas (KETK) — A potentially lethal dose of fentanyl can fit on the tip of a sharpened No. 2 pencil, according to the Texarkana Texas Police Department. Officials say that two milligrams of fentanyl is 50 times stronger than heroin.

Fentanyl is a synthetic opioid that medical professionals legally use to treat patients with chronic severe pain or severe pain after surgery, according to the U.S. Drug Enforcement Administration.

“Under the supervision of a licensed medical professional, fentanyl has a legitimate medical use. Patients prescribed fentanyl should be monitored for potential misuse or abuse,” the DEA said.

According to the DEA, illicit fentanyl is primarily made in secret foreign labs and smuggled into the United States. Experts say that fentanyl is being mixed in with illegal drugs to increase potency and may be sold on the streets as powders, nasal sprays and pressed into pills to make them look like legitimate prescription opioids.

“Because there is no official oversight or quality control, these counterfeit pills often contain lethal doses of fentanyl, with none of the promised drug,” according to the DEA.

Experts say that there is a strong risk that illegal drugs have been contaminated with fentanyl. Because of its low cost and potency, some drug dealers have been mixing fentanyl with drugs like heroin, methamphetamine and cocaine which heightens the chance of a deadly interaction.

According to the DEA, Fentanyl can cause effects such as:

  • Euphoria
  • Pain relief
  • Relaxation
  • Sedation
  • Confusion
  • Drowsiness
  • Dizziness
  • Nausea
  • Vomiting
  • Urinary retention
  • Pupillary constriction

An overdose of fentanyl may result in the following:

  • Disoriented near unconsciousness
  • Changes in pupillary size
  • Cold and clammy skin
  • Cyanosis – blue discoloration of the skin
  • Respiratory failure leading to death
  • Coma