We are seeing an increase in fatal overdoses involving fentanyl in the form of white powder, even though fentanyl in pills remains the most common form. White powder fentanyl could easily be mistaken for other drugs, like cocaine, or pressed to look like rock cocaine. From our 2022 overdose report, among the overdose deaths where a fentanyl-substance was identified, the majority (64%) were linked to pills, but almost a quarter (23%) were linked to powders. Fentanyl is an extremely powerful opioid.