Imagine ingesting a drug that has the appearance of a sludgy concrete mix and is considered fatal — even after just one dose.

“Gray death,” as it is being called, is a combination of heroin, fentanyl (a powerful painkiller), carfentanil (an animal tranquilizer), and a synthetic opioid called U-47700, otherwise known as “Pink” or U4.

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Last year, the U.S. Drug Enforcement Administration listed the synthetic opioid U-47700 (developed in 2015) in the category of the most dangerous drugs it regulates.

And if you think reading that list of ingredients is alarming — the powerful punch each of these substances adds to the mix is downright frightening. Fentanyl is 50 times stronger than heroin, and carfentanil is a whopping 100 times stronger than fentanyl.

With a sticker price of about $10 to $20 dollars per dose, this cocktail is all too accessible — making it attractive to drug users who will inject, swallow, smoke or snort it. The gray concoction packs a much higher potency than heroin alone, so it’s no surprise to anyone that the high comes fast — and with devastating consequences.

Even those who don’t set out to use this designer drug are at risk of exposure — possibly even death.

According to several news reports, the mix seems to have contributed recently to several overdoses in states such as Alabama, Ohio and Georgia. MDLinx notes that the Georgia investigation bureau has received 50 overdose cases in just the past three months involving gray death.

These numbers are just another example of the ever-growing popularity of opioid drugs in the U.S. The Centers for Disease Control and Prevention (CDC) reported that opioids (including prescription opioids and heroin) killed more than 33,000 people in 2015.

Also in 2015, the CDC and the Drug Enforcement Administration (DEA) put out an emergency preparedness and response statement regarding the increase in fentanyl drug confiscations and fentanyl-related overdose fatalities.

Related: Hidden Victims of the Opioid Crisis

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Unfortunately, gray death is just one of many combinations of heroin laced with other opioids to hit our streets over the last few years. Even those who don’t set out to use this designer drug are at risk of exposure — possibly even death.

Gray death is considered powerful enough to be absorbed through the skin, putting anyone who accidentally comes into contact with this mix in danger. This is scary news for our first responders ,including police officers, paramedics and firefighters, who are often the first on the scene with any situation involving drugs or overdoses.

Sara Hermanson is a freelance writer in Washington State whose focus is health, wellness, fitness and parenting.