It's said to be laced on almost every drug out there today, including marijuana, cocaine, psychedelics, and meth.
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And now, another substance is making its way into those same drugs.
It's called Carfentanil, but it's not exactly new. Its intended use is as an animal tranquilizer.
"It's used by veterinarians to put down three-ton elephants, large animals of all kinds and it is now on our streets," says Flint Andersen with PAIN (Parents and Addicts in Need).
Carfentanil is already showing up in southern California.
As for the Valley, Fresno County District Attorney Lisa Smittcamp says it's only a matter of time before law enforcement starts finding it here.
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You might be wondering - why would anyone put a powerful drug intended for elephants in something humans can consume?
"It's all about greed and money. That's all drug sales are, it's all about greed and money," says Smittcamp.
It's still widely unknown how well Narcan will be able to combat a Carfentanil overdose.
For now, the Drug Enforcement Agency recommends administering multiple doses of Narcan every 2 to 3 minutes until the person overdosing responds.
Most of the time, people don't even know they're taking fentanyl, and won't know they're ingesting Carfentanil.
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For now, the best effort against the crisis is to educate.
"You have to talk to your children so they're armed with knowledge, they're armed with understanding, and they're ready," says Smittcamp.
The District Attorney also points to the county's media campaign in partnership with the DEA, which includes large billboards, getting the word out about the dangers of fentanyl, as a way to get more parents informed before Carfentanil gets here - and starts to kill.