The substance first appeared in America and was thought to be a unique chemical compound before being identified as a mixture of drugs.
[4] As with other illicit narcotics, gray death carries a higher risk of serious adverse effects than prescribed opioids due to the unknown and inconsistent composition of the product.
[5] Even experienced opioid users risk serious injury or death when taking this drug mixture.
[5] This difficulty is regularly encountered when treating overdoses of high-affinity opioids in the fentanyl chemical family or with buprenorphine.
It may be necessary to increase the dosage of naloxone or its frequency of administration in order to counteract respiratory depression.