The Cuyahoga County Medical Examiner has issued a public health warning saying they have detected carfentanil in pills designed to look like OxyContin.

OxyContin is a powerful opiate used to treat severe pain, although it has also been sold as a street drug.

The presence of carfentanil, however, could be lethal: It is an animal sedative that has been linked to dozens of overdose deaths since the start of the opioid crisis. At least 58 people died in Cuyahoga County last year from ingesting carfentanil.

"This situation is alarming, as the potency of carfentanil is substantially greater than the oxycodone found in OxyContin, and there is a serious risk of unintentional overdose in their use,” said Dr. Thomas P. Gilson, the county medical examiner. “People who recreationally use OxyContin purchased from street sources should be aware of this very dangerous development that may result in rapid death."

The pills in question were brought to the medical examiner's office from the Cleveland Division of Police. Dr. Gilson added anyone receiving OxyContin legally from a pharmacy will not be affected by this warning.