From what I've seen it tends to be sold in disguise a lot. Pressed M30's for example, are a counterfeit of Malincroot 30mg Oxycodone that have become synonymous with fentanyl. Notoriously manufactured by Mexican cartels and pedalled in the US. They show up in smaller numbers around the world but outside the US they're often imitations of the cartels fentanyl versions and tend to contain substitute compounds like the opioid analogues that became popular during the "research" chemicals boom. They exploited a loophole in the law which meant, (for some time), they were legal. New legislation has corrected that now but the cat is out of the bag now and some of them are still showing up quite prolifically. There's a good few of them that are many times stronger than fentanyl. They are so strong that addiction to them cannot be treated with the likes of methadone or buprenorphine/subutex/suboxone, and narcan (the common antidote for opioid overdose) is often not strong enough to treat OD's. When it is successful it requires multiple repeat shots to do so and the effects can wear off whilst the opioid is still in the users system so they literally slip back into overdose again some time later. This is due to some of the analogues having a particularly long half life.
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