A new wave of concern is spreading across parts of the Midwest as law enforcement, public health officials, and addiction recovery centers issue urgent warnings about “purple fentanyl”. This variant—fentanyl adulterated with lidocaine, a local anesthetic—has proven resistant to Narcan (naloxone), the life-saving opioid overdose reversal medication. First identified in Omaha, Nebraska, and now in Johnson County, Missouri, purple fentanyl is alarming due to its intensified effects and failure to respond to conventional emergency treatment.