Fake pills are ravaging communities across the U.S.

What began in 2015 as an outbreak of counterfeit opioid painkillers and Xanax that contained potentially deadly doses of fentanyl or fentanyl analogues has spread to all 50 states, and has killed residents in all of them.

Illegal pill presses have given drug counterfeiters the ability to adapt.

In 2020, they expanded their offerings with pills mimicking Adderall, Aleve, aspirin and even the diabetes drug metformin, and new, dangerous ingredients such as methamphetamine, isotonitazene, clonazolam and etizolam. The fake pill trade has become such a crisis that in September 2021, the DEA issued a public safety alert to warn Americans about them.

Mexican drug cartels smuggle millions of these pills over the border, but the U.S. also has homegrown traffickers who import ingredients and pill presses from China and manufacture their own deadly pills.

Counterfeit oxycodone pills containing fentanyl Source: Office of the U.S. Attorney for the Southern District of California

Counterfeit oxycodone pills made with fentanyl (Office of the U.S. Attorney for the Southern District of California)

Get PSM's Weekly Newsletter

Sign up here

Find out what's happening in your state.

PSM Resources about the Counterfeit Pill Crisis

Hawaii Becomes Final State To Report A Fake Pill Death (August 2021)

Deadly Counterfeit Pills Found in All 50 U.S. States; Deaths Now Reported in 42 of Them (October 2020)

Do You Know What a Pill Press Is? (August 2019)

Illegal Pill Presses: An Overlooked Threat to American Patients (with NABP and NADDI, March 2019) and April 2021 update (with NADDI)

Fentanyl 101: An Introduction to the Fentanyl Crisis in the U.S. (August 2018)

43 States And Counting: The Deadly Combination Of Imported Fentanyl And Counterfeit Medicines (April 2018)

Real Victims of Counterfeit Medicine (Ongoing profiles of American counterfeit drug victims, including those poisoned by counterfeit pills.)

Save Peoples' Lives with Naloxone

The drug temporarily reverses the effects of opioids and it is available without an individual prescription at U.S. pharmacies in every state. It's often covered by health insurance, and sometimes community programs distribute it for free.

Consult NEXT Distro to learn about access to naloxone in your state.

Videos:  Watch our most recent video about counterfeit pills and  subscribe to our YouTube playlist to catch all our updates.

youtube-video-thumbnail

Reports

Joseph Friedman, MPH, et al,"Trends in Drug Overdose Deaths Among US Adolescents, January 2010 to June 2021," Journal of the American Medical Association, April 12, 2022.

Provisional Drug Overdose Death Counts, Centers for Disease Control, National Center for Health Statistics, 2021

Drug Enforcement Administration:

Combatting the Opioid Crisis: Exploiting Vulnerabilities in International Mail (United States Senate, January 2018)

Report On The Potential Impact Of Drug Importation Proposals On U.S. Law Enforcement (Freeh, Sporkin, and Sullivan LLC, Freeh Group International Solution, LLC, June 2017)

Counterfeit Alprazolam Poses A 'Major Public Health Threat' (Medscape, August 8, 2016)

“Fentanyl And A Novel Synthetic Opioid U-47700 Masquerading As Street ‘Norco’ In Central California: A Case Report” (Annals of Emergency Medicine, July 26, 2016)