Carrie Luther holds a picture of her beloved son, Tosh, who died after accidentally taking counterfeit Xanax in 2015.

The evening of October 26, 2015, twenty-nine-year-old Aptos, California resident Tosh Ackerman took a Benadryl and part of a Xanax pill to help him sleep. He never woke up, and his girlfriend found him dead the next day. Ackerman died because the Xanax he took was counterfeit. It contained a fatal dose of a powerful synthetic opioid called fentanyl.

Tosh Ackerman was a respected member of his community, known and loved by his co-workers and customers at Nob Hill Grocery in Watsonville, CA, and a devoted brother and friend. His death was a shock and a blow to everyone who knew him. In a condolence letter to his mother, one customer characterized him as “genuine and pleasant.” “He cared about what I had to say,” she wrote. “He was a person who engaged with you, always with a smile and a kind word...[all] who knew Tosh felt the same way I did about him."

His family, too, felt his loss keenly. Tosh was extremely close to his family, often getting together for family dinners and to play games with his mom, dad, three siblings and two nieces, who adored him. They shared a love of sports and enjoyed going to many San Francisco Giants games together. 

Law enforcement investigating Tosh’s death found Benadryl, and three-quarters of a Xanax pill in a Motrin bottle in his room. According to Sgt. Chris Clark, the Santa Cruz Sheriff’s Office detective who worked on Tosh's case, a toxicology report revealed that he had overdosed on fentanyl, a synthetic opioid 50 to 100 times more potent than morphine. FDA testing confirmed that Tosh's Xanax was the source. It was counterfeit, and contained fentanyl rather than the alprazolam he expected. Later, the Santa Cruz County Sheriff's Office arrested a local man after they found more of the counterfeit medication among many other illicit substances in his home.

The remains of the pill that killed Tosh Ackerman. Source: Carrie Luther

Tosh was a unique young man, but this terrible story is far from unique. That same week, another young man died after taking a pill from the very same batch of counterfeit Xanax that killed Tosh. A third person was hospitalized. In May 2017, NBC Bay Area reported that there had been 130 known overdose deaths linked to fentanyl in the Bay Area since 2015. The CDC does not track fentanyl deaths separately from other synthetic opioid deaths, but their national statistics indicated that deaths caused by synthetic opioids rose to 9,580 in 2015 (a 72% increase over 2014). In parallel, the DEA reported that in 2015 forensic laboratories across the country had found 13,002 incidences of fentanyl in their drug testing (a 65% increase over 2014). 

Tosh's Grave Marker

These statistics indicate that fentanyl is a substantial part of the United States' opioid epidemic, which the New York Times estimates claimed 59,000 lives in 2016. According to a July 2016 DEA report, drug traffickers import unregulated fentanyl, or even more potent fentanyl analogs, in powder form from China at a very low cost. In the past, they mixed fentanyl with illegal drugs like heroin to boost the potency of their products, often without telling their buyers. That activity continues, but more recently traffickers in Mexico, Canada and the United States have been purchasing industrial pill presses along with fentanyl, and manufacturing their own convincing counterfeit prescription pills. Hundreds of thousands of these pills have entered the U.S. market since 2014.

The potential profit for drug traffickers is tremendous: an investment of as little as $5,000 for a kilogram of fentanyl, a pill press, and die molds could yield as much as $20 million in pills that each contain one milligram of fentanyl. Counterfeit pill traffickers have no industry standards, however. Manufacturing processes are unreliable and manufacturing errors are catastrophic: two milligrams of fentanyl, an amount the same size as two grains of table salt, is a fatal dose for a person who is not a regular opioid user.

On the day he died, Tosh had a case of hives. According to his grandmother, they had been plaguing him for weeks. He spent the day at the beach with friends, but when he got home he was so itchy he couldn't sleep. Battling insomnia, he spoke to his girlfriend, Zoe, on the phone for an hour and made plans to meet up with her the following day. Sometime that night, in an effort to sleep, Tosh took part of a Xanax pill. When he didn't call her the next day, Tosh's girlfriend stopped by his house to check on him. She found him still in bed. He had vomited, and was cold and unresponsive. She called 911, and tried to revive him, but Tosh was already dead. 

Tosh Ackerman would never have willingly taken a pill made of fentanyl. He thought he was taking prescription Xanax. Tosh was a much-loved brother, son and friend with a bright future ahead of him. His loss, as with so many others, is an American tragedy. People don't know that counterfeit prescription drugs made with fentanyl are out there, or that they are risking their lives unless they buy their medicine from a licensed American pharmacy. 

Carrie Luther is working hard to get the word out. "Since Tosh's death," she told us, "I have been committed to telling Tosh's story to high school students, but want to do more. I believe that every time I speak I save lives. This epidemic is not over and we need to take it seriously."

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