Health officials have issued a warning about the growing number of Americans dying from overdoses involving counterfeit pills. A report from the Centers for Disease Control and Prevention (CDC) revealed that the proportion of fatal overdoses involving fake tablets has more than doubled from 2019 to 2021. These counterfeit pills, designed to resemble legitimate medications like Xanax and Oxycodone, often contain fentanyl.
Between July 2019 and December 2021, the CDC analyzed 30 jurisdictions to determine the proportion of overdose deaths that involved counterfeit pill use. During this period, there were a total of 106,293 overdose deaths from all drugs. The report showed an increase in the proportion of drug overdose deaths involving counterfeit pills between 2019 and 2021, with western states such as Alaska experiencing a particularly dramatic rise.
In October 2022, the DEA Task Force seized 300,000 rainbow pills and 22 pounds of powdered form fentanyl. Deaths caused by fentanyl in the US saw a significant surge in the 2010s, rising from 2,666 in the beginning of the decade to 19,413 by 2016. The Covid-19 pandemic worsened the situation, with a record-breaking 72,484 deaths recorded in 2021.
The proportion of overdose deaths involving counterfeit pills more than doubled from 2% in July-September 2019 to 4% in October-December 2021. In western jurisdictions such as Alaska, New Mexico, and Utah, this percentage more than tripled, going from 4.7% to 14.7%. Pills discovered at overdose scenes were considered counterfeit if they were identified as fake, tested positive for different drugs than advertised, or were unmarked.
Most individuals who consumed counterfeit pills were below the age of 35, Hispanic or Latino, and had a history of prescription drug misuse. The influx of cheap fentanyl from China, Mexico, and India, along with the rise of the unregulated dark web, facilitated the proliferation of the fake pill market.
In May of last year, Mac Miller’s drug supplier received a sentence of over 17 years in prison for distributing counterfeit oxycodone laced with fentanyl, which caused the rapper’s fatal overdose. Earlier this year, Robert De Niro’s 19-year-old grandson also died after consuming fake oxycodone containing fentanyl. The US opioid crisis has been escalating for decades, but the pandemic intensified it due to lockdowns, hospital closures, and increased vulnerability to addiction and lack of access to prescriptions.
Fentanyl was originally developed in 1959 as a painkiller for cancer patients, typically administered through injection or patches. However, during the US opioid epidemic, it began appearing more frequently in pill form. Fentanyl is an extremely potent synthetic opioid, surpassing morphine’s strength by 100 times and heroin’s by up to 50 times. It is often the culprit in accidental overdoses.
Of the deaths involving fake pills between 2019 and 2021, 41% contained illegally manufactured fentanyl. Xylazine, also known as ‘tranq,’ was detected alongside fentanyl in 2% of these cases. Xylazine, a cheap animal tranquilizer produced in China, is increasingly finding its way into the American illicit drug market and creates an even more lethal combination when combined with fentanyl.
The report emphasized the importance of overdose prevention messaging, urging individuals to only use legitimate pharmaceutical pills prescribed to them and warning that illicitly obtained pills may contain highly potent drugs. It also mentioned that providing access to fentanyl test strips and drug-checking services can help individuals identify the contents of pills.
President Joe Biden recently announced a plan to reduce overdose deaths from fentanyl and xylazine, aiming for a 15% reduction by 2025. The overdose crisis in the US has been escalating since the 2010s, with fentanyl flooding the illicit drug supply.
Fentanyl can enhance the intensity of a drug user’s high but is also highly toxic, with as little as two milligrams being lethal to an adult. Overdose deaths soared during the Covid-19 pandemic, as people faced job insecurity, rising mental health issues, and limited access to resources.
Furthermore, doctors have raised concerns about the emergence of a Chinese-made drug deadlier than fentanyl known as nitazenes. This group of lab-made opioids, similar to fentanyl, is increasingly being mixed into heroin and counterfeit prescription pills sold on the streets, leading to fatal overdoses. Nitazenes are believed to be approximately 1,000 times more potent than morphine, requiring at least two doses of naloxone to combat an overdose compared to the standard one dose for fentanyl. Doctors at Mount Sinai, New York, have issued a warning to clinicians to be aware of these opioids in the drug supply to ensure proper care for affected patients.
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