US: DEA issues warning over counterfeit pills

NBC News –

DEA is alerting all citizens to an increase in drug overdose deaths tied to counterfeit pills containing the powerful synthetic opioid fentanyl.

Manufactured by Mexican drug trafficking (DTOs), and marketed as a medication such as oxycodone on the illicit drug market, these pills can be deadly. One pill can be enough to kill someone.

Fentanyl is a synthetic opioid that is 100 times stronger than morphine.

Killer counterfeit pain pills circulating the streets of Mobile

DEA lab analysis has identified pills ranging from .02 milligrams to 5.1 milligrams of fentanyl per tablet, with 26% of the counterfeit pills tested containing a lethal dose of fentanyl. A deadly dose of fentanyl can be as little as 2 milligrams.

DEA urges the public to obtain prescription drugs only from state-licensed pharmacies that are located in the United States, where the U.S. Food and Drug Administration and state authorities can assure the quality of drug manufacturing, packaging, distribution, and labeling.

Counterfeit pills are extremely dangerous, as they often contain toxic or illicit ingredients such as fentanyl, increasing the likelihood of an overdose, said Brad L. Byerley, Special Agent in Charge of DEA’s New Orleans Field Division.

Mexican drug trafficking organizations (DTOs) are pushing these deadly substances into the illicit drug market to expand their business among the already increasing opioid-addicted population. Manufacturing these pills using deadly substances like fentanyl is a reflection of the evil by which these drug traffickers operate for their profit. Americans are dying across the country and here in Louisiana. To anyone going outside the healthcare system to obtain otherwise legitimate medications, I would say this: Don’t do it. You can never be certain of what you’re getting and you’re playing Russian roulette with your life.

REALITY CHECK: Fentanyl – Why a drug meant to relieve pain is causing so much of it


Counterfeit pills are fake medications that have different ingredients than the actual medication. They may contain no active ingredient, the wrong active ingredient, or have the right ingredient but in an incorrect quantity. Counterfeit pills may contain lethal amounts of fentanyl or methamphetamine and are extremely dangerous because they often appear identical to legitimate prescription pills, and the user is likely unaware of how lethal they can be.


The majority of counterfeit drug production occurs in other countries, mainly China, Mexico, and India. Furthermore, an increasing number of pills laced with fentanyl are being produced in the U.S. Mexican and domestic drug trafficking organizations operating in the U.S. produce counterfeit pills with pre-made chemicals and drugs from China and/or Mexico. They are usually produced in substandard conditions, labeled incorrectly, and may include dangerous, unapproved substances. There are no quality control mechanisms in the illicit labs producing counterfeit pills to ensure dosing is not lethal. Online sales via internet marketplaces and social media are the major sources for obtaining counterfeit pills.

A significant number of high school and college students purchase Adderall and Xanax from dark web drug markets and/or through social media referrals, which market deadly versions of these drugs tainted with fentanyl and/or methamphetamine. Some students begin using prescription stimulants, often referred to as “study drugs,” in the belief it will benefit their academic performance, but the nonmedical use of prescription stimulants has not been proven to improve academic performance.

What are common street names?

Counterfeit oxycodone M30 pills: Mexican Blues, Blues, M-Boxes

What do they look like?

Counterfeit pills are nearly identical to actual prescription medications. The majority of counterfeit pills resemble oxycodone 30mg pills (M30s), but can also mimic hydrocodone, alprazolam (Xanax), Adderall, and other medications.

There are indications that drug trafficking organizations are specifically targeting kids and teens by creating counterfeit pills in a variety of shapes and bright colors to appeal to that age group. Counterfeit M30 pills can vary in color from white to blue. The best way to avoid counterfeit medication is to take only medications prescribed by a licensed medical professional and dispensed by a registered pharmacist.

How are they used?

Counterfeit pills are especially dangerous because people think they are purchasing legitimate prescription medications. However, these fake pills often contain lethal amounts of illicit drugs. Distributors in the United States are selling counterfeit pills on social media, appealing to a younger audience that use these apps. Minors and young adults experimenting, as well as regular substance users, believe they are buying authentic oxycodone, Adderall, Xanax, or other medicines, but are unwittingly purchasing counterfeit pills that contain lethal amounts of drugs, usually fentanyl and methamphetamine. Fentanyl is approximately 100 times more potent than morphine, and 50 times more potent than heroin as a painkiller. Twenty-six percent of tablets tested in a DEA laboratory contained a lethal dose of fentanyl.

What is their effect on the body?

Counterfeit pills that contain fentanyl can be deadly. A lethal dose of fentanyl is about two milligrams, equivalent in size to a few grains of salt. Fentanyl, similar to other commonly used opioid analgesics (e.g., morphine), produces effects such as relaxation, euphoria, pain relief, sedation, confusion, drowsiness, dizziness, nausea, vomiting, urinary retention, pupillary constriction, and respiratory depression. Synthetic opioids, such as illicit fentanyl, remain the primary driver of the increase in overdose deaths, accounting for 80 percent of all deaths involving an opioid.

Counterfeit pills containing methamphetamine are highly addictive and act on the central nervous system. Taking even small amounts of methamphetamine can result in wakefulness, increased physical activity, decreased appetite, rapid breathing and heart rate, irregular heartbeat, increased blood pressure, and hyperthermia (overheating).

What are the overdose effects?

Fentanyl overdose may result in stupor, changes in pupillary size, cold and clammy skin, cyanosis, coma, and respiratory failure leading to death. The presence of the triad of symptoms such as coma, pinpoint pupils, and respiratory depression are strongly suggestive of opioid poisoning.

Methamphetamine overdose may result in death from stroke, heart attack, or multiple organ problems caused by overheating.

Which drugs cause similar effects?

Drugs that cause similar effects to fentanyl include other opioids such as morphine, hydrocodone, oxycodone, hydromorphone, methadone, and heroin. Drugs that cause similar effects to methamphetamine include cocaine and potent stimulant pharmaceuticals, such as amphetamines and methylphenidate.

What is their legal status in the United States?

Fentanyl-like substances are currently emergency scheduled through October 22, 2021, as Schedule I narcotics.

Methamphetamine is a Schedule II stimulant


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