June 17, 2020: Deadly fake pills have reached 49 U.S. states
It’s been happening since at least 2015, but many people are still not aware that counterfeit prescription pills laced with fentanyl and fentanyl analogs are circulating in the United States. And that’s tragic, because every month media coverage reveals the names of people from many walks of life and of a variety of ages who have died of fentanyl poisoning after taking one of these pills—often without knowing their pills weren’t what they seemed to be.
Just since May 1, 2020, journalists have written about the deaths of Emilio Velci in California, Lantz Tucker in Kansas, Jonyvan Johnson in Indiana, Marcus Kory Krogh in Minnesota, and LaJeune Q. Gay and Kristina L. Rosbach in Washington. Sources reported additional unnamed deaths in two cities in California and in Indiana, Minnesota, Ohio, Oklahoma, Pennsylvania, Utah, Tennessee and Washington.
PSM first heard about these pills in October 2015, when three San Franciscans and two Santa Cruz County residents died of opioid poisoning after taking pills they thought were Xanax. One of those people was Tosh Ackerman who died after taking just a quarter of a pill. Digging into the subject, we found that deadly fake prescription pills had been around since at least February 2015, when Joe Patterson, a young father-to-be in Georgia, was killed after he took an oxycodone for a pulled muscle. By March 2016, clusters of deaths from counterfeit pills made with deadly fentanyl had been found in communities like Sacramento, where 52 people were poisoned, and 14 died in just four weeks, including Jerome Butler. In April 2016, the legendary musician Prince died because of counterfeit Vicodin made with fentanyl, and by the end of the year 24 states had reported finding counterfeit pills. By June 2019, counterfeit pills made with fentanyl had been found in every U.S. state except for Hawaii.
Where do these pills come from? According to the DEA, criminal organizations were smuggling finished counterfeit pills into the country from Mexico and Canada, but they also came from domestic pill manufacturing operations. Traffickers inside and outside the U.S. were buying pill presses, pill molds that mimicked painkillers and anti-anxiety medications and low-priced powdered medicines in bulk from China, or sometimes Mexico. (Synthetic opioids dominate this trade, but law enforcement has also shut down operations that sold fake Adderall pills made with methamphetamine, and fake Xanax made with unregulated bulk-produced alprazolam or other benzodiazepines.) Fentanyl and pill presses are readily available for sale on the Internet, and overseas sellers ship Americans these supplies in the U.S. mail, hiding them among the more than 140 billion items the U.S Postal Service processes.
A small investment makes it possible for anyone to start producing real-looking pills made from cheap fentanyl or related analogues. In 2016, the DEA estimated that dealers could generate between $5 and $20 million in retail sales from a kilogram of fentanyl, depending on the intended strength of the pills. Drug dealers, however, do not have the expertise or the conscience to make certain that each of these pills has an evenly distributed dose of fentanyl. When the University of California tested pills associated with the deaths in Sacramento, they found that fentanyl content in each pill ranged from 0.6 and 6.9 milligrams. Fentanyl is so powerful that just two milligrams of it can be fatal.
The frightening truth is that it’s impossible to know what these drug traffickers are selling. Counterfeiters murdered Jerome, Joe and Tosh, but also Maggie Divita Crowley, Eric Griffin, Robbie Hodge, Josh Holton, Travis Jacobson, Blain Padgett, Jaydon Rogers, Ashley Romero, Nathan Van De Mark, Mike Fuselier and many, many more.
This is why it is incredibly important that patients only take prescription medications that they have purchased in the legal supply chain. Hospitals and licensed pharmacies buy products from licensed wholesalers selling FDA-approved medicines manufactured in FDA-reviewed manufacturing facilities. Working with a pharmacist or hospital is the surest method of avoiding deadly fake pills and of being sure the medicine you need is both safe and effective.
Relevant PSM Resources:
- 5 Ways to Save Money and Stay Safe From Counterfeit Drugs (updated May 2019)
- 49 States Have Reported Deadly Counterfeit Pills Made with Fentanyl (January 2020)
- Illegal Pill Presses: An Overlooked Threat To American Patients (March 2019)
- 43 States and Counting: The Deadly Combination of Imported Fentanyl and Counterfeit Medicines (April 2018)
- Fentanyl 101
- Real Victims of Counterfeit Drugs
Additional sources for this week’s video and post:
- Combating the Opioid Crisis: Exploiting Vulnerabilities in International Mail, Senate Permanent Subcommittee on Investigations.
- “Postal Facts: A Decade of Facts and Figures,” U.S. Postal Service.
- Counterfeit Prescription Pills Containing Fentanyls: A Global Threat, U.S. Drug Enforcement Agency, July 2016.
- “Counterfeit Pill Drug Ring in San Antonio Sold Over 800,000 Fake Pills in Two Years,” The Partnership for Safe Medicines, July 12, 2019.
- “Champaign Man Sentenced to 13 Years in Prison for Trafficking Millions of Counterfeit Xanax Pills on Darknet, Money Laundering,” U.S. Department of Justice, January 6, 2020.
- “‘Norco’ Fentanyl Overdose Deaths Rise to 14; Problem Spreads to Bay Area,” Los Angeles Times, April 26, 2016.
- Daniella Silva, “Prince Died After Taking Fake Vicodin Laced With Fentanyl, Prosecutor Says,” NBC News, April 19, 2018.
- Stephen Baxter, “Santa Cruz County Authorities Warn of Lethal Counterfeit Xanax Containing Fentanyl,” The Mercury News, May 4, 2016.