The August 2021 indictment of an alleged fentanyl pill dealer for the death of a Maui resident, makes Hawaii the final U.S. state to confirm a counterfeit pill fatality.

Reports of dangerous fake prescription pills began appearing in 2015, and PSM has been tracking the spread of this crisis state by state until today, when these fake pills have now killed in all fifty states.

At first, homegrown criminals like Aaron Shamo bought pill presses and powdered drugs from China and made finished pills to sell on the street or the dark web.

But around 2018 Mexican cartels entered the business, scaled it up and dwarfed the competition.

Overseas labs that used to ship fentanyl or fentanyl pills directly to dealers are trying to avoid prosecution by shipping precursor chemicals to Mexico and letting the Cartels make fentanyl and fentanyl pills from them

Dealers still sell on the dark web and the street, but they also sell one-on-one to young Americans via social media, killing buyers who think they are getting real medicine.

A recent bipartisan report says the cartels are using Chinese money launderers to hide their profits.

Now that pill traffickers have mastered the process, they are diversifying, making pills that contain other ingredients, with and without fentanyl.

Fentanyl is also appearing in all kinds of illicit drugs: cocaine, meth, and MDMA.

This has been going on for years, but too many Americans are still only becoming aware of it when a close friend or family member dies.

Every family we have spoken to wishes they had known about counterfeit pills sooner--and every family wants to help yours avoid a tragedy. Start here for tips about how to talk to YOUR family before someone you love makes a decision with deadly consequences.