June 23, 2025: New botulism outbreaks tied to suspect Botox injections
Major Stories
More than 40 cases of botulism linked to Botox injections have been reported in the U.S. and U.K. over the last two months. A Kentucky med spa admitted treating patients with illegally imported Botox between 2019 and 2023.
Over the last seven weeks, the media has reported more than 40 cases of botulism tied to Botox injections—at least 12 in Massachusetts, one in Oregon and 28 in County Durham, England. Authorities in Massachusetts and Oregon have not stated whether the cases were the result of fake or improperly handled injections. U.K. regulators told the BBC that they are investigating the alleged sale of fake “Botox-like” products in north east England. The cases, which include at least seven hospitalizations, resemble a similar outbreak in the U.S. last year.
At the same time, a medical spa in London, Kentucky, has pleaded guilty to buying Botox from unlicensed foreign suppliers in Korea and Turkey between August 2019 and August 2023. According to a Department of Justice press release, Facial Expressions customers spent nearly $25,000 to treat side effects from the illegal injections. The spa’s owner, Paula K. Gill, also pleaded guilty to providing false information to the DEA, after knowingly lying to the agency about whether her dentist license had ever been suspended.
A woman who developed botulism from a counterfeit injection spoke about her experience to Glamour in 2024.
Domestic News
The FDA warned three fake online pharmacies to stop selling Americans unapproved medicines. A Rhode Island man pleaded guilty to a pill pressing scheme.
Screenshot from an online pharmacy the FDA warned in May 2025.
The FDA posted warning letters it had sent to three fake pharmacies for selling unapproved and misbranded semaglutide; prescription opioids and benzodiazepines and prescription opioids, codeine and ritalin.
Sambo Sok of Cranston, Rhode Island pleaded guilty to making and distributing pills made of methamphetamine and fentanyl. Searches of his property yielded more than 12 kilograms of illicit drugs, including 21,600 meth pills and five pill presses.
Legislation
Massachusetts Senate Bill 868, which would establish a prescription drug affordability board with the power to establish upper payment limits, advanced to the state’s Senate Committee on Ways and Means on June 16, 2025.
Consult our pages on pill presses, prescription drug affordability boards, and drug importation to keep track of other legislation.
Patient safety issues in the GLP-1 space this week
A June 28th post in a group focused on retatrutide underscores the risks of unregulated substances, noting an unnamed vendor had sold gray market tirzepatide and tesamorelin contaminated with a disinfectant. Users who had injected the products developed injection site reactions, dark urine, face twitching and low blood pressure.
International News
Ukrainian police busted a counterfeiting network that manufactured steroids disguised as prescription medicine.
Image from the Ukrainian bust (Photo: OGPU)
Police in Ukraine dismantled a large operation that produced anabolic steroids disguised as medicines for sale online. The counterfeit products had factory packaging, labeling, holograms, and instructions. Law enforcement seized 20,000 packages of over 30 different types of medicine, 5,000 loose tablets, thousands of vials filled with anabolic drugs, raw supplies, equipment and the equivalent of $475,000 in cash.
Authorities in India seized counterfeit statins and more fake versions of a drug that treats high blood pressure.