Fake pills are ravaging communities across the U.S.

Bag of Counterfeit Fentanyl Pills
Source: U.S. Attorney's Office
What began in 2015 as an outbreak of counterfeit opioid painkillers and Xanax that contained potentially deadly doses of fentanyl or fentanyl analogues has spread to all 50 states, and has killed residents in 42 of them.
Illegal pill presses have given drug counterfeiters the ability to adapt. In 2020, they expanded their offerings with pills mimicking Adderall, Aleve, aspirin and even the diabetes drug metformin, and new, dangerous ingredients such as methamphetamine, isotonitazene, clonazolam and etizolam.
Mexican drug cartels smuggle millions of these pills over the border, but the U.S. also has homegrown traffickers who import ingredients and pill presses from China and manufacture their own deadly pills.
PSM Coverage
Reports and Infographics
Deadly Counterfeit Pills Found in All 50 U.S. States; Deaths Now Reported in 42 of Them (October 2020)
Do You Know What a Pill Press Is? (August 2019)
Illegal Pill Presses: An Overlooked Threat to American Patients (with NABP and NADDI, March 2019)
Fentanyl 101: An Introduction to the Fentanyl Crisis in the U.S. (August 2018)
43 States And Counting: The Deadly Combination Of Imported Fentanyl And Counterfeit Medicines (April 2018)
Real Victims of Counterfeit Medicine (Ongoing profiles of American counterfeit drug victims, including those poisoned by counterfeit pills.)
Videos: Watch our most recent video about the counterfeit pill threat here, and subscribe to our YouTube playlist to catch all our updates.
Research
Provisional Drug Overdose Death Counts, Centers for Disease Control, National Center for Health Statistics, 2021
Drug Enforcement Administration:
- National Drug Threat Assessments: 2020, 2019, 2018, 2017, 2016
- DEA Issues Warning Over Counterfeit [Adderall] Pills, August 2019
- Drugs Of Abuse: A DEA Resource Guide 2017 Edition
- Fentanyl: A Brief Guide For First Responders, June 2017
- Counterfeit Prescription Pills Containing Fentanyls: A Global Threat, July 2016
Combatting the Opioid Crisis: Exploiting Vulnerabilities in International Mail (United States Senate, January 2018)
Report On The Potential Impact Of Drug Importation Proposals On U.S. Law Enforcement (Freeh, Sporkin, and Sullivan LLC, Freeh Group International Solution, LLC, June 2017)
Counterfeit Alprazolam Poses A 'Major Public Health Threat' (Medscape, August 8, 2016)
“Fentanyl And A Novel Synthetic Opioid U-47700 Masquerading As Street ‘Norco’ In Central California: A Case Report” (Annals of Emergency Medicine, July 26, 2016)
State News
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National Media Coverage
CDC Says Illicit Fentanyl Causing Spike In Opioid Deaths (July 31, 2017)
Pill Presses For Counterfeit Drugs Seized In Record Numbers (March 17, 2017)
Pills That Kill: Why Are Thousands Dying From Fentanyl Abuse? (The Guardian, December 11, 2016)
U.S. Seeks Curb On Chemicals Used To Make Fentanyl, A Powerful Opioid (The Wall Street Journal, October 14, 2016)
Prince's Death And The Growing Fear Of The 'Kill Pill' (CNN, August 26, 2016)
Illegally Made Fentanyl Seems To Be Fueling A Spike In Overdoses (NPR, August 25, 2016)
Fake Xanax Can Be A Killer (CBS News, August 10, 2016)
How Knockoff Fentanyl Dodges Cops (The Daily Beast, June 6, 2016)
'Death Pill': Fentanyl Disguised As Other Drugs Linked To Spike In U.S. Overdoses (The Guardian, May 10, 2016)
Chinese Labs Modify Deadly Fentanyl To Circumvent Ban On Sales To U.S. (STAT, April 26, 2016)
Deadly Fentanyl Trade Linked To Chinese Companies (NPR, April 21, 2016)
‘Truly Terrifying’: Chinese Suppliers Flood U.S. And Canada With Deadly Fentanyl (STAT, April 5, 2016)