Counterfeit pills made with fentanyl are becoming more prevalent across the United States

The deadly consequences of taking just one counterfeit pill are repeating across the states and devastating the lives of victims, family, friends and even emergency responders.

Learn more what fentanyl is, how it gets into American pills, and what we can do to keep it out of the U.S.

Counterfeit Pills Laced With Fentanyl Are Ravaging Communities Across North America

For more than a decade, counterfeit drugs with unreliable ingredients have caused patients suffering by not curing their illnesses. Now, counterfeit drugs with deadly ingredients threaten American lives with just one dose. A closed, secure supply chain is even more imperative when the risk of breakage is death.

Since 2013, Canadian authorities have been battling an illicit market in counterfeit medications made from fentanyl, a dangerous painkiller 25-40 times stronger than heroin. In their efforts to stop suffering and death, Canadian authorities shut down over 20 fentanyl labs between 2013 and 2016. In 2015, U.S. authorities began reporting waves of overdoses and fatalities after residents took counterfeit Xanax or opioids that contained fentanyl or fentanyl analogues. The problem has spread to all 50 states, and authorities have also been seeing pills containing carfentanil, an even more powerful drug used to sedate large animals.

The DEA reports that pills containing fentanyl or its analogues are manufactured in Canada or Mexico and smuggled across the border, but they're also made domestically when Americans buy powdered fentanyl and pill presses (often from China) to distribute it themselves. The drugs are so toxic that investigators have to wear HAZMAT suits to avoid exposure.



Deadly Counterfeit Pills Found in All 50 U.S. States; Deaths Now Reported in 42 of Them (PSM, October 2020)

49 States Have Reported Deadly Counterfeit Pills Made with Fentanyl (PSM, January 2020)

48 States Have Reported Deadly Counterfeit Pills Made with Fentanyl (PSM, July 2019)

Illegal Pill Presses: An Overlooked Threat to American Patients (NABP, NADDI & PSM, March 2019)

Deadly Fentanyl-Laced Counterfeit Pills Have Spread To 46 States In The Last Two And A Half Years (PSM, February 20, 2019)

43 States And Counting: The Deadly Combination Of Imported Fentanyl And Counterfeit Medicines (PSM, April 2018)

Combatting the Opioid Crisis: Exploiting Vulnerabilities in International Mail (United States Senate, January 2018)

40 States And Counting: The Deadly Combination Of Imported Fentanyl And Counterfeit Medicines (PSM, September 2017)

40 States and Counting: One Page Summary (PSM, September 2017)

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)

Drugs Of Abuse: A DEA Resource Guide 2017 Edition (2017)

Fentanyl: A Brief Guide For First Responders (DEA, 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)

Counterfeit Prescription Pills Containing Fentanyls: A Global Threat (DEA,  July 2016)

National News Coverage:

Fentanyl Linked To Thousands Of Urban Overdose Deaths (August 15, 2017)

CDC Says Illicit Fentanyl Causing Spike In Opioid Deaths (July 31, 2017)

CDC Awards $12 Million To California, 22 More States to Fight Opioid Epidemic (July 24, 2017)

When The Mailman Unwittingly Becomes A Drug Dealer (June 26, 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)

This Photo Shows Exactly Why Fentanyl Is Deadlier Than Heroin (PBS, September 30, 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)

Counterfeit Pain Pills Likely Came To Prince Illegally (CBSNews, 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)

GOP Senator Calls For China To Crack Down On Illegal Opioid (The Hill, May 25, 2016)

'Death Pill': Fentanyl Disguised As Other Drugs Linked To Spike In U.S. Overdoses (The Guardian, May 10, 2016)

Deadly Fentanyl Epidemic Linked To China (, April 27, 2016)

This New Street Drug Is 10,000 Times More Potent Than Morphine, And Now It's Showing Up In Canada And The U.S. (The Washington Post, April 27, 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)