Counterfeit pills involved in growing share of overdose deaths in the US, CDC study finds

Overdose deaths reached record levels in the United States in recent years, and a new report shows that counterfeit pills are involved in a growing share of those deaths.

The US Drug Enforcement Administration issued a public safety alert about a sharp increase of fake prescription pills laced with fentanyl and methamphetamine about two years ago. According to the agency, more than 9.5 million counterfeit pills were seized in 2021, more than the prior two years combined.

A new report from the US Centers for Disease Control and Prevention captures the deadly consequences, tracking detailed accounts of deaths that were submitted to the CDC’s State Unintentional Drug Overdose Reporting System by 30 jurisdictions.

Overdose deaths with evidence of counterfeit pill use became more than twice as common between the second half of 2019 and the end of 2021. In the last few months of 2021, about 5% of people who died from a drug overdose showed evidence of counterfeit pill use, according to the new report.

Illicitly manufactured fentanyl was involved in nearly all overdose deaths with evidence of counterfeit pills use, including more than two out of five deaths that were exclusively caused by it, the CDC researchers found. Methamphetamine was detected in about a quarter of deaths where counterfeit pills were involved, while cocaine and benzodiazepines were present in more than one in eight cases.

Many of these drugs are produced by gangs and criminal drug networks and made to look like prescription opioid drugs such as oxycodone or hydrocodone, or stimulants used to treat ADHD.

About three-quarters of the counterfeit pills involved in drug overdose deaths were meant to look like oxycodone, according to the new CDC report.

The DEA has said that the vast majority of counterfeit pills brought into the United States are produced in Mexico.

Exposure to different types of counterfeit pills and drugs might vary by region, according to the report. But data suggests that counterfeit pills laced with fentanyl are “infiltrating drug markets in western US states.”

Overdose deaths involving counterfeit pills were consistently most common in Western states, and they rose faster than average in recent years – tripling from about 5% in mid-2019 to nearly 15% at the end of 2021.

Hispanic individuals and those under the age of 35 were also found to be more at risk.

To help avoid overdoses, experts say that people should only use pharmaceutical pills that are prescribed to them and received directly from a pharmacy or other health care provider.

Access to fentanyl test strips and other drug-checking products and services can help identify the content of pills and encourage use of harm reduction measures such as having naloxone available, the researchers wrote.

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