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The Guardian - US
The Guardian - US
World
Chris McGreal in New York

Increase in fake prescription pills fuels record drug overdose deaths in the US

A member of the Sinaloa cartel, one of the cartels making counterfeit pills, shows capsules in Culiacan, Mexico.
A member of the Sinaloa cartel, one of the cartels making counterfeit pills, shows capsules in Culiacan, Mexico. Photograph: Alexandre Meneghini/Reuters

A flood of counterfeit prescription pills has added to record levels of drug overdose deaths in the US, according to a new study by the Centers for Disease Control and Prevention (CDC).

The CDC said the number of deaths from fake pills, principally sold as opioid painkillers or the tranquiliser Xanax, more than doubled across the US between mid-2019 and the end of 2021, and tripled in western states such as Alaska, Utah and New Mexico.

More than 90% of the counterfeit drugs contained the extremely powerful synthetic opioid fentanyl, which has driven total US overdose deaths to more than 100,000 a year. Other fake pills contained illicit benzodiazepines, which are used in the Xanax, or a combination of the two.

Fentanyl is frequently laced into heroin, cocaine and methamphetamine to boost their power and value without the user knowing. But because as little as 2mg of the drug can kill a person, it is easy to overdose.

Many who buy counterfeit pills were seeking legitimate prescription drugs in an effort to avoid fentanyl, which claims nearly 200 lives a day.

The CDC said fake prescription pills accounted for nearly 5% of deaths over the period studied, although that rose to nearly 15% in the western US. The agency said demand for fake opioid painkillers was highest in the west of the US, while half of deaths in the south were from counterfeit versions of the Xanax.

The CDC noted that those who died from fake pills “more often were younger, Hispanic, and had prescription drug misuse history” compared with those killed by overdoses in other circumstances.

The Drug Enforcement Administration (DEA) warns that six out of 10 counterfeit pills laced with fentanyl contain a potentially lethal dose of the drug. The agency, which is running a One Pill Can Kill campaign to highlight the dangers of buying drugs on the black market, said that seizures of the fake tablets have escalated from 20m in 2021 to 46m so far this year.

“These pills are largely made by two Mexican drug cartels, the Sinaloa cartel and the Jalisco cartel, to look identical to real prescription medications, including OxyContin, Percocet, and Xanax, and they are often deadly,” the DEA says in its campaign.

Overdoses have killed more than 1 million Americans over the past quarter of a century – the vast majority from opioids – with no end in sight to the worst drug epidemic in US history.

Last week, the Biden administration committed an additional $450m to combat the opioid epidemic, including money for a fentanyl awareness campaign targeted at young people, recovery programmes and drug interdiction. But the White House only expects to make a dent in the overall death toll, aiming to reduce lives lost to fentanyl and xylazine, a powerful sedative also known as “tranq” that is increasingly found in drug supply, by just 15% over the next two years.

In addition, a medication that can reverse drug overdose, known as naloxone or Narcan, will be available at pharmacies without a prescription in the coming days, although many states already distribute it free.

The problem is not restricted to the US. A Los Angeles Times investigation earlier this year found that pharmacies in major Mexican cities were selling fake painkillers and attention deficit hyperactivity disorder (ADHD) drugs made of fentanyl and methamphetamine in what appeared to be factory-sealed bottles.

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