DEA says six out of 10 fake prescription pills analyzed contain potentially deadly dose of fentanyl

A bag of fentanyl-laced counterfeit pills that was seized by law enforcement.
(Courtesy of U.S. Attorney’s Office)

Overdose deaths from fentanyl continue to rise in the region and the country; officials warn users that ‘one pill can kill’ with so much of the illicit drug supply infused with the synthetic opioid


More than half of the fake pills analyzed in Drug Enforcement Administration laboratories this year were found to be laced with a potentially fatal dose of fentanyl, a powerful synthetic opioid fueling an unprecedented number of fatal overdoses in the country.

The DEA said six out of 10 fake prescription pills it tested contained a potentially lethal dose of fentanyl, up from four out of 10 discovered in testing in 2021. It was unclear how many pills underwent analysis.

For the record:

4:16 p.m. Nov. 27, 2022This story was updated to clarify the DEA found six out of 10 fake prescription pills analyzed contained a potentially fatal dose of fentanyl. The initial story incorrectly said six of the 10 pills contained fentanyl.

“More than half of the fentanyl-laced fake prescription pills being trafficked in communities across the country now contain a potentially deadly dose of fentanyl,” DEA Administrator Anne Milgram said in a statement as part of a public safety alert issued Monday, Nov. 21.

Federal officials say counterfeit pills, which often look like legitimate prescription medications including OxyContin, Percocet and Xanax, are being mass-produced by the Sinaloa Cartel and the Jalisco Cartel in Mexico. Precursors imported from China and other countries are pressed into pills, powder or mixed into other drugs.

Fentanyl is a highly addictive synthetic opioid that is 50 times more potent than heroin and 100 times more potent than morphine.

According to the Centers for Disease Control and Prevention, 107,622 Americans died of fatal drug overdoses in 2021, with 71,238 of those deaths involving synthetic opioids, primarily fentanyl.

Because a tiny amount of fentanyl can lead to a fatal overdose, officials have warned users that fake prescription drugs can be laced with fentanyl and “one pill can kill.”

The DEA’s report on drug lab findings comes just days after the county released report cards showing skyrocketing numbers of unintentional deaths in the region from methamphetamine and fentanyl.

According to the local Prescription Drug Abuse Task Force report, there has been an 869 percent increase in unintentional fentanyl-caused deaths in the past five years, jumping from 84 deaths in 2017 to 814 in last year. Officials also reported that half of the unintentional methamphetamine deaths reported last year also involved fentanyl.

“The San Diego report card numbers are disturbing. The DEA report is disturbing because we have been tracking this problem,” said Dr. Roneet Lev, an emergency and addiction physician at Scripps Mercy Hospital who sits on the county’s prescription drug abuse task force.

“The bottom line is there is no safe illicit drug supply,” she said. “Unless you are getting pills from the pharmacy with your name on it, you cannot trust the pills.”

With illegal fentanyl flooding the illicit drug market, teens and adults need to be told that any drug experimentation is dangerous. Lev said anyone who is around friends or family members experimenting with drugs should be sure to have naloxone on hand. The medication can reverse the effects of an opioid overdose if administered promptly.

“Years ago kids would make a mistake, would experiment and would be forgiven,” Lev said. “Nowadays it can be a death sentence, and that is very scary.”

According to the task force’s annual report, there was a 44 percent decrease in the annual number of dispensed prescription opioid pills per resident in San Diego County over the past seven years — from 36.5 pills dispensed in 2014 to 20.6 in 2021.

But the firehose supply of illicit fentanyl flowing in the region remains a problem.

Earlier this year, officials dubbed San Diego County a “national epicenter” for fentanyl trafficking, reporting that more than 5,000 pounds of the drug had been seized in San Diego and Imperial counties by U.S. Customs and Border Protection agents in the first nine months of 2022. While drug trafficking organizations initially were adding small amounts of fentanyl to drugs like methamphetamine, they now are moving significantly larger quantities of fentanyl pills and powder across the border, authorities said.

“A decade ago, we didn’t even know about fentanyl, and now it’s a national crisis,” U.S. Attorney Randy Grossman said in statement released in August. “The amount of fentanyl we are seizing at the border is staggering. The number of fentanyl seizures and fentanyl-related deaths in our district are unprecedented.”

As work continues to address the fentanyl and methamphetamine problem, more needs to be done removing the stigma associated with addiction so people will feel more open to seeking treatment, said Dr. Joe Sepulveda, medical director for substance use disorder services at Family Health Centers of San Diego, who sits on the Prescription Drug Abuse Task Force.

It is a chronic medical condition like diabetes, Sepulveda said, but too many still continue to treat it as a moral failing.

He said he’d like to see fentanyl test kits readily available for those who use drugs, and more effort to meet users “where they’re at” with things like street health clinics and programs that allow drug users to exchange used needles for new ones. Despite the rising number of deaths — and the fact that 2022 fentanyl deaths clearly will exceed the 2021 total — Sepulveda sees reasons for optimism, noting that the county expects to receive $100 million from an opioid court settlement that can be spent to expand services.