Today the Drug Enforcement Administration released a Public Safety Alert warning the public about “the alarming increase in the lethality and availability of fake prescription pills containing fentanyl and methamphetamine.”
International and domestic criminal drug networks are mass‐producing fake pills, falsely marketing them as legitimate prescription pills, and killing unsuspecting Americans. These counterfeit pills are easy to purchase, widely available, and often contain deadly doses of fentanyl. Pills purchased outside of a licensed pharmacy are illegal, dangerous, and potentially lethal. This alert does not apply to legitimate pharmaceutical medications prescribed by medical professionals and dispensed by pharmacists.
A press release accompanying the Alert, stated fentanyl and methamphetamine are primarily made in labs south of the border with China supplying the chemicals to make fentanyl and its analogs. Drug dealers and cartels use pill presses to convert the products into counterfeit prescription opioids pills, as well as counterfeit Adderall (amphetamine mixed with dextroamphetamine) and Xanax (a benzodiazepine tranquilizer).
Non‐medical drug users purchase these drugs on the black market believing they are buying “diverted” legal products with which they are familiar, and succumb to overdoses from much more potent illicit fentanyl or methamphetamine. The DEA announced a new campaign called One Pill Can Kill that includes a website to help black market customers distinguish between counterfeit and authentic prescription pills.
What’s odd about the DEA issuing the Public Safety Alert today is that this is old news. The agency has been talking about this in the mainstream press for a number of years. I discussed it in a commentary in the Cincinnati Enquirer in 2018, a few months after a Minnesota prosecutor announced that the music artist Prince died by ingesting a counterfeit Vicodin pill that was made from fentanyl.
Another interesting feature of the Public Safety Alert is that, perhaps unintentionally, it informs the public that the war on drugs is an abysmal failure:
DEA and its law enforcement partners are seizing deadly fake pills at record rates. More than 9.5 million counterfeit pills were seized so far this year, which is more than the last two years combined. Officials report a dramatic rise in the number of counterfeit pills containing at least two milligrams of fentanyl, which is considered a deadly dose. The number of DEA‐seized counterfeit pills with fentanyl has jumped nearly 430 percent since 2019, a staggering increase. DEA laboratory testing further reveals that today, two out of every five pills with fentanyl contain a potentially lethal dose. Additionally, methamphetamine is increasingly being pressed into counterfeit pills.
And it also points the way to reducing overdose deaths: drug legalization.
According to the Centers for Disease Control and Prevention, last year more than 93,000 people died of drug overdoses in the United States, marking the largest number of drug‐related deaths ever recorded in a year. Fentanyl, the synthetic opioid most commonly found in counterfeit pills, is the primary driver of this alarming increase in overdose deaths…The only safe medications are ones prescribed by a trusted medical professional and dispensed by a licensed pharmacist. Any pills that do not meet this standard are unsafe and potentially deadly.
While I take issue with the Alert’s contention that the only safe medications are those prescribed by a trusted medical professional, I think the DEA is not being subtle when it points out that legal drugs are safer than those obtained in the black market.
The DEA also makes it clear in the Alert that the overdose crisis is not caused by doctors prescribing opioids to their patients in pain.
Now if only lawmakers would seize upon the obvious.
# Reprinted with permission. Dr. Singer's original blog post can be read here.
Jeffrey Singer
Jeffrey A. Singer is a senior fellow at the Reason Foundation, where he focuses on health care policy and drug policy. He is President Emeritus and founder of Valley Surgical Clinics, Ltd., Arizona's oldest and largest private group surgical practice. From 2017 to 2026, he served as a senior fellow in the Cato Institute's Department of Health Policy Studies and as a Visiting Fellow at the Goldwater Institute. Singer is a member of the Board of Scientific Advisors of the American Council on Science and Health and serves on the expert panel for Doctors for Drug Policy Reform. From 1994 to 2016, he was a regular contributor to Arizona Medicine, the journal of the Arizona Medical Association. He served on the Advisory Board Council of the Center for Political Thought and Leadership at Arizona State University from 2014 to 2018. His writings have appeared in peer-reviewed medical and scientific journals, as well as in publications such as the Wall Street Journal, Washington Post, USA Today, The Hill, and National Review. He has been a guest on national and local television and radio. Singer received his BA from Brooklyn College (City University of New York) and his MD from New York Medical College. He is a Fellow of the American College of Surgeons.
