The number of people who have overdosed and died from fake prescription pills has more than doubled in recent years, the Centers for Disease Control and Prevention reported Thursday.
The majority of those deaths were among people younger than 35, who were taking what they thought was oxycodone or Xanax, it said.
But the drugs obtained did not come from a legitimate pharmacy; they were bought on the street, in classrooms or from friends. The counterfeit pills may look like the real deal, but are usually made from a variety of unknown ingredients.
“People are pressing pills and even gummies” in ways that look legitimate, said Tonja Myles, an addiction expert and community engagement adviser with Huntsman Mental Health Foundation in Salt Lake City.
Very often, however, they’re laced with deadly levels of fentanyl.
“People don’t always know what’s in them,” said Julie O’Donnell, an author of the new report and an epidemiologist in the CDC’s division of overdose prevention. “The risk of overdose is heightened among people who think that they’re using legitimate pharmaceutical pills.”
The CDC report, released to coincide with International Overdose Awareness Day, found that from mid-2019 to the end of 2021, overdose deaths involving counterfeit drugs more than doubled, from 2% to 4.7%.
The numbers, which O’Donnell said are “definitely an underestimate,” come from the CDC’s state unintentional drug overdose reporting system. The system relies on information gathered from death certificates, coroner’s reports, toxicology reports and witness accounts.
Illicit fentanyl was detected in 93% of all overdose deaths involving fake pills. More than half of the deaths — 57.1% — occurred among people younger than 35.
Jake Carter of Noblesville, Indiana, reportedly thought he was taking oxycodone when he went to bed Jan. 2, 2021, the day before his 24th birthday.
By all accounts, he was looking forward to the new year. His fiancee, Kaylee Dugger, 24, was pregnant.
“He was excited for his birthday. He was excited to be a dad. He was excited to get married,” she said.
But the pills Carter took were counterfeit, with tests later showing they’d been laced with deadly levels of fentanyl.
Carter never woke up on his birthday.
“It wasn’t intentional,” Dugger said of Carter’s overdose death. She hopes speaking about his death will steer others away from counterfeit pills.
“If I can make something good out of his death, it’s spreading awareness of fentanyl poisoning and also overdose awareness,” she said.
Drug overdose deaths in the U.S. are at historic highs. In 2021, almost 107,000 people died from drug overdoses. Preliminary estimates for 2022 put that figure at 105,000, according to the CDC.
The report found geographic differences in terms of counterfeit drugs. Fake oxycodone was found most frequently in the West and fake Xanax was found most frequently in the South.
When researchers just looked at Western states, overdose deaths from counterfeit pills more than tripled, from 4.7% in 2019 to 14.7% as of late 2021. The increase is likely due to an increase in the illegal and counterfeit drug supply, O’Donnell said.
The increases highlight the need, Myles said, to impress upon young people the dangers of taking pills that may be counterfeit.
“I tell parents all the time, ‘You got to have candid conversations'” with your kids, she said. “Even if it’s aspirin, don’t take it from a friend.”

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