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February 28, 2024

Fake prescription pills laced with fentanyl and meth are putting drug users at greater risk of overdose, DEA says

Pill press machines are being used to produce counterfeit versions of oxycodone, Xanax and Adderall. People who use them may be unwittingly exposing themselves to highly potent substances.

Addiction Overdoses
Fake Prescription Pills Provided Image/DEA

Fake prescription pills are being laced with fentanyl and methamphetamine and sold online and on the streets, DEA officials say. Above, two bags with a combined 20,000 counterfeit m30 oxycodone pills seized by the U.S. Drug Enforcement Administration's Philadelphia field office.

Fake prescription pills laced with deadly fentanyl and methamphetamine are being sold online and on the streets, aggravating the national drug overdose crisis, according to the U.S. Drug Enforcement Administration.

This is happening through the use of pill presses – machines that can be illegally purchased on the internet and used to produce and stamp thousands of fake prescription tablets an hour, said Patrick J. Trainor, supervisory special agent with the DEA's Philadelphia field division. The pills can be made to look like authentic oxycodone, Xanax and Adderall tablets. 


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There's a "bit of a black market for pill presses," Trainor said. "What we have seen is people who purchase pill presses specifically for stamping fake pills."

Mexican cartels are primarily producing the counterfeit pills that then circulate on the street, on the dark web and on social media – where teenagers, students and other people sometimes buy them, thinking they are getting real drugs. They may be unwittingly exposed to fentanyl or methamphetamine, or both, increasing their risk of overdose and death.

The counterfeit pills do not actually contain oxycodone, Xanax or Adderall, Trainor said. Rather, they combine fentanyl or methamphetamine with a binding agent that makes the pills look like authentic drugs. 

During a 12-month period ending in August, nationwide drug overdose deaths spiked to a record high of approximately 112,000, according to the most recent data from the U.S. Centers for Disease Control and Prevention. Philadelphia, home to the Kensington neighborhood – one of the largest open-air drug markets in the country – had a record 1,413 fatal drug overdoses in 2022, according to the city's department of public health.

The DEA seized more than 78.4 million fentanyl-laced fake pills in 2023, with 7 of every 10 pills containing a lethal dose of fentanyl, according to laboratory testing.

"Hands down," the most common fake prescription pills resemble m30 oxycodone tablets that may actually contain fentanyl that suppliers mix with cutting agents to bind pills. Fake Adderall and Xanax tablets are also in high circulation, Trainor said.

Fentanyl, a synthetic opioid approximately 50 times stronger than heroin, induces the kind of sedation that oxycodone and Xanax pills do, which is part of the reason drug suppliers use it to cut those fake prescription pills.

Fentanyl is so potent that people who do not have a tolerance for it and who unwittingly take it, such as in a fake prescription pill, may overdose and die.

Methamphetamine is a stimulant, as is Adderall. Methamphetamine is a highly addictive central nervous system stimulant that in high doses can cause cardiovascular collapse and sometimes death.

Pill Press MachineProvided Image/DEA

Criminal enterprises purchase pill press machines illegally online and use them to create fake versions of drugs like oxycodone, Adderall and Xanax that actually contain fentanyl and methamphetamines, the DEA says. Above, pill presses seized by law enforcement officers in the Philadelphia region.


People are unwittingly taking fentanyl and methamphetamine through fake prescription pills. Also, illegal suppliers using pill presses are not necessarily producing pills of the potency stamped on a tablet – for instance on an m30 oxycodone or a 2 mg Xanax tablet, also common in Philadelphia and nationwide, Trainor said.

Counterfeit "pills are going to have different strengths," Trainor said.

Users sometimes mix different pills and drugs together – perhaps mistakenly thinking they know the doses they are handling – "and it's not an exact science," putting people at an even higher risk for overdose, Trainor said.

It may be possible that some local dealers do not know that they are selling fake prescription pills laced with fentanyl and methamphetamine, according to the DEA.

Cartels press fake pills to drive addiction and to make profits, as they are meeting an illicit demand for prescription pills, Trainor said. 

The DEA issued a letter this week emphasizing that e-commerce platforms selling pill press machines are "regulated persons" and must comply with "reporting requirements on the distribution, importation and exportation" of them.

Specifically, individuals or companies who want to buy one or multiple pill presses must fill out a DEA form, which merchants are required to inspect.

The most common pill press being used by drug traffickers is the TDP-5, Trainor said. The machine can press approximately 5,000 pills an hour and costs about $1,000, according to a search on the internet.

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