IMF: Illicitly Manufactured Fentanyl
Following the DEA's "One Pill Can Kill" campaign, this article addresses IMFs
You may have heard of the DEA’s campaign “One Pill Can Kill.” The DEA created this campaign “to encourage the use of social media to help raise public awareness of a significant nationwide surge in counterfeit pills that are mass-produced in labs, deceptively marketed as legitimate, and are killing Americans at an unprecedented rate.”
Every day that goes by without individuals heeding this message means another day of fatal overdoses. Illicit drugs have never been safe, but they are especially dangerous these days. Did you know that a potentially deadly dose of fentanyl is only 2 mg (milligrams)? Do you know how little that is? Check out this photo. It’s the amount of powder on the tip of the pencil.
Compare that to a lethal dose of cocaine, which starts at about 1000 mg. Fentanyl is 100 times more powerful than morphine and 50 times more powerful than heroin. It has increasingly been the reason for overdoses and deaths among people who are addicted to opioids or who recreationally take fake pills. The dramatic increase in opioid overdose deaths is largely due to fentanyl poisoning. Pharmaceutical fentanyl was developed as a pain management treatment for cancer patients and others with severe pain and has since turned into a nightmare for many.
Per the CDC, evidence of counterfeit pill use in overdose deaths more than doubled between July 2019 and December 2021 and tripled in the western United States. Although the percentage of overdose deaths from counterfeit pill use was below 6%, it more than doubled during this time period. Reported was a total of 106,293 overdose deaths from 30 different jurisdictions. Those who died from counterfeit pill use tended to be younger, more often Hispanic or Latino, and more frequently had a history of prescription drug misuse and drug use by smoking. Behind taking counterfeit pills, smoking was the most common route of drug use among deaths from counterfeit pill use, at 39.5%.
Illicitly manufactured fentanyls were the only drugs that caused death in 41.4% of deaths with evidence of counterfeit pill use and 19.5% of deaths without such evidence. Exposure to different types of counterfeit pills and drugs might vary by region, but they are out there and not difficult to find.
The DEA seized more than 59.6 million fentanyl pills and more than 13,000 pounds of fentanyl powder in 2022. Then, in 2023, the DEA seized more than 80 million fentanyl-laced fake pills and nearly 12,000 pounds of fentanyl powder. That is equivalent to more than 381,000,000 lethal doses of fentanyl! These seizures have been in all 50 states and in the District of Columbia. Nowhere are you safe.
The fentanyl seizures of 2024 so far would make more than 216,000,000 deadly doses. And the DEA’s laboratory tests indicate that 7 out of every 10 pills seized by the DEA contain a lethal dose of fentanyl. As published by the J_ournal of the American Medical Association_, when police in Rhode Island sent counterfeit oxycodone pills that were seized in 2022 to the lab for testing, it was found that 99.3% contained fentanyl, as well as another potentially deadly drug, xylazine, which is a horse tranquilizer. That means almost every fake oxycodone pill seized during 2022 contained fentanyl!
If the DEA is seizing that many potentially lethal pills, how many are making it into the hands of consumers? Too many! Every year, more fentanyl pills are seized, but it doesn’t stop people from buying them, taking the gamble, and risking their lives by consuming them.
Criminal drug networks mass produce these counterfeit pills, falsely market them as legitimate prescription pills, and are flooding our country with them. A lot of money can be made selling counterfeit pills, and it is well known that many people are misusing and/or are dependent upon opioid pain relievers. Drug traffickers are using fake pills to exploit the opioid crisis and prescription drug misuse. Not only that, but illegal fentanyl is cheaper than most other drugs on the streets and is being cut into cocaine, heroin, methamphetamines, and other drugs because of its extreme potency, which makes the drugs cheaper, more powerful, more addictive, and more dangerous. Fentanyl-laced drugs are often taken unknowingly, and fentanyl cannot be detected by sight, taste, smell, or touch.
Counterfeit pills are easy to purchase, and many are made to look just like legitimate prescription pills, so it is hard to tell the difference between real and fake pills. Common counterfeit pills are made to look like commonly prescribed medications such as OxyCodone, OxyContin®, Tylox®, Percodan®, Valium®, Xanax®, Restoril®, Ativan®, Klonopin®, Adderall®, Concerta®, Dexedrine®, Focalin®, Metadate®, Methylin®, and Ritalin®. The doses of these pills may be irregular or uncertain, and they may not act like the medications they are meant to replicate.
In 2022, more than 110,700 people died by drug poisoning in the United States, mostly from fentanyl overdose. According to the Oklahoma State Department of Health, methamphetamine overdose deaths are the most common in Oklahoma, but fentanyl deaths are on the rise; they were involved in more than 80% of opioid-related deaths in 2022. From 2019 to 2022, the number of fentanyl overdose deaths increased 12 times, from 50 deaths in 2019 to 609 in 2022. Adults aged 45–54 years had the highest rate of death, and males were 90% more likely to die than females. Of those who died, 66% had a history of substance use.
Contributing to overdose deaths is not going unpunished. According to the United States Attorney’s Office Western District of Oklahoma, in September 2023, an Oklahoma man was sentenced to serve 10 years in federal prison for the distribution of fentanyl that resulted in an overdose. One month prior, the woman who delivered the fentanyl pill to the victim was sentenced to serve 2 years in federal prison after pleading guilty to distributing fentanyl. The person who took only one-half of the fentanyl pill overdosed and nearly died; they survived only because of life-saving measures by Chickasha Police.
U.S. Attorney Robert J. Troester stated: “It only takes one deadly fentanyl-laced pill to cause a fatal overdose. Far too many have died due to the flood of fentanyl in the United States and Oklahoma. We stand with and support our DEA partners to do all we can to stop the illicit flow of fentanyl where we can and hold those who dispense this deadly poison accountable.”
Even more recently, in May 2024, U.S. Attorney Troester announced that a fentanyl overdose death led to two Oklahomans pleading guilty to participating in a drug conspiracy. At sentencing, the individuals involved face up to 20 years in federal prison and fines of up to $1,000,000 each.
Signs of fentanyl overdose, which are the same as any other opioid overdose, include:
- Slow, weak, or no breathing, which may include snoring or gurgling noises
- Falling asleep or losing consciousness and won’t wake up
- Limp body and cold/clammy skin
- Lack of response to stimulation
- Small, constricted “pinpoint” pupils
- Blue or discolored lips and fingertips from lack of oxygen
If you suspect fentanyl or other opioid overdose:
- Call 9-1-1 immediately.
- Administer naloxone, if you have it.
- Try to keep the person awake and breathing.
- Start rescue breathing if indicated.
- Stay with the person while waiting for the emergency responders to arrive.
It is important to know that a Good Samaritan law (63 O.S. § 2-413.1) was enacted in Oklahoma to provide immunity, under certain circumstances, to individuals seeking medical attention for someone who has overdosed.
The real and lasting solution to prevent overdosing from fentanyl or any other drug is to get into treatment. The next pill or puff could be the last one you or your loved one will ever take. Be safe and get help now!
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