Fake pain killers driving new black market trend

Hundreds of thousands of fake prescription pain killers laced with the opioid fentanyl, sometimes in deadly amounts, have made their way into the US drug market, indicating a new trend in black market trade.

The news was published in a report by the US Drug Enforcement Administration, which claimed the counterfeit pills were fuelling the US fentanyl and opioid crisis, with addictions, overdoses and deaths expected to increase. Fentanyl availability, seizures and known overdose deaths are higher than at any other time since the drug’s creation in 1959, the report stated.

"The seizures of fentanyl-laced pills and clandestine pill press operations all across North America indicate that this is becoming a trend, not a series of isolated incidents," the DEA report said.

Fentanyl is a synthetically produced opioid approved for the treatment of severe pain and is 50-100 times stronger than morphine. However, the drug and fentanyl-related compounds have been mass produced illegally in China, though small-scale labs have been found in the US and Canada. The illicit drugs are then marketed to drug trafficking groups in Mexico, Canada and the USA, which on-sell to people addicted to opioids.

The fentanyl market has expanded dramatically in the US, with testing of fentanyl exhibits increasing by 65% between 2014 and 2015. The DEA report said there were approximately eight times as many fentanyl exhibits in 2015 as there were during the 2006 fentanyl crisis, when fentanyl was mixed with heroin and distributed to unsuspecting heroin users causing more than 1000 deaths. "This clearly demonstrates the unprecedented threat and expansion of the fentanyl market," the DEA report said.

Since 2014, US law enforcement agencies have been seizing a new form of fentanyl as counterfeit prescription opioid pills laced with fentanyl or fentanyl-related compounds. The fake pills often closely resemble the authentic medications they were designed to mimic, such as oxycodone, and the presence of fentanyl is only detected upon laboratory analysis.

The dosage of fentanyl has varied in the pills that have been seized. About 2 milligrams is a lethal dose for a non-opioid-dependent individual.

The counterfeit tablets entering the US market are likely to be driving the market expansion, and the DEA warned the fake pills were expected to result in more opioid-dependent individuals, overdoses and deaths.

"Motivated by enormous profit potential, traffickers exploit high consumer demand for prescription medications by producing inexpensive, fraudulent prescription pills containing fentanyls," the DEA report said. "The equipment and materials necessary to produce these counterfeit drugs are widely available online for a small initial investment, greatly reducing the barrier to entry into production for small-scale drug trafficking organisations and individual players."

The counterfeit pills sell for between US $10 and $20. At these prices, a kilogram of fentanyl used to manufacture counterfeit pills can generate between $5 and $20 million.

The DEA report also warned that due to the success, so far, of secreting fentanyls in counterfeit opioid medications, it is expected that fentanyls will emerge in a variety of other counterfeit prescription drugs as traffickers seek to expand the market in search of higher profits. Already cases in the US have been seen – nine people died from fake anti-anxiety Xanax pills containing fentanyl in Florida between January and March 2016.

From August 2013 through to the end of 2015, US law enforcement agencies seized at least 239 kilograms of illicitly produced fentanyls. There were more than 700 fentanyl-related deaths reported in the US between late 2013 and 2014.

There are as many as 4.3 million people in the US who use pain relievers for non-medical purposes.