DEA Issues Public Safety Alert on Sharp Increase in Fake Prescription Pills Containing Fentanyl and Meth

DEA Warns that International and Domestic Criminal Drug Networks are Flooding the United States with Lethal Counterfeit Pills


WASHINGTON, D.C. – Today, the Drug Enforcement Administration issued a Public Safety Alert warning Americans of the alarming increase in the lethality and availability of fake prescription pills containing fentanyl and methamphetamine. DEA’s Public Safety Alert, the first in six years, seeks to raise public awareness of a significant nationwide surge in counterfeit pills that are mass-produced by criminal drug networks in labs, deceptively marketed as legitimate prescription pills, and are killing unsuspecting Americans at an unprecedented rate.


These counterfeit pills have been seized by DEA in every U.S. state in unprecedented quantities. More than 9.5 million counterfeit pills were seized so far this year, which is more than the last two years combined. DEA laboratory testing reveals a dramatic rise in the number of counterfeit pills containing at least two milligrams of fentanyl, which is considered a lethal dose. A deadly dose of fentanyl is small enough to fit on the tip of a pencil.


Counterfeit pills are illegally manufactured by criminal drug networks and are made to look like real prescription opioid medications such as oxycodone (Oxycontin®, Percocet®), hydrocodone (Vicodin®), and alprazolam (Xanax®); or stimulants like amphetamines (Adderall®). Fake prescription pills are widely accessible and often sold on social media and e-commerce platforms – making them available to anyone with a smartphone, including minors.


“The United States is facing an unprecedented crisis of overdose deaths fueled by illegally manufactured fentanyl and methamphetamine,” said Anne Milgram, Administrator of the Drug Enforcement Administration. “Counterfeit pills that contain these dangerous and extremely addictive drugs are more lethal and more accessible than ever before. In fact, DEA lab analyses reveal that two out of every five fake pills with fentanyl contain a potentially lethal dose. DEA is focusing resources on taking down the violent drug traffickers causing the greatest harm and posing the greatest threat to the safety and health of Americans. Today, we are alerting the public to this danger so that people have the information they need to protect themselves and their children.”


The vast majority of counterfeit pills brought into the United States are produced in Mexico, and China is supplying chemicals for the manufacturing of fentanyl in Mexico.


The drug overdose crisis in the United States is a serious public safety threat with rates currently reaching the highest level in history. Drug traffickers are using fake pills to exploit the opioid crisis and prescription drug misuse in the United States, bringing overdose deaths and violence to American communities. According to the Centers for Disease Control and Prevention (CDC), more than 93,000 people died of a drug overdose in the United States last year. Fentanyl, the synthetic opioid most commonly found in counterfeit pills, is the primary driver of this alarming increase in overdose deaths. Drug poisonings involving methamphetamine, increasingly found to be pressed into counterfeit pills, also continue to rise as illegal pills containing methamphetamine become more widespread.


Drug trafficking is also inextricably linked to violence. This year alone, DEA seized more than 2700 firearms in connection with drug trafficking investigations – a 30 percent increase since 2019. DEA remains steadfast in its mission to protect our communities, enforce U.S. drug laws, and bring to justice the foreign and domestic criminals sourcing, producing, and distributing illicit drugs, including counterfeit pills.


This alert does not apply to legitimate pharmaceutical medications prescribed by medical professionals and dispensed by licensed pharmacists. The legitimate prescription supply chain is not impacted. Anyone filling a prescription at a licensed pharmacy can be confident that the medications they receive are safe when taken as directed by a medical professional.


The issuance of today’s Public Safety Alert coincides with the launch of DEA’s One Pill Can Kill Public Awareness Campaign to educate the public of the dangers of counterfeit pills. DEA urges all Americans to be vigilant and aware of the dangers of counterfeit pills, and to take only medications prescribed by a medical professional and dispensed by a licensed pharmacist. DEA warns that pills purchased outside of a licensed pharmacy are illegal, dangerous, and potentially lethal. For more information, visit

The Allegany County Health Department Behavioral Health Services has been made aware of increased use of Xylazine across the state. Xylazine has been involved in fatal overdoses in Allegany County.

Xylazine Fact Sheet for Public Guidance


Brief Summary

Since 2019, Maryland has seen an increase in the use of Xylazine as an adulterant to the illegal drug

supply. Comparing the first three quarters for calendar years 2019 and 2020, the Office of the Chief

Medical Examiner (OCME) Unintentional Intoxication Death data through February 28, 2021, shows an

increase of 175% (76 to 209) in the number of opioid related overdose deaths involving Xylazine.

Xylazine is FDA approved for veterinary use as a sedative for large animals, such as horses. Xylazine is not

FDA approved for human use due to side effects, including sedation, hypotension, and bradycardia.

Xylazine is commonly used as an adulterant with heroin and fentanyl and increases the risk of overdose

and death.



What Is Xylazine?

  • Xylazine was first synthesized in 1962.
  • Xylazine is a white or gray powder that may turn pink when mixed with water.
  • Xylazine can be swallowed, inhaled, smoked, snorted, or injected.
  • Xylazine is frequently found in a combination with heroin and cocaine. This combination is
  • referred to as a “speedball.”
  • Xylazine is sold under the following names: Rompun®, Anased®, Sedazine®, and Chanazine®.
  • In the US, the street names for Xylazine include: Tranq Dope, Tranq, Trashcan, Steph Curry,
  • Collateral Damage, Cardi B, 550, Rampage, or Black Mask.



Important Notes about Xylazine

  • Xylazine may not be identified in routine lab analysis because it is primarily used as a cutting
  • agent, not a primary or secondary substance of misuse.
  • Xylazine does not bind to the opioid receptor, so Naloxone is not an effective tool. However, it is
  • still recommended that Naloxone be administered for all suspected overdoses, due to the
  • likelihood that the overdose involves heroin or fentanyl.
  • Xylazine is not a DEA scheduled drug.



(301) 759-5050

12501-12503 Willowbrook Road, PO Box 1745

Cumberland, Maryland 21501-1745

OUR MISSION: Prescribe Change Allegany County’s mission is to create awareness and educate the citizens of Allegany County,
Maryland about the growing crisis of opioid prescription drugs, and heroin misuse and abuse in our community.