Counterfeit Pills

What you need to know

Over time, the issues related to the opioid epidemic have changed. Today, people who use drugs, communities, and law enforcement are dealing with a drug supply that is often contaminated with fentanyl and other powerful substances. Pills not made by pharmaceutical companies have found their way into the nation’s drug supply. Many of these fake pills look just like real medications, such as:

  • Oxycodone (Oxycontin®, Percocet®)
  • Hydrocodone (Vicodin®)
  • Alprazolam (Xanax®)
  • Stimulants like amphetamines (Adderall®)

Law enforcement agencies around the country are seizing more pills containing fentanyl. As a result, more and more overdose emergencies are linked to these counterfeit or fake pills. People take what they think is a prescription medication, but it turns out to be fake or contaminated (laced) with fentanyl.

Fentanyl is a very strong substance with a high risk of misuse and addiction. It takes only a very small amount, about the size of a couple grains of salt (as little as two milligrams), to cause an overdose death. To give some perspective, about 5,000 milligrams of salt can fit in a teaspoon.

In 2022, the U.S. DEA seized more than 58.4 million fake pills with fentanyl. They found that 6 out of 10 (60%) of those fake pills contained a potentially lethal dose of fentanyl (2 mg), compared to 40% in 2021.

These fake pills are sold on social media and e-commerce sites to anyone with a smartphone, including teens and young adults. They are often represented as different emojis on these platforms. Refer to the image below put together by the DEA to show some of the common emojis:

Source: U.S. Drug Enforcement Administration

What you can do

Whether you use prescription medication or other drugs, there are steps you can take to stay safe.

  • Learn to recognize the signs of an overdose, and have naloxone on hand. Download our naloxone flier.
  • Because you cannot tell real pills from fake ones, it is important to only take pills that were prescribed to you, and not anyone else, by an accredited and licensed medical professional. Prescription medication is never sold on the internet or social media sites. Medications obtained in any other way may be deadly.
  • Safely use, store and dispose of your unused prescription medications. To find a DEA-sponsored Drug Take Back event or a collection site for your unused prescriptions, visit this website.
  • Test your drugs with fentanyl test strips. Check out our other tips for safer drug use and search where to find test strips near you.

Learn more about counterfeit pills at dea.gov/onepill and more about fentanyl on our fentanyl page.