Recent investigations by the Los Angeles Times have revealed a disturbing trend in Mexican pharmacies: customers looking for Adderall, oxycodone and other drugs are being sold counterfeit pills containing dangerous substances like methamphetamine and fentanyl.
In the cities of Tijuana, Cabo San Lucas and San José del Cabo, pills advertised and sold as legal medicines have tested positive for the much stronger substances. Of 17 pills analyzed by the investigative team, 71% contained either fentanyl or meth.
Fentanyl is a synthetic opioid similar to morphine, but approximately 50 to 100 times stronger, according to the National Institute on Drug Abuse. It is sometimes prescribed by law by doctors to treat pain, but it is also often sold illegally and is a common adulterant among street drugs. Methamphetamine is closely related to Adderall, an amphetamine stimulant, but is much stronger.
The appearance of both substances in pharmacy supply chains signals a new danger. Prescribed or not, people who seek medication from pharmacies generally do so in the belief that they are getting what they are told. But the new data suggests otherwise. The LA Times report’s findings reinforce findings of a similar 2023 form study by UCLA researchers. In this analysis, the scientists found that more than a quarter of the 40 pharmacies visited were selling counterfeit pills. In addition, some pharmacies in Mexico offer their customers single pill “samples” of medicines. The researchers found that about 44% of these “pill samples” were laced with unadvertised substances, including meth, fentanyl and heroin.
The prevalence of fentanyl and meth in Mexican pharmacies could be particularly dangerous for US tourists, who may be more vulnerable to exposure to counterfeit medicines. “Pharmacies offering counterfeit drugs were consistently located in tourist-served micro-neighborhoods and generally displayed English-language advertisements,” the UCLA study authors wrote.
The new data also raises questions about the persistent shortage of Adderall in the US. For those who rely on the stimulant to manage their ADHD, the lack of supply available in the US could prompt them to look elsewhere.
The shortage could also potentially explain why meth is used as a supplement or substitute in counterfeit pills. While there is currently no shortage of oxycodone or hydrocodone, the counterfeit fentanyl-laced drugs for pharmacies may be cheaper or easier to source and more profitable to sell than the genuine versions.
The issue of counterfeit or substandard medicines is not entirely new. About 1 in 10 medical devices sold in developing countries are estimated to be classified as “inferior”, according to a report from 2017 by the World Health Organization. But substandard medicines are a different story from pharmacies selling counterfeit pills laced with dangerous substances. “I’ve never seen anything like it [before]Celia Farfán-Mendez, a UC San Diego researcher who studies cartels, told the LA Times. “I think it speaks to the lack of law enforcement overseeing what’s happening in the pharmacies.”
The extreme uncertainty surrounding the issue is concerning. Unlike the US, Mexico does not keep reliable statistics on the number of drug overdose deaths. The country has come forward only 1,700 dead of all drugs in 2020, a suspiciously low number compared to the US statistic of more than 91,000 dead in the same period. And unless Mexico tracks overdoses, it’s difficult to determine the extent of the damage the counterfeit pills could be causing.
The findings of the LA Times and UCLA investigations are a stark reminder of the dangers of counterfeit drugs. Medical tourism from the US to Mexico has grown increasingly popular in recent years, and the prevalence of counterfeit pills in Mexican pharmacies is a serious concern.
People who seek medication from pharmacies generally do so in the belief that they are getting what they are told, but the new data suggests otherwise. The issue of counterfeit or substandard medicines is not new, but pharmacies selling counterfeit pills laced with dangerous substances is a different story. It’s not just about getting the right medical treatment or false advertising – it’s a matter of life and death.
: A Growing Danger