Friday, September 1, 2023

Counterfeit Pills Increasingly Involved in U.S. Overdose Deaths

The percentage of overdose deaths involving counterfeit pills in the United States more than doubled between late 2019 and late 2021, according to findings published today in the CDC’s Morbidity and Mortality Weekly Report. The percentage of overdose deaths involving counterfeit pills more than tripled in western states in the country.

“Drug overdose deaths are at historically high levels in the United States, with a preliminary estimate of more than 105,000 deaths in 2022,” wrote Julie O’Donnell, Ph.D., of the National Center for Injury Prevention and Control and colleagues. “Counterfeit pills can expose new populations to highly potent drugs such as IMFs [illicitly manufactured fentanyls] and illicit benzodiazepines, and persons using pills might not be aware of their contents.”

O’Donnell and colleagues relied on data submitted to the CDC’s State Unintentional Drug Overdose Reporting System to examine trends in overdose deaths with evidence of counterfeit pill use. This system contains information submitted by jurisdictions throughout the country about drug overdose deaths from death certificates, postmortem toxicology reports, and more.

The authors calculated quarterly percentages of overdose deaths with evidence of counterfeit pill use from July 2019 to December 2021 based on information provided by officials from 29 states and the District of Columbia. The authors also examined information about the demographics of the people who died by overdose, the circumstances of the death, and the drugs involved.

From July 2019 to December 2021, 106,293 overdose deaths occurred among the 30 jurisdictions with complete data. Between July-September 2019 and October-December 2021, the overall quarterly percentage of overdose deaths involving counterfeit pills increased from 2.0% to 4.7%, according to O’Donnell and colleagues. The authors noted that the trend was “driven by an increase from 4.7% to 14.7% in western jurisdictions. Percentages remained below 4% in all other regions.”

Compared with people who died of drug overdose that did not appear to involve counterfeit pills, people who died of drug overdose involving counterfeit pills tended to be younger and Hispanic and have a history of prescription drug misuse.

“The highest percentages of deaths with evidence of counterfeit oxycodone use (both alone and with counterfeit alprazolam) were in western jurisdictions, whereas nearly one half of deaths with evidence of counterfeit alprazolam use only were in southern jurisdictions. This finding suggests that exposure to different types of counterfeit pills and drugs might vary by region,” O’Donnell and colleagues wrote. “Prevention and education materials that incorporate local drug seizure data and information about regional drug markets might be particularly effective at highlighting relevant counterfeit pill types and reducing deaths.”

For related information, see the Psychiatric News articles “Severe Grief Tied to Experiencing, Witnessing Overdose” and “Xylazine Present in Increasing Number of Fentanyl Overdose Deaths, CDC Finds.”

(Image: iStock/Sunshine Seeds)

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