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The Fentapill Problem - A Summary

We are working hard on creating educational resources for both parents and teachers. Download our 2 page PDF Summary on the Fentapill problem. What is it? What can we do about it?

Definition: A fentapill is a counterfeit prescription pill made of fentanyl.

The Problem: Since around 2013-14, the number of people fatally poisoned by counterfeit prescription pills (fentapills) has skyrocketed. We estimate that approximately 7,500 Americans died in 2020 after taking a single pill that they believed to be a legitimate prescription medication but was actually a fentapill. Hundreds of millions of fentapills are in circulation in the US at any given time. Victims are frequently young people between the ages of 14-24 who are experimenting, or who use pills only occasionally.

The Background:

Young people are familiar with prescription pills – the current generation is used to taking them for self-medication and recreation. Responding to this demand, drug traffickers make huge profits by producing realistic-looking fakes using fentanyl (e.g., Xanax, Oxycodone, Percocet and Vicodin) and selling them on the black market, primarily via social media.

What is Fentanyl?

Fentanyl is a powerful synthetic opioid.

  • Powerful: 100x stronger than morphine; Comes on fast; High yield – a small amount makes a lot of doses; Very addictive.

  • Synthetic: Not plant-based; Made in a lab; Unlimited supply = Low cost.

  • Opioid: Same drug class as morphine and heroin; Blocks pain signals between brain and body; has a euphoric effect.

Unique Characteristics:

The fentapill problem is a discrete subset of the Opioid Crisis with a number of unique characteristics.

  • As counterfeits, fentapills are advertised on social media and sold under false pretenses to young people seeking legitimate prescription medications. This is fraud.

  • The victims are unwitting. They did not intend to buy fentanyl and were unaware that it was present in the pill they purchased and consumed.

  • Prescription pills are this generation’s gateway drugs. Fentapill victims tend to be young, trusting and inexperienced, which makes them attractive targets for unscrupulous drug dealers.

Why is This Happening?

In the early 2000s, the US Government cracked down on the black market for prescription pills in response to the Opioid Crisis. But many people had become addicted, so small-time drug dealers started smuggling fentanyl through the US Mail and pressing pills in garage operations. The Mexican Cartels soon recognized the enormous profit potential and cornered the market. Since about 2015, almost all fentapills are produced in Mexico and smuggled across the US Border.

Why are Fentapills So Deadly?

Fentanyl has a very narrow “therapeutic window,” which is the difference between the amount of the drug required to have an effect and the amount that causes death. It is a very difficult balance to strike. Illegal pill press operations have no quality controls, so a significant percentage of every batch contains pills that are potentially deadly.


This is a relatively new problem, and the traditional narrative has yet to be updated to accurately describe its unique characteristics. Here are some common misconceptions:

  • Fentapills are not “laced with” fentanyl. They are 100% fake. The term “laced” implies that pill pressers start with the legit medication and then add some fentanyl. This is not true. They are not modified or adulterated versions of the real drug. Fentapills are “made of” fentanyl – that is the only active ingredient.

  • Victims do not “overdose.” They are “poisoned.” It is impossible to overdose on a single prescription pill. The term “overdose” assigns blame on the victim, which rightfully falls on the dealer. Remember the fraud element – fentapill victims never intend to buy or take fentanyl. If they had taken the medication they sought, they would not have died.

What Can We Do About the Problem?

This is a complex problem and there are significant resources at all levels of government dedicated to reducing/controlling the supply of fentanyl. As parents, teachers, and everyday citizens, the most impactful thing we can do is warn young people that potentially deadly fentapills are everywhere. Focus on grassroots efforts to get the message directly to the most vulnerable age group (14-24). Here are the main talking points:

  • The market has been flooded with hundreds of millions of fake prescription pills that are made of fentanyl.

  • Assume that any pill you get online or from a friend is a fentapill, and possibly deadly.

  • Do not trust any assurances that “these pills are safe.” No one knows for sure, no matter what they say. You can’t reliably test a fentapill.

  • M-30s are the most common markings on fentapills. Do not take a pill marked M-30.

  • No Random Pills! If you didn’t get it from your doctor, don’t put it in your mouth.

Fentapill Summary Sheet
Download PDF • 341KB

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