- The Washington Times - Sunday, January 20, 2019

Most people who see someone die after ingesting a pill would avoid that pill. For opioid addicts, it’s just the opposite.

After an overdose death, addicts flock to that drug dealer because they figure that’s where they can get the most potent stuff, said McGregor Scott, U.S. attorney for the Eastern District of California.

“They look at it as, ‘This guy has something extra,’ and as upside down as that sounds to us, the addicts are drawn to that because of the higher high they are seeking,” he said.

In turn, dealers are increasingly substituting or lacing Xanax and OxyContin, sold illegally on the streets, with deadly fentanyl, a synthetic opioid that gives a powerful high at a small fraction of the cost of dealing real pharmaceuticals.

The trick, yielding nearly a 100,000 percent profit margin, is lucrative for the cartels.

The counterfeit pills mimic their legal counterparts so closely that even street dealers can’t tell them apart.

As little as 2 milligrams of fentanyl can be fatal. More than 28,000 overdose deaths in 2017 were linked to synthetics, according to the Centers for Disease Control and Prevention, accounting for a staggering proportion of painkiller overdose fatalities.

For those who don’t die, the high is addictive enough to keep them coming back.

“The drug dealers handling this stuff have no idea what they are handling,” said Kevin Eaton, the resident agent in charge of the Drug Enforcement Administration’s office in New Bedford, Massachusetts. “A small amount is enough to kill a small child, and people don’t even know.”

The fake pills are particularly dangerous because of the populations they entice.

Many opioid addicts took pills legally prescribed, became hooked and went looking for them on the black market after their prescriptions ran out.

Yet the pharmaceuticals have dried up on the streets as governments and physicians groups crack down on overprescribing. That could reduce the population of the addicted — but it also has cut into the supply, sending prices soaring.

An 80-milligram pill of OxyContin can fetch as much as $80 on the street. When sold legally, the same tablet costs about $6.

Knockoffs filled with fentanyl are much cheaper. Cartels can buy 1 kilogram of fentanyl from a Chinese laboratory for about $20,000. That’s enough to produce 1 million milligram pills that are sold on the street for $20 each — a $20 million return on a $20,000 investment.

That is about 20 times more profitable than heroin.

“The profit margin is exponentially greater because it is a chemical, so you don’t have a growing season or hire teams to process the fields. It’s really driven by the profit margin,” Mr. Scott said.

Authorities say overdoses linked to counterfeit prescription medicines have been rising in recent months.

The Cuyahoga County, Ohio, medical examiner’s office last month issued a public health warning about a batch of pills made with fentanyl and disguised as oxycodone.

Washington state police in September arrested two local dealers suspected of distributing phony Percocet believed to be responsible for a rash of overdoses in three counties.

A police raid on one of the dealer’s homes yielded more than 10,000 fentanyl pills disguised as oxycodone, 33 firearms and nearly $1 million in gold coins and cash, including $200,000 hidden in a dishwasher and another $110,000 stashed behind drywall, according to court documents.

A December traffic stop in Mr. Scott’s district netted 13,000 counterfeit oxycodone pills filled with fentanyl.

“There is not an FDA or pharmaceutical aspect to this,” Mr. Scott said. “The cartels put whatever they got in those pills. It might be too much, and you die or you might live until tomorrow. There is no way to know.”

Authorities say most counterfeit pills flowing into the U.S. have been pressed already by the cartels.

In some instances, though, low-level dealers buy pill presses to make their own product. The devices, which press powder into pill form, can be purchased online easily. Several commanding about $2,000 are available through Amazon.

The fakes are so good that it can take lab testing to spot them as non-factory products.

In September, the Justice Department indicted Melissa Scanlan, a 31-year-old San Diego resident known to her customers as the “drug llama,” for selling 50,000 fentanyl pills designed to look like oxycodone prescription pills. The blue pills, stamped with the “M” and “30” manufacturing marks used by Mallinckrodt Pharmaceuticals, closely resembled legal Percocet, according to court documents.

“If fentanyl is disguised as something else, it is impossible for a citizen to make that determination, so this is a problem that needs to be solved at the source rather than circulation,” said James Pasco, executive director of the National Fraternal Order of Police.

Authorities said there is little they can do beyond enforcement and alerting the public.

Mr. Scott said his office hosted an opioid awareness summit last fall and he has reached out to medical professionals and treatment providers to alert citizens to the danger of fentanyl.

“We are doing the best we can to educate the community. Fentanyl is a whole different thing in terms of its lethality,” he said.

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