Written by Rich Grosfelt August 2026
Most people don’t wake up in the morning, have their cup of coffee or tea and then say to themselves “You know what, I think today is the day that I’m gonna try fentanyl” … But there is more likely a chance of them taking or trying what they believe to be is real Oxycontin, Xanax, or Adderall. Depending where that pill was made or where it came from can carry consequences that are just as deadly.
I would like to preface this article by letting you know it comes from the perspective of someone who’s been in both law enforcement and the outreach/prevention field. I served as a Special Agent with the U.S. Drug Enforcement Administration (DEA) for about 28 years, conducting narcotic investigations during which time I attained a decent working knowledge of the current drug trends situation. After that, I became the Outreach Coordinator for the DEA Pharmaceutical Diversion Control Unit at the New Jersey Division. The Diversion Unit of the DEA is a unit that most people have never heard of - their responsibility is to prevent and investigate the diversion of controlled pharmaceuticals and listed chemicals from legitimate sources while ensuring that there is an adequate supply for legitimate medical and scientific needs. The Outreach role focused on community-based activities, events, and educational initiatives designed to raise awareness of dangerous drug use in order to reduce the demand for drugs and give assistance to community coalitions and drug prevention initiatives.
The good news, according to U.S. Centers for Disease Control and Prevention (CDC) statistics, is that U.S. drug overdose deaths have decreased for the third consecutive year in 2025. At its peak in the 12-month period ending in August 2023, there were approximately 112,418 predicted drug overdose deaths. Most recently, in the past 12- month period ending March 2026, the predicted number has dropped to approximately 67,798. Again, even though the numbers are down which is promising, the number is still way too high and the majority of these overdose deaths are still due to fentanyl.
Fentanyl is a highly potent synthetic opioid. Legitimate pharmaceutical grade fentanyl manufactured in the United States is approved by the U.S. Food and Drug Administration (FDA) for use as an analgesic and anesthetic, which is used in certain medical settings. Illicit fentanyl, on the other hand, is manufactured by Mexican drug cartels using chemicals mainly from China based chemical suppliers. This illicit fentanyl is then made into different forms in order to appeal to different kinds of drug users – powder form to be mixed into or substituted for cocaine or heroin, as well as into fake trademarked prescription medication pills. Three of the most common fake prescription pills trafficked by the cartels are Oxycontin®, Adderall®, and Xanax®. It should be noted that US pharmaceutical grade Oxycontin® contains oxycodone, authentic Adderall® contains amphetamine, authentic Xanax® contains alprazolam. The fake versions of all of these do not contain the authentic associated medication, but instead are made using illicit fentanyl.
Back in the days of being a street agent while conducting a number of heroin investigations, I thought at the time, wow, what could be worse than heroin…. well, we found it, it’s fentanyl. Don’t get me wrong, heroin is still nasty but when you compare it to fentanyl which is 50 times more potent than heroin, we have hit another level of lethality in the illegal drug source.
Why fake pills? Cartels and traffickers have exploited the trust that Americans had in prescription drugs. They also took advantage of the fact that many Americans became addicted to pain medications - which could have innocently started because of a car accident injury, dental procedure, sports injury, etc. Social media platforms have also been used by dealers to advertise and sell their products with very little chance of getting caught. Perception of risk may additionally play a part, especially as it is viewed by our youth - the lower the perception of risk, the higher the chance for use or abuse. The reasons for the low perception of risk and attraction by youth as it pertains to legitimate pharmaceutical pain medications could be for a number of reasons:
- The belief that prescription drugs are safer than street drugs
- They view them as medicine
- Prescription medications are from doctors/pharmacies
- No needles are involved in their use
- They are not buying them from typical “drug dealers”
- They are easy to get via social media, delivered right to your door
The problem with these misconceptions is not only that the prescription medications can be just as dangerous as illegal street drugs, but depending on the source of the pills, they might not be taking the authentic version of the drug they think they are, and are in fact taking a fake pill potentially laced with a lethal amount of fentanyl. The other issue is that it is impossible to distinguish the fake pills from the authentic ones.
The old picture you might conjure up in your mind of someone who has overdosed on drugs might include an image of a person with a needle hanging out of their arm, lying in the gutter of a street. The faces of those who have overdosed on fentanyl are nothing like that anymore - it can be the face of anyone; fentanyl does not discriminate. I have worked with many prevention organizations that host events honoring those have lost their lives to substance abuse, many due to fentanyl, where they display memorial posters with a picture and story which creates a visual reminder that this can affect anybody.
In the many school presentations that I have done, I always ask the group of students who has heard of fentanyl before? Most raise their hands. When I take it a step further and ask them to tell me something about fentanyl, most if not all of the hands go down. Students in elementary, middle, and high school need to be more informed about fentanyl as well as about the role that easily obtainable fake pills play in drug overdoses.
Not only does everyone need to get a better understanding of why this drug is responsible for so many overdoses, but they also need the tools and information to pass along in order to educate our youth and community members so that they don’t make the same deadly mistake that so many have already made. Teachers, parents, coaches, student assistance counselors, community leaders, just to name a few, are all in a position to take part in prevention. Other synthetic opioids even more powerful than fentanyl are now finding their way into the drug supply, which makes the education of our youth on this topic paramount if we want to keep those CDC numbers falling.