Thread by @NaturesPoisons

Jake died last May, presumably from taking a Xanax mimic containing fentanyl, the family released yesterday. This tragic death is sure to shed light on the growing problem of "fake pills," so here's everything you need to know about them. A 🧵. si.com/college/2021/1…

"Fake pills" have been around for a long time, but they received national attention in late 2015, when several people in SanFransisco died after taking Xanax bars purchased off the street. They were not alprazolam, but contained fentanyl, instead. cbsnews.com/news/fake-xana…

Much like bootleg Gucci bags, there's some terminology here regarding these knockoff pills:
Counterfeit - looks real, has the actual drug
Fake - looks real, has no drug
Mimic - Looks real, has other drugs

The most common mimic is Xanax bars and oxycodone pills. Almost all these contain fentanyl instead of alprazolam and oxycodone, respectively.

Where does fentanyl come from? Mostly from overseas labs, like in China. Labs can make *TON* quantities of fentanyl quick and cheap.

It is so much cheaper to make fentanyl than to grow a field of opium poppy, harvest it, transform the latex into heroin, and ship it. So much cheaper. We are literally flooded with fentanyl.

How flooded? The FedEx hub in Memphis receives 35K packages a day from China! In 2017, they seized 552 kg of fentanyl. For scale, that's 552 million 1 mg doses of fentanyl. And imagine what they *didn't* catch.

How does this relate to pills? Also in Memphis, agents raided a house that had three commercial pill presses, capable of spewing out 56K pills per hour! Here's 4935 M30 oxycodone mimics...all with fentanyl.

Some mimics look legit, others look janky. Here's generic pharmaceutical oxycodone and a mimic. You can probably guess which is which. So why mimic oxycodone? Purdue pharma created a huge demand and addicted millions. Legit oxy sells for ~$1/mg, so a 30 mg pill sells for $30!

Like with any drug on the street, you don't know what you're getting. Here's an extreme example (a slide from a death investigation talk of mine) that contained 20 different drugs! Why so many? I dunno, it's a witch's brew.

So do people know they aren't getting the "real deal" when they buy pills? Just like every user should know by now that "heroin" is really fentanyl, most *should* know that these pills aren't what they pretend to be. Should, but young college kids? Probably not.

It's a huge and growing problem, not just in the United States, but around the world. In the US it's fueled by our shoddy health care system, corporate greed that addicted millions, and antiquated drug laws. Pill mimics have killed thousands (maybe tens of?).

As a reminder, this is how Prince died - from a Vicodin (hydrocodone) mimic that was really fentanyl, and much, much more potent. nbcnews.com/news/us-news/n…

Nothing much came from Prince's death, but I have a feeling politicians, particularly from Texas where Jake and his brother Sam (now a QB with the Indianapolis Colts) are immensely popular, will speak out about the pill problem. I'll let you figure out why.

Did Prince know he was taking fentanyl? I dunno. Did Jake know he was taking fentanyl? I dunno, and neither you nor I should speculate on either. Just know that these deaths could have been prevented.

The end.

Happy Friday and enjoy your weekend!