A deadly problem has been quietly taking root in the United States. Illicit fentanyl, a synthetic opioid that is 50 to 100 times more potent than morphine, is being sold as counterfeit pain medication. Consumers should take heed, as it can be lethal in very small doses, as evident by the death of the singer Prince last year.

According to CNN, counterfeit pills made with fentanyl, but marked as oxycodone or Xanax, can be deadly. Unsuspecting buyers, including patients with severe pain, have no idea what they are really getting from a rogue online pharmacy or a drug dealer. Counterfeit fentanyl is easy to manufacture. Pill presses that are made in China, can be purchased easily and inexpensively online, and they can be used to turn fentanyl powder into pill form to mimic drugs, such as the pain killer, oxycodone, and the anti-anxiety drug, Xanax.

States, including Massachusetts, Rhode Island, Ohio and Delaware have reported an “alarming surge” in fentanyl-related deaths in recent months. In fact, in some states, the number of deaths from fentanyl now exceeds those from prescription opioids. In Massachusetts, for instance, Boston police are warning about counterfeit fentanyl pills that are nearly indistinguishable from prescription oxycodone and are being sold to buyers who presume the pills, which are accurately formed and marked with the designation A/215, are oxycodone 30 mg tablets.

“Anyone who ingests these fentanyl pills may put themselves in serious danger of overdosing which can result in death,” police said. They also warn consumers to use caution in handling them as you can absorb fentanyl through your skin.

CNN reports that in January 2017, the acting DEA Administrator, Chuck Rosenberg, went to China to meet with officials about keeping synthetic fentanyl and pill presses from being shipped legally to the United States. Since then, the Chinese government has banned six variations of synthetic fentanyl. Still, consumers should take precautions and only purchase prescription drugs from reputable online and brick-and-mortar pharmacies. To be safe, before you buy, make sure your online health purchases are safe by using CSIP partner LegitScript’s pharmacy verification tool.

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The Center for Safe Internet Pharmacies (CSIP) and our 12 member companies have the shared goal of helping address the growing problem of consumer access to illegitimate pharmaceutical products on the Internet. Continue to read this blog for updates on CSIP’s education, enforcement and information-sharing efforts.