Two thirds of the counterfeit pill patients were under thirty-five

**Counterfeit prescription pill availability has sharply increased in the
United States**, and is increasingly linked to overdose deaths. A pill pressed
to look like a prescription oxycodone tablet — an "M-30" — may contain
fentanyl instead.

This report covers 143 suspected exposures evaluated at a single US
hospital.

Who, and how badly

Two thirds under thirty-five, and most of those admitted ending up in
intensive care.

Why the 90% matters

A counterfeit pill is not a controlled product. **In about nine exposures out
of ten, something in addition to fentanyl was present** — which means neither
the person taking it nor the clinician treating them knows what is in it.

That is the practical difference between a counterfeit pill and a diverted
prescription. A real oxycodone tablet has a known dose of a known drug.
This has neither, and the additional substances may not respond to naloxone.

What is recommended

• Outreach focused on younger people misusing prescription pills — which
  is where the two-thirds figure points
• Improving access to harm reduction
• **Linking patients treated for overdoses in hospitals to substance use
  treatment**

That last one recurs across the overdose literature, and for the same reason
each time: a patient who has just survived an overdose in an emergency
department is reachable in a way they may not be again, and most are
discharged without a referral.

*Source: Suspected Counterfeit M-30 Oxycodone Pill Exposures and Acute
Withdrawals Reported from a Single Hospital — Toxicology Investigators
Consortium Core Registry, U.S. Census Bureau Western Region, 2017–2022. MMWR,
Centers for Disease Control and Prevention.*