US warns against Mexican pharmacies selling tainted, counterfeit pills

The US State Department on Friday issued a warning to Americans to “use caution” when buying drugs from drugstores in Mexico, issuing the health warning a week after a letter from two lawmakers and an investigation by the Los Angeles Times.

“The U.S. Department of State is aware of recent media reports of counterfeit drugs available in pharmacies in Mexico, including those contaminated with fentanyl and methamphetamine,” the alert said. “Counterfeit pills are easily promoted on social media and can be bought in small off-chain pharmacies in Mexico along the border and in tourist areas.”

The new note is stronger than previous language on the ministry’s website, which warned that counterfeit pills are rampant in the country. It was not stated that they could be purchased from legitimate pharmacies or that they might contain such potent and deadly substances.

“The State Department’s warning is a good and necessary step,” said Chelsea Shover, a UCLA researcher whose team documented the issue this year. “But there’s still a lot we don’t know about the scope of this problem, and I think figuring that out will be crucial to issuing more accurate warnings and taking action.”

The department did not answer a list of questions about the advisory, but sent a statement.

On Friday, the US Embassy in Mexico City “issued a health alert to inform US citizens of the danger of counterfeit drugs available from pharmacies in Mexico, including those potentially contaminated with fentanyl and methamphetamine,” it said it in the statement.

Mexican authorities and officials did not respond to requests for comment. In recent weeks, President Andrés Manuel López Obrador has denied that his country is involved in the fentanyl trade, despite ample evidence.

The State Department’s warning comes a week after Sen. Edward J. Markey (D-Mass.) and Rep. David Trone (D-Md.) sent a letter urging the department to “notify Americans traveling to Mexico to warn immediately of the danger they face when buying pills from Mexican pharmacies.”

The letter cited the Times investigation and the findings of UCLA researchers, both of which documented dangerous counterfeit pills being sold over-the-counter in drugstores in northwestern Mexico.

“US tourists who unknowingly purchase counterfeit pills from Mexican pharmacies — both with and without a prescription, according to the Los Angeles Times — face mortal risks from drugs that have effectively been poisoned,” the lawmaker wrote.

A spokesman for Markey’s office said Saturday the alert was “an important first step,” but the senator has “not yet received a response from the State Department” to the letter he and Trone sent to the department this month.

“I’m glad the State Department has heeded my call to issue a health alert for Americans visiting Mexico, who are raising the alarm about the dangers of fentanyl-contaminated pills and other powerful drugs sold in some Mexican pharmacies,” Markey said in an email.

Of the 17 pills the Times reporters tested this year, 71% tested positive for stronger drugs. Pills sold as oxycodone or percocet tested positive for fentanyl in three cities; Pills sold as Adderall tested positive for methamphetamine in two cities.

Many pills were almost indistinguishable from their legitimate counterparts, and all were purchased over the counter from small, independent pharmacies in northwestern Mexico.

The UCLA team found similar results when they tested 45 samples from four cities in the same region. Using infrared spectrometry, the researchers found heroin in three pills they bought.

Although counterfeit drugs were known to be increasingly common on the black markets in Mexico and the United States, the powerful synthetic drugs were not known to have made their way into pharmacy supply chains. Drug market experts predicted fatal consequences of the pollutants.

“Whenever you have counterfeit products that contain fentanyl, people will use them and die,” Shover said at the time.

Five weeks later, The Times published an investigation into the final hours in the life of Brennan Harrell, a 29-year-old California man who died in 2019 after consuming fentanyl-contaminated pills at a pharmacy in Cabo San Lucas, Mexico.

His parents said they worked with the Drug Enforcement Administration, which conducts and assists human trafficking investigations in the United States and Mexico. Agents were investigating the matter, the Harrells said, but did not alert the public to the potential risk.

A DEA spokesman declined to comment on Friday’s State Department warning, citing a previous DEA email.

“We do not regulate Mexican pharmacies, which is why we have recommended that you contact the authorities in Mexico,” the email reads. “The US Department of State issues travel advisories/resources for Americans leaving the country, so we refer you to them for information provided to American citizens visiting Mexico.”

Harrell’s parents fought for more than three years to get the State Department to issue a prominent warning about the dangers of Mexican pharmacies.

“This warning should have come almost in 2019 when I alerted the State Department,” Brennan’s mother, Mary, told The Times on Saturday.

All other deaths, she said, “are in their hands and how many deaths we will not know.”

That’s partly because Mexican autopsies don’t consistently include testing for fentanyl. In addition, drug experts say the country’s mortality data falls far short of overdose deaths.

While more than 91,000 people died from overdoses in the United States in 2020, Mexico had fewer than two dozen opioid-related deaths that year, according to the country’s official data. In the same year, the United States recorded more than 68,000 opioid overdose deaths.

The Department of State issues travel advisories for each country and assesses the caution that US travelers should exercise. The lowest recommendation – color-coded blue – suggests that people abroad should “take normal precautions”; The top-level advisor, coded red, warns that Americans “should not travel there” due to life-threatening risks.

When there are specific – and often more short-term – security concerns in another country, the department issues alerts on things like demonstrations, crime trends and weather events.

On Monday, the State Department issued a broad spring break “travel advisory” warning travelers of concerns in Mexico, including crime, drowning, medical emergencies and pharmaceuticals.

“Counterfeit drugs are common and may prove ineffective, are of the wrong strength, or contain dangerous ingredients,” the warning reads. “Medications should be purchased in consultation with a doctor and from reputable establishments.”

This warning was largely a repetition of the instructions on the website and did not include warnings required by law about counterfeit drugs sold in drugstores.

On Friday, the State Department issued the more detailed Health Alert: Counterfeit Medicines alert, which provides more detail on the concerns raised in recent reports. However, the department did not answer a question about how long their warning would remain in place.

“Drugs, both over-the-counter and prescription-only in the United States,” the warning said, “are often readily available with little regulation.”