By Alyssa M.
In 2018, three men in Orange County were charged in connection with a large-scale counterfeit opioid operation. Authorities discovered thousands of homemade fake pills made to mimic prescription OxyContin. But these pills weren’t legitimate. They were laced with fentanyl, a synthetic opioid up to 50 times more potent than heroin.
What looked like everyday painkillers were, in fact, deadly imposters.
This case was an early warning sign of a crisis that has since exploded nationwide. Today, counterfeit pills containing fentanyl are driving a staggering share of overdose deaths in California and across the U.S.
Fentanyl’s Role in the Overdose Crisis
In 2022, fentanyl and other synthetic opioids were the leading cause of drug overdose deaths in California, accounting for 59% of all overdose fatalities. This surge mirrors a national trend: that same year, nearly 108,000 people died from drug overdoses in the U.S., with approximately 76% involving opioids, primarily synthetic opioids like fentanyl.
According to the Centers for Disease Control and Prevention (CDC), overdose deaths involving synthetic opioids increased by about 4% from 2021 to 2022, while deaths involving heroin and prescription opioids declined.
The spread of illicitly manufactured fentanyl is largely driving the sharp increase in deaths. Far more potent, cheaper, and unpredictable than pharmaceutical-grade fentanyl, this synthetic opioid is often mixed, intentionally or unintentionally, into counterfeit pills or other street drugs without the user’s knowledge, making fentanyl especially dangerous.
These counterfeit pills are nearly indistinguishable from legitimate medications such as oxycodone, Xanax, or Adderall. Yet even a tiny amount of fentanyl can be deadly. According to the U.S. Drug Enforcement Administration (DEA), six out of every ten pills tested in 2024 contained a potentially lethal dose (2 milligrams) of fentanyl. That same year, the DEA seized more than 60 million counterfeit pills, equivalent to over 380 million potentially fatal doses.
Despite aggressive enforcement efforts, the crisis continues to escalate. Many Americans remain unaware of the risks, underscoring the urgent need for expanded public education, harm reduction strategies, and access to treatment.
The Rise of Fentanyl Laced Pills
Pharmaceutical fentanyl, when prescribed and administered by medical professionals, has long been used to treat severe pain, particularly in cancer and palliative care. It is typically dispensed in tightly controlled forms such as transdermal patches or lozenges.
In recent years, however, illicitly manufactured fentanyl has flooded the U.S. drug market, primarily trafficked from Mexico. Drug trafficking organizations have exploited the opioid crisis by mass-producing counterfeit pills that closely mimic legitimate medications. Illicit manufacturers often use commercial-grade equipment to press these fake pills, deliberately designing them to deceive even experienced users. With its extreme potency, low production costs, and ease of concealment, fentanyl has become the drug of choice for traffickers. Its widespread use in counterfeit pills has dramatically increased the risk of fatal overdoses nationwide, especially in California.
Fentanyl-related deaths began to spike around 2019. Between 2019 and 2022, California experienced a sharp rise in overdose fatalities involving counterfeit opioids, many of which were unknowingly consumed by users expecting a less potent drug.
In some parts of the country, there are early signs that overdose deaths may be leveling off. Among younger Americans, data suggests a cultural shift away from opioids toward substances like cannabis and psychedelics. However, this trend is not enough to offset the devastating impact of fentanyl.
In California, fentanyl-related deaths continue to rise. Individuals caught in cycles of opioid use remain among the most vulnerable, facing a heightened risk of fatal overdose with each use.
California’s Efforts to Fight Counterfeit Pills
As counterfeit pills laced with fentanyl continue to drive overdose deaths, California has ramped up its response to the ongoing crisis. At the heart of this effort is “Facts Fight Fentanyl,” a statewide awareness campaign under the Overdose Prevention Initiative. The program aims to destigmatize addiction, educate the public about the dangers of fentanyl, and increase access to life-saving treatment and resources.
“In 2023, California saw nearly 8,000 opioid-related overdose deaths; more than 7,000 of those were related to fentanyl. Increasing awareness of fentanyl and naloxone is key to reducing stigma, preventing overdoses and, ultimately, advancing the health and well-being of California’s diverse people and communities.”
— CDPH Director and State Public Health Officer, Dr. Erica Pan
The campaign combats dangerous misinformation and expands access to naloxone, giving more Californians the tools they need to respond to opioid overdoses. Making treatment options easier to find and talk about breaks down stigma and builds healthier, more informed communities across California.
How to Help in the Fight Against Fentanyl
Fighting the fentanyl crisis starts with awareness. Understanding the risks, recognizing the signs, and knowing how to respond can save lives, possibly even someone you know.
One of the most powerful things you can do is help break the stigma surrounding drug use and addiction. Judgment and shame often prevent people from seeking the help they need. By approaching the issue with compassion and knowledge, we create safer, more supportive communities.
Here’s how you can make a difference:
- Educate Yourself and Others: Learn how fentanyl is being distributed through counterfeit pills, and share that knowledge with friends, family, and community members.
- Carry Naloxone: This life-saving medication can reverse an opioid overdose. It is easy to use, widely available, and legal to carry in California.
- Talk Openly: Normalize conversations about substance use and mental health. Creating a safe space to talk can encourage someone to seek help.
- Support Harm Reduction: Advocate for programs that provide access to treatment, safe use supplies, and overdose prevention tools.
- Stay Informed: Follow trusted sources for updates on fentanyl trends, local resources, and prevention strategies.
The fentanyl crisis affects people from all walks of life. Your voice, your empathy, and your actions can help protect lives and build a stronger, more informed community.
If you or a loved one is currently struggling with fentanyl addiction, Tree House Recovery can help. Our rehab in Orange County, CA, provides a supportive environment where people can heal from the effects of fentanyl, and build coping skills that contribute to their long-term recovery. Call our team at (855) 202-2138 today to learn more about how we can help you and our community heal from the ongoing opioid crisis.