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Deadly counterfeit pills mimic common prescription medications

By David R. Shorey, East County Program Manager, Institute for Public Strategies

November 17, 2020 (San Diego’s East County) -- It was his birthday and 22-year-old Vista resident Zach Budlong decided to meet up with some friends at a beach party to celebrate. Furloughed from his job because of COVID-19 and impacted by a reduction in unemployment benefits, Zach looked to the gathering as a way to celebrate and let off some steam. 

As the party progressed into the early morning hours of the next day, it’s believed that someone gave Zach what appeared to him to be a Xanax. At 7a.m., Zach’s girlfriend checked in on him and found him unresponsive. First responders couldn’t revive him and Zach died soon after their arrival.

Experiences like this are playing out all over San Diego County and across the country. In their aftermath, there are conversations about counterfeit pills and something called fentanyl. The question often asked is how could something that looked like a common medication cause such a tragedy?


Law enforcement deal everyday with the impact of drugs on the street. Across certain parts of East County, we are seeing higher rates of arrests for drug-related crimes. La Mesa has the highest rates in the region at 44%, while more than one in three crimes in Santee and the unincorporated East County are drug related. That’s according to the San Diego Association of Governments Criminal Justice Clearinghouse. When it comes to fentanyl, police are more likely to come in contact with the deaths firsts and the dealers second.


Fentanyl is an inexpensive, highly potent drug that is being mixed into counterfeit pills circulated through street-level dealers. It has changed the course of an already unprecedented opioid epidemic in the U.S. Its deadly impact is being felt among younger drug users who mistakenly view prescription medications as safer alternatives to common street drugs.


That perspective, combined with counterfeit pills that are almost indistinguishable from the real ones, makes ingesting any prescription pill that isn’t out of a bottle given to you by a pharmacy, a game of Russian Roulette.


Fentanyl Is Fatal


It takes only two milligrams of fentanyl to cause a fatal overdose. That’s the equivalent of a dash of the white powder the size of Lincoln’s nose on a penny. (See photo.) While the counterfeit pills in circulation may look like the real ones on the outside, what is inside is a completely different story. The pills are usually produced in backroom, makeshift mills with inconsistent concentration of the drug. One of the phony pills could have little to no fentanyl, while the next could be deadly.


In San Diego County, fentanyl is showing up at an alarming rate. An estimated three fentanyl overdose deaths a day were recently recorded by health officials. Substance misuse is on the rise. The combination of increased isolation due to the pandemic and the proliferation of fentanyl, makes the problem even worse.


Overdose Deaths


Lakeside, Blossom Valley and Jamul are already among the highest areas for opioid overdose deaths in San Diego County. Information from the San Diego Prescription Drug Abuse Taskforce (PDATF) 2020 Annual Report show fentanyl overdose deaths in the county are on course to triple this year compared to last. There were 92 deaths in 2018. That number increased to 152 in 2019. In the first half of 2020 the number increased to 203, with even more deaths reported since. The severity of the problem can be traced by going back only five years. From 2015 to 2019, fentanyl related deaths increased 619%. That’s not a typo.


The opioid epidemic began in the late 1990's with the over-prescription of opioids like OxyContin for chronic pain treatment. Then, as efforts to reduce over-prescription increased, a second wave of opioid use kicked in. That wave was caused by users addicted to prescription opioids who turned to heroin and other street drugs as prescription medication became less available.


Opioids act on the body in a way that increases the likelihood of overdose with prolonged use, by slowing the body’s overall function, especially in the lungs. Opioids also slow the liver function where the drugs are metabolized and processed out of the system. This brings a heightened danger since the slower the liver functions, the longer the drug takes to achieve half-life. Frequent users may take their usual dose unaware of the amount of the drug remaining in their system, thus, increasing the likelihood of overdose. Slower breathing makes death from prolonged opioid misuse almost a certainty.


Get Resources to Help Others or Help Yourself


In partnership with the PDATF and through our Overdose Data to Action Program (OD2A), the Institute for Public Strategies utilizes the IPS upstream approach to prevent opioid misuse in the East County and South Bay. Free presentations and workshops for neighborhood, community, and civic groups are available. Our presentations can be tailored to address a wide span of demographics from young to seniors and those from various cultural and ethnic communities. We provide literature and graphics in various languages to help spread awareness and information regarding fentanyl. Contact the OD2A project by email at


Additional resources include the San Diego County District Attorney’s Opioid Project and the California Department of Public Health’s online Opioid Overdose Surveillance Dashboard with statewide information. If you or anyone you know has a problem with opioid use, contact the Access & Crisis Line at (888) 724-7240. 



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