‘The supply is so tainted’: Counterfeit pills cut with fentanyl pose increasing risk

Vanessa Miller thought she’d beaten a seven-year heroin addiction in 2013. But when she had surgery to remove her tonsils in October, the doctor prescribed her opioids to help with the pain, unwittingly leading her back to addiction.

The 36-year-old mother of two from Woodstock initially took the pain pills as directed. But as her body reacted, she said, she began thinking, “I really like this,” and took more than she was supposed to.

“I ran out and called the office in pain, and [the doctor] didn’t know my history, and he called me in more” painkillers, Miller said. “After that, things started to spiral. Then I started buying off the street.”

At first, she bought from people she knew, but on April 26, after exhausting her contacts, she wound up in Rockford, buying from a stranger.

Any pill you buy off the street has the potential to have fentanyl in it.”

—  Laura Fry, executive director of Live4Lali, referring to pills sold on the street laced with fentanyl

“It was a Friday and I was trying to get into treatment,” Miller said. “I called multiple places and was told we have waiting lists four months long.”

Another place said they didn’t take her insurance. She then drove to a clinic in Fox Lake, where she’d scheduled an appointment three weeks earlier to get Suboxone, a drug used to treat narcotic dependence. She was told the provider did not show up and she “had a meltdown and was told, ‘There is nothing I can do to help you.’”

“I was in withdrawal. It had been two days since I had my last pain pill,” she said.

Miller then drove to Rockford, where she bought 10 pills believing they were Norco, a medication containing hydrocodone and acetaminophen that is no longer sold under that brand name. Later that day, had lunch with a friend in Schaumburg and then stopped at Target. Before walking into the store, she took five pills. As she walked around the store, she said she felt a “little dizzy” and returned to her car.

That’s the last thing she remembers until she woke up in a confused panic in an ambulance and tried to jump out as a police officer attempted to calm her down and told her she was not in any trouble.

“I was found in the parking lot next to my car in the pouring rain,” Miller said. “Someone did CPR on me; I had handprint bruises on my chest. I was given four doses of Narcan by first responders; it was not pleasant.”

After her remaining pills were tested with a fentanyl test strip, she learned the pills, although imprinted with the 10/325 markings typically found on Norco, were laced with fentanyl.

“Counterfeit pills” refer to nonprescription pills bought on the street by people believing they are Xanax, benzodiazepines, Norco, Oxycontin, Percocet, Ativan, trazodone and other narcotics, but are laced with fentanyl. Counterfeit pills can be deadly and have been showing up more and more in recent years, said Laura Fry, executive director of Live4Lali.

Live4Lali is an Arlington Heights-based advocacy group that works to reduce stigma and prevent substance use disorder, including by providing test strips, naloxone and clean needles, Fry said.

Patrick Slocum, 44, of Woodstock, is Live4Lali’s full-time McHenry County outreach coordinator. He’s also been hearing about an uptick in counterfeit pills.

Many people with a substance use disorder fall into the same trap as Miller, he said.

“What is happening is people are becoming dependent on the pills their doctors are prescribing to maintain pain and even if taken as prescribed, they become dependent,” Slocum said. Once a doctor stops prescribing the opioids, the person, now addicted, turns to the dark web and the streets. But no one really knows what they are getting.

Fry recalled last fall a “low-level dealer” in Palatine asking her to test 400 Percocet pills he had, which she said turned out to be fentanyl. Fry said the dealer told her: “I don’t want these. These are going to kill people” – so she drove right to the police station and dropped them off.

Fry has talked to drug dealers about the dangers of unwittingly selling pills laced with fentanyl to unsuspecting buyers. She tells them, “Let me give you a lesson in business 101: You don’t kill your customers. That is not how you make money.”

She said one dealer responded: “‘If you had to have your hip replaced and ... saw that out of 100 patients, one of them died, would you still have the surgery? This is just part of the business. ... Not everyone dies.’”

“Dealers are not chemists or pharmacists when mixing up batches of drugs,” Fry said, adding that anyone can buy a pill press on Amazon and mix the substances, which are not often mixed very well. “So you might have two pills completely fentanyl, and the next two have less fentanyl, and you just don’t know what you are getting.”

The surge in fentanyl on the streets, Fry said, is due to a lack of heroin. While heroin requires growing and maintaining fields of poppies, fentanyl requires only chemicals that are easily accessible on the dark web. Fentanyl is mixed with other drugs because the other drugs enhance and prolong the effect – and the synthetic opioid has driven a huge surge in overdoses in recent years.

“Any pill you buy off the street has the potential to have fentanyl in it,” Fry said.

Fry and others walk a line of not encouraging people to take illicit drugs while trying to help them protect themselves if they do. To that end, she said, she advises people always to have fentanyl test strips handy, test everything before ingesting, never use alone and buy from known dealers.

She also said doctors are supposed to be using “best practices” when prescribing opioids, including asking for a patient’s full history of drug use, which Miller said was not done after her tonsil surgery. Doctors “at a minimum” should be prescribing naloxone when prescribing opioids in case of an overdose, Fry said.

Doctors at hospitals including Northwestern Medicine in McHenry County and Advocate Good Shepherd in the Barrington area said they prescribe or give naloxone – which can reverse an opioid overdose – when prescribing opioids. However, emergency department staff at Northwestern Medicine said they have not seen an increase in overdoses connected to counterfeit pills.

Naloxone kits are available to a variety of patients in the emergency departments.

“This can include patients presenting with an opioid-related reason for the visit (overdose, withdrawal, etc), patients who may have a pain management plan on file, a patient with a prescription history of benzodiazepines with opioids, and patients who have used pills or drugs on the street,” said Kelly Monestero, emergency department director of operations at Northwestern Medicine McHenry and Woodstock hospitals.

Daniel Campagna, director of emergency medicine at Northwestern Medicine Huntley, McHenry and Woodstock, said his department does not prescribe naloxone for every patient prescribed narcotics.

“We consider the risk of the patient and prescribe Narcan for those who we would consider being at higher risk for respiratory depression/complications,” Campagna said. “So it is available for us to prescribe to any patient, but in practice we are offering it to high-risk patients.”

Recently a Wisconsin man was charged with drug-induced homicide in the death of a person who died in McHenry. During the investigation, police found counterfeit Percocet/oxycodone pills in the bedroom of the person who died, which the coroner said was from adverse effects of fentanyl.

“The supply is so tainted,” Fry said.

Miller, who grew up in and out of foster care, has lost loved ones to drug overdoses and said that she is now clean and in an intensive outpatient recovery program. Since her relapse, she has found much support from the community and those in the program.

She’d thought she was being safe because she was using pills and not ingesting powder. She believed there was no risk of fentanyl being in pills.

Miller is sharing her story because she hopes it helps others.

“I have a lot of support now and a lot of people that care about me that I didn’t know I had,” she said. “I found new support and I am working really hard.”

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