The State Department issued a warning Friday for Americans to “be careful” when buying drugs at pharmacies in Mexico, issuing the health alert a week after a letter from two lawmakers and an investigation by the Los Angeles Times newspaper.
“The United States Department of State is aware of recent media reports of counterfeit pharmaceuticals available in pharmacies in Mexico, including those tainted with fentanyl and methamphetamine,” the alert said.
“Counterfeit pills are easily advertised on social media and can be purchased at small, non-chain pharmacies in Mexico along the border and in tourist areas.”
The new notice is stronger than previous language on the department’s website, which warned that counterfeit pills were common in the country. He did not specify that they could be purchased from legitimate pharmacies or that they could contain such powerful and deadly substances.
“The State Department warning is a good and necessary step,” said Chelsea Shover, a UCLA researcher whose team documented the problem this year. “But there’s still a lot we don’t know about the scope of this problem, and I think finding it will be critical to issuing more accurate warnings and taking action.”
The State Department did not respond to a list of questions about the notice, but instead sent a statement.
On Friday, “the United States Embassy in Mexico City issued a health alert informing citizens of the United States of the danger of counterfeit pharmaceutical products available in pharmacies in Mexico, including those potentially contaminated with fentanyl and methamphetamine,” it read.
The Mexican agencies 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 warning came a week after Sen. Edward J. Markey, D-Mass., and Rep. David Trone, D-Md., sent a letter calling on the Department to immediately “advise Americans traveling to Mexico of the danger they face when buying pills in Mexican pharmacies.
The letter cited the Times investigation and the findings of UCLA investigators, which documented the over-the-counter sale of dangerous counterfeit pills in pharmacies in northwestern Mexico.
“American tourists who inadvertently buy counterfeit pills at Mexican pharmacies – with and without a prescription, according to the Los Angeles Times – face deadly risks from drugs that have actually been poisoned,” the lawmakers wrote.
A spokesman for Markey’s office said Saturday that the alert was “an important first step” but that the senator “has not yet received a response from the State Department” regarding the letter he and Trone sent him.
“I’m glad the State Department has heeded my call to issue a health alert for Americans visiting Mexico that raises alarm about the dangers of fentanyl-tainted pills and other powerful drugs sold in some Mexican pharmacies.” he said in an email.
Of the 17 pills Times reporters tested this year, 71% tested positive for more powerful drugs. In three cities, tablets sold as oxycodone or Percocet tested positive for fentanyl; in two cities, tablets sold as Adderall tested positive for methamphetamine.
Many pills were almost indistinguishable from their legitimate counterparts, and all were purchased over the counter at small, independent pharmacies in northwestern Mexico.
The UCLA team found similar results when they analyzed 45 samples from four cities in the same region. Using infrared spectrometry, the investigators also found heroin in three pills they purchased.
Although counterfeit medicines were known to have become increasingly common in the black markets of Mexico and the United States, it was not previously known that the powerful synthetic drugs had found their way into pharmacy supply chains. Drug market experts predicted that the contaminants would have fatal consequences.
“Any time you have counterfeit products that contain fentanyl, people are going to use it and die,” Shover said at the time.
Five weeks later, the LA Times published an investigation detailing the final hours of Brennan Harrell, a 29-year-old California man who died in 2019 after consuming fentanyl-tainted pills purchased at a pharmacy in Cabo San Lucas, Mexico.
His parents said they cooperated with the US Drug Enforcement Administration (DEA), which conducts and assists with trafficking investigations in the United States and Mexico. Agents investigated the matter, the Harrells said, but did not alert the public to the potential risk.
A DEA spokesperson declined to comment on the State Department alert on Friday, referring to an earlier email from the DEA.
“We do not regulate Mexican pharmacies, so we recommend that you contact the authorities in Mexico,” the email said.
“The US Department of State issues travel advisories/resources for Americans traveling outside of the country, so we referred them to them regarding information provided to US citizens visiting Mexico.”
Harrell’s parents fought for more than three years to get the State Department to issue a prominent, conspicuous 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.
Any other death, he said, “is in their hands, and how many more deaths we will not know.”
In part, that’s because Mexican autopsies don’t routinely include tests for fentanyl. In addition, drug experts say the country’s mortality data vastly underestimates overdose deaths.
While more than 91,000 people died of overdoses in the United States in 2020, Mexico recorded fewer than two dozen opioid deaths that year, according to the country’s official data. That same year, the United States recorded more than 68,000 opioid overdose deaths.
The State Department issues travel advisories for each country, rating the level of caution that travelers from the United States should take. The lowest-level advisory, color-coded blue, suggests that people should “take normal precautions” while abroad; the highest-level advisory, coded red, warns that Americans “should not travel” there due to life-threatening risks.
For specific, and often short-term, security concerns in another country, the Department issues alerts on things like protests, crime trends, and weather events.
On Monday, the State Department issued a broad spring break “travel advisory” warning travelers about concerns about Mexico, including crime, drowning, medical emergencies and pharmaceuticals.
“Counterfeit drugs are common and may be ineffective, have the wrong concentration, or contain dangerous ingredients,” the alert said. “Medications must be purchased by consulting a medical professional and in accredited establishments.”
That alert was largely a repetition of existing guidance on the site and did not include warnings that lawmakers had requested regarding counterfeit drugs being sold in pharmacies.
On Friday, the State Department released a more detailed warning, “Health Alert: Counterfeit Pharmaceuticals,” which offers more detail on concerns raised in recent reports. However, the department did not respond to a question about how long its alert would remain in effect.
“Pharmaceutical products, both over-the-counter and by prescription in the United States,” the alert said, “are often available for purchase with little regulation.”
