A few lines in a Senate appropriations proposal could force U.S. officials to confront a deadly threat they ignored for years: Counterfeit, fentanyl-laced painkillers sold at pharmacies in Mexico.
If approved, Secretary of State Antony J. Blinken would have 90 days to draft a report that would — for the first time — reveal key details about overdoses caused by fake pills sold in Mexican drug stores.
Sen. Jack Reed, a Rhode Island Democrat, added the relevant language to a U.S. Senate report that directs agencies on how to spend money appropriated in the legislation for State Department operations and foreign relations.
The appropriations bill itself would allocate $125 million to fund efforts to stop global trafficking of synthetic drugs including fentanyl “through diplomatic engagement, law enforcement cooperation and capacity building,” according to a committee summary.
It would also require the State Department to appoint a “Counter Fentanyl Coordinator.” The bill has passed out of committee but has yet to be taken up by the full Senate.
The bill and report were rolled out in July, one month after a Los Angeles Times investigation demonstrated how widespread the problem of pharmacies selling tainted counterfeit pills is in Mexico. Times reporters tested dozens of pills purchased in pharmacies across the country and found that more than half were fakes containing powerful narcotics including fentanyl and methamphetamine.
Shortly after a Times report in February showed that tainted, counterfeit pills were common at pharmacies in three cities in Baja California and Baja California Sur, the State Department issued an extensive travel warning. In the months since that initial Times report, authorities in Mexico have audited, raided or shut down more than 150 drug stores across the country.
Reed said he first learned of the problem earlier this year from Celia and Terry Harms, a Rhode Island couple who shared their story in a Times report in April. The Harms’ 29-year-old son Jonathan died in 2017 after taking a counterfeit pill he bought at a pharmacy in Cancún. The store passed off tablets made of illicit fentanyl as the legitimate painkillers Jonathan needed to treat his severe migraines.
Pharmacies south of the border have long been known for selling a wide range of medications over the counter, including many that would require a prescription in the U.S. Until early this year, experts had generally believed those pills were what store owners said they were.
But the Times’ reporting has called that assumption into question, finding that roughly a third of the opioid painkillers reporters tested were positive for fentanyl and 80% of the Adderall they tested was positive for either methamphetamine or, in one case, MDMA, the party drug commonly known as ecstasy.
The U.S. Drug Enforcement Administration and the State Department have known about the problem since at least 2019, when a Ventura County couple informed them of their own 29-year-old son’s death after he took a fentanyl-tainted pill purchased at a Cabo San Lucas pharmacy. But for years, neither agency warned the public about the deadly risks.
“I included language in the Senate’s version of the State, Foreign Operations, and Related Agencies Appropriations bill,” Reed, a majority member of the Senate’s powerful Appropriations Committee, said via email. “It would ensure the Secretary of State provides Congress a report on the scope of the problem posed by counterfeit prescription medications and potential solutions.”
Reed included the language in a dedicated subsection of the Senate report accompanying the bill, which appropriates the money that funds the activities of the State Department among other priorities. The Senate report will effectively carry the weight of law if the bill is enacted.
Within 90 days of that, Blinken will have to send a report to the Senate’s Appropriations Committee. The document must include three things: Information about all overdoses and overdose deaths of U.S. citizens from counterfeit prescription pills bought in Mexico in the last seven years that the State Department is aware of; an evaluation of how involved drug cartels are in the distribution of those counterfeit medications; and “recommendations on how American citizens can stay safe from the threat of counterfeit prescription medication while traveling abroad.”
Drug market experts say cartels are probably the source of the pills, though it’s not always clear whether pharmacy workers know when they’re selling fakes.
Regardless, Reed said, the proposal will help keep travelers safe.
“We need to do everything we can to keep Americans traveling abroad informed and aware of threats like this, including health alerts,” he said. “Hopefully this reporting requirement will raise awareness and warn others.”
The Senate report also includes separate language calling on the State Department to work with authorities in Mexico and other countries “to improve detection of synthetic drugs and precursor chemicals, including counterfeit pills in local pharmaceutical supply chains, and to address the growing presence of criminal networks.”
Addiction experts, including UCLA researcher Chelsea Shover, welcomed the possibility of more data on the number of overdoses, even while raising questions about how well those figures have been tracked.
“Having this data would be a major step to understand the scope of this problem,” said Shover, who co-authored a paper this year documenting the problem based on testing from four cities in northern Mexico.
“I don’t think it’s going to be possible to get a really accurate number,” she added, “but a better sense would be helpful because quantifying a problem is one step toward addressing it.”
But for the Harms family and others who have lost loved ones to this deadly phenomenon, the proposed changes come several years too late. Still, Celia Harms says she is “overwhelmed with gratitude” for Reed and his efforts to address the problem.
“The L.A. Times articles I sent [Reed] and our story about Jonny definitely shaped funding these legislative efforts,” she said, adding that she “can hardly contain my hope for meaningful change. I know there’s a long way to go — passing the Senate and the House — but hopefully fentanyl is a bipartisan issue.”