Fentanyl and Speed found in medications

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    In this video, Dr. Seheult of MedCram discusses fentanyl overdoses. This is noted to be becoming much more common. Dr. Seheult describes a patient that did not take illicit drugs but did take chronic pain medications. His family were trying to get a hold of him and weren’t able to so. After 3 days, they went over to his home and found him still alive but on the ground and unconscious. He presented to the ER with severe hypernatremia (high sodium levels), a severely elevated thyroid level T3 with a suppressed TSH, he was in kidney failure and had a significant metabolic acidosis. After he was resuscitated and was able to speak, he disclosed that he had started taking medications from a friend at the gym that would help him lose weight. The urine drug screen found methamphetamines and fentanyl. Dr. Seheult suspected thyroid hormone was also present to help him lose weight. This leads to a bigger issue that you just don’t know what is in some medications unless they have been third party tested.

    Why is fentanyl being found in drugs?

    As many already know, there is an epidemic of fatal fentanyl overdoses.  Fentanyl is a synthetic opioid that is 200 times more potent than morphine so even small doses can lead to overdose. It has a profound effect on the respiratory drive and the consciousness of a patient. It is very easy to overdose on. There has been a dramatic increase in this over the past five years. One cause for this is that there has been a significant rise in counterfeit medication usage particularly in Mexico. The U.S. Embassy issued a statement to exercise caution when purchasing medications in Mexico due to the fact that pharmaceuticals both over the counter and those requiring prescription in the U.S. are often readily available for purchase with little regulation and counterfeit medication is common and may prove to be ineffective, the wrong strength, or contain dangerous ingredients.  They believe there are organized efforts to make counterfeit medications which are able to be made for a lot cheaper and sold at a much higher price.

    What can fentanyl do?

    The two types of medications that are being counterfeited the most are Adderall  and pain medications. Pain medications such as Percocet and Norco can be synthesized for much cheaper and with less regulation with a synthetic drug such as fentanyl.  Fentanyl would give similar analgesic effects; however, fentanyl is extremely potent and any production calculation that is off can be fatal. If there is too much it will cause a suppression of your respirations which can lead to a metabolic acidosis and eventually cardiopulmonary arrest and death.

    Why is methamphetamine being found in drugs?

    Adderall which is a stimulant can be counterfeited with methamphetamines.

    How common are counterfeit drugs?

    There was an article in the LA Times in 2023 that found from visiting 29 pharmacies in Mexico in 8 different cities that found in 40 opioid medications, 15 of them (37%) were counterfeit and had fentanyl and one had no medication in it. From the 15 Adderall samples, 12 were found to contain methamphetamines and ecstasy. In Puerto Vallarta, they found the pills came from a regional pharmacy chain.  

    The U.S. Embassy in Mexico stated that the Drug Enforcement Administration reported that counterfeit prescription pills are sold by criminals on both sides of the border. They are readily advertised on social media and can be purchased at small, non-chain pharmacies in Mexico along the border and in tourist areas.  It is important to be cautious and only purchase medications from reputable sources. 


    LINKS / REFERENCES: Provisional Drug Overdose Death Counts (CDC) | https://www.cdc.gov/nchs/nvss/vsrr/dr… 

    Fentanyl-tainted pills now found in Mexican pharmacies from coast to coast (LA Times) | https://www.latimes.com/world-nation/… 

    HEALTH ALERT: COUNTERFEIT PHARMACEUTICALS (U.S. Embassy) | https://mx.usembassy.gov/health-alert… 

    Fentanyl drives state, regional and local overdose crisis (SMDP) | https://smdp.com/2022/09/17/fentanyl-…

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