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Tracie Hunte: It's The Takeaway. I'm Tracie Hunte, in for Melissa Harris-Perry.

The rate of drug overdoses continues to rise in the US, in part due to the increasing presence of fentanyl in street drugs like heroin and cocaine. There's a new supply stream of contaminated drugs, certain pharmacies in northwestern Mexican cities, that specifically cater to American tourists looking for prescription drugs.

A recent investigation by the LA Times found that some of these pharmacies are selling counterfeit prescription drugs that are laced with fentanyl and methamphetamine. 71% of the pills they tested, it came up positive for these drugs. In some towns, it's an open secret. Keri Blakinger, an LA Times staff writer who worked on the piece, spoke with Janae Pierre for The Takeaway.

Keri Blakinger: The first pharmacy that we visited, the person behind the counter was warning us about some of the other places. We asked for some of the things that would've required a prescription, but we were able to get them over the counter. That's part of the whole issue with our reporting, that these are things that people are getting over the counter and might not suspect there's anything wrong with them, because a legitimate pharmacy is giving them out.

In this case, we ended up getting some oxycodone. None of it tested positive for fentanyl. However, when we got them, the person behind the counter warned us, "Hey, this one's an American one, and this one's fine. This one is a Mexican one, and this is a lot stronger," then also warned us that some of the other places were selling things that might have fentanyl in them.

Janae Pierre: How many pharmacies did you visit, and where?

Keri Blakinger: There were about half a dozen that would sell us single pills without a prescription. We tested 17 pills from those pharmacies. These were all from cities in Northwestern Mexico. We went to Tijuana and Cabo, San Jose Del Cabo. There was also a team of researchers that, around the same time, had been doing some of this similar testing. They did not specify what cities they did their testing in, but said that it was also in northwestern Mexico.

They used both the testing strips that we used, and they also used an FTIR machine, to be able to tell, at a more granular level, what all was in these pills. They made very similar findings. They found Adderall that was actually meth, and they found oxycodone, that was actually fentanyl. They also found one oxycodone that was fentanyl and heroin.

Janae Pierre: Just so we're clear, what is it that people are trying to buy when they end up getting pills that are laced with fentanyl?

Keri Blakinger: Yes, this is the really concerning thing, is that these pills are often oxycodone, sometimes even the lower doses of oxycodone, like Percocet. In one case, there was a Vicodin, there was also some of the Adderall, that was actually meth. One of the red flags is that these are pills that were being sold individually, over the counter. In these cases, these are all things that require a prescription. I think there's a belief that things in Mexico don't require a prescription, and many don't, but in theory, oxycodone should.

Oxycodone is actually more tightly controlled in Mexico than it has been in the US. Getting that, a bottle of it, as a legitimate prescription, would typically be difficult in Mexico. If you are buying a single oxycodone over the counter in Mexico, it may be legitimate, but that is a red flag, and you should be suspicious.

Janae Pierre: Yes, I want to talk about that a bit more. How are pharmacies getting these counterfeit pills? Does it have anything to do with the cartels?

Keri Blakinger: Presumably, yes. We obviously did not actually ask the pharmacy workers, "Are you getting these from a cartel?" They might not know, honestly. They might just know it's coming from something that's not their normal supplier. They might think it's legitimate oxycodone that was diverted from proper pharmaceutical supplies. We did interview experts who explained why the cartels would have a motivation to do this. It really comes down to the economics of it, that fentanyl is cheap to make.

It's relatively easy to synthesize, unlike heroin, for instance, it does not require a field of poppies, because it's synthetic. It just requires the proper precursor chemicals. It's easier to make fentanyl, just buy a pill press, and make your own pills, than to try to synthesize your own oxycodone or divert legitimate supplies. If they want to expand their markets, they would go from having pills that are available on the street, that are actually fentanyl but made to look like oxycodone, and instead be selling them in pharmacies.

That can open up a broader market of people who don't feel safe buying drugs on the street, of medical tourists who are there thinking that this is just a way to get discount prescriptions.

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Tracie Hunte: We're going to pause for a moment, but there's more on fentanyl laced prescription drugs coming from Mexican pharmacies, right after this.

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Okay, we're back. Janae Pierre is speaking with Keri Blakinger about her LA Times investigation into pharmacies in Mexico, that are distributing counterfeit prescription drugs that are laced with fentanyl.

Janae Pierre: We know that even a little fentanyl can be deadly, especially to unsuspecting users. What do we know about what happens to the people who take these pills?

Keri Blakinger: Very little. Mexican mortality data has undercounted overdoses for some time, and although it is true that Mexico has historically been a lower opioid-using country than the US, those numbers still seem extremely low. Given the extent to which the mortality data undercounts overdoses, we don't really know if this has caused any noticeable uptick in deaths. It's not really clear how broadly this is happening across the country, and whether it would be enough to actually have a sizable increase in deaths.

When you're talking about things like non-fatal overdoses, those aren't really meaningfully tracked at all, unless emergency services were called.

Janae Pierre: What are US and Mexican government agencies doing about this?

Keri Blakinger: I would say that's also unclear at this time. I don't think we got any responses from Mexico before our first story, although we have gotten in touch with some officials since then. When it comes to US officials, we didn't get much at all. We did get some comments from elected officials, there's been some senators and congresspeople who have been calling for investigations, or wanting to explore what new laws could be passed, but we haven't gotten anything meaningful from the White House, the State Department, or the DEA.

Janae Pierre: What does it mean for the fentanyl and opioid crisis that these drugs are no longer just on the streets, but now in pharmacy supply chains?

Keri Blakinger: I think that it could represent a shift and a new wave of this ongoing problem. I do want to emphasize this is not to say that all Mexican pharmacies are suspect. If you are going to a big chain to buy something with a legitimate prescription, or you are buying some other drug that is not a narcotic. We don't currently have any reason to believe that those supplies are unsafe.

What we specifically found was drugs that should have required a prescription, but were being sold over the counter, or being sold individually, and from small, independent pharmacies. They were definitely stores that were pharmacies, but they were not the big chains.

Janae Pierre: Keri, what's next for your investigations on this?

Keri Blakinger: Right now, we are really trying to find more people who were impacted by this. We would love to hear from people who have gone to Mexico, bought pills in a situation like what I've described, and had some adverse reaction, or maybe even know someone who overdosed, whether it was fatal or non-fatal. If anyone would like to reach out, you can find me pretty easily on Twitter, keribla, or you can email me at keri.blakinger@latimes.com

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Tracie Hunte: That was Janae Pierre talking with Keri Blakinger, from the LA Times. This is The Takeaway.

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