(Des Moines Register / Charly Haley)
Four Iowa health and public safety agencies issued a warning Monday about counterfeit pain pills recently found in Iowa.
The fake pain pills have been confirmed by the Iowa Division of Criminal Investigation in un unspecified number of cases. These pills were made to resemble the prescription pain reliever oxycodone, but they were found to contain the more powerful and illicit synthetic opioids fentanyl and U-47700, which is also known as "U4" or "pink."
The warning issued Monday by Iowa's Department of Public Health, Department of Public Safety, Poison Control Center and Office of Drug Control Policy said:
"Counterfeit pills like those found in Iowa that are not prescribed or dispensed by health care professionals may contain deadly amounts of fentanyl or other synthetic opioids...Because some illicit synthetic opioids can be highly lethal when touched or inhaled, Iowans are cautioned against handling or using prescription medicine, or anything resembling prescription medicine, if it's not issued by an authorized health care provider."
These illicit synthetic opioids are usually found in powder form, often mixed with heroin. It's new to see these synthetic opioids in pill form, disguised as prescribed medicine, said Steve Lukan, director of the Governor's Office of Drug Control Policy. Reports of counterfeit pain pills containing these potent drugs began surfacing in other parts of the U.S. last year.
People who are already addicted to prescription medications could be particularly vulnerable to these fake pain pills because once their prescribed medicine runs out, they may turn to other sources for the drug, such as street dealers, Lukan said.
"The big concern right now is obviously that these are drugs being sold on the street," he said. Though it may look the same as a prescription pill, "they don't know what they're getting into when they're dealing with this.
"Even though it says oxycodone, that doesn't make it safe," he said.
People have died in Iowa after overdosing on fake pain pills, Lukan said, but he declined to provide specific information on how many deaths have been caused by the drugs. Lukan also declined to say how many cases of these fake pain pills have been confirmed by state investigators, and he declined to say whether the cases are concentrated in a specific part of Iowa.
State drug investigators don't know how prevalent these fake pain pills are in Iowa, and if they're in one area of the state, they could be elsewhere, said Paul Feddersen, assistant director of the Iowa Division of Narcotics Enforcement.
"Who knows how much of it is out there?," he said. Feddersen also declined to offer specific information about the confirmed cases, which remain under investigation.
The state issued its warning on Monday because the presence of fake prescription pills is new to Iowa, and "it's only going to increase," Feddersen said. The problem is prevalent in other states, he added.
The drugs' presence in Iowa remains under investigation, officials said.
Investigators have not pinpointed the origin of these drugs coming into Iowa, but in other parts of the U.S., it appears the drugs are being manufactured overseas, Lukan said.
Fentanyl and its derivatives were first found in Iowa about two years ago, and their presence, along with associated overdoses, has increased rapidly, according to the state agencies' Monday statement.
Opioid overdose was the primary cause of death for 67 people in Iowa last year. Ten of those deaths were attributed to heroin, while the rest were prescription pills or other opioids, according to data from the Iowa Department of Public Health.
Ten years earlier, in 2006, opioid overdose caused 43 deaths in Iowa, with two of those being from heroin.
Despite state agencies' warning Monday, the Des Moines Police Department, Iowa's largest police department, said it has not seen a recent increase in reports of synthetic opioids.
"True opioids continue to be a significant concern. We have not experienced a rise in reports of synthetic, or fake, opioids," said Sgt. Paul Parizek, department spokesman.
"Our advice to anyone who is taking the risk of using illicit or illegal narcotics is: Don't. The risks involved are too great," he said.
The Ames Police Department, which issued warnings about the synthetic opioid U4 earlier this year, hasn't seen the drug in pill form, said Cmdr. Geoff Huff, department spokesman. But Huff said Ames officers are aware of fake prescription pills, and he expects they could appear in Ames if they've been found in other parts of Iowa.
"The important thing is that people understand that this is not coming from a pharmacy. You're going to end up with something deadly," Huff said. "They're made to look like a regular prescription pill, but you don't know what you're putting in your body."
Monday's warning about the counterfeit prescription pills "also applies to law enforcement officers and first responders who may come in contact with counterfeit drugs," the state agencies' statement said.
"Iowans are urged to talk with children about safe use of medicines, and report suspicious activity to local law enforcement," the statement said.
Lukan encouraged parents to talk to their teenage children who may be at risk for experimenting with drugs, and he said families must intervene if their loved one appears to be addicted to painkillers or other opioids.
"It could become normalized in someone's household," which is dangerous, he said.
The Iowa Poison Control Center advises hospital and emergency medical service personnel to treat a synthetic opioid overdose the same as that of any other opioid overdose: maintain airway and ventilation; and know that larger than normal doses of the opioid antidote naloxone (3 to 4 milligrams or more) may be needed to reverse the respiratory depressant effects of fentanyl, fentanyl derivatives and U-47700.
All Iowans with questions about synthetic opioids can contact the Iowa Poison Control Center at 800-222-1222 or iowapoison.org.
More information can also be found at drugfreeiowa.org.