5 Facts Young People Should Know About Fentanyl and Counterfeit Pills
The illegal drug supply has changed, and that has created new risks for young people.
One of the biggest concerns is illegally made fentanyl, a powerful synthetic opioid that can be mixed into other drugs or pressed into counterfeit pills. These pills may be made to look like legitimate prescription medications, which means someone may take fentanyl without realizing it is there.
Understanding the facts about fentanyl and counterfeit pills can help young people recognize the risks and make more informed decisions.
Here are five facts young people should know.
1. Fentanyl Is Extremely Powerful
Fentanyl is a synthetic opioid. Pharmaceutical fentanyl is legitimately prescribed by doctors to treat severe pain, but illegally made fentanyl has become a major contributor to overdose deaths in the United States.
According to the CDC, fentanyl can be up to 50 times stronger than heroin and 100 times stronger than morphine.
Because fentanyl is so potent, even a small amount can cause an overdose. Illegally made fentanyl is especially dangerous because a person may not know that it has been added to another drug.
Source: CDC — Fentanyl Facts
2. Fentanyl Is Involved in Most Youth Overdose Deaths
The impact of fentanyl on young people has been significant.
According to the CDC, from 2020 through 2024, 75% of overdose deaths among young people ages 10–19 involved fentanyl.
Fentanyl may be present in counterfeit pills or mixed with other substances without the person taking them knowing.
This means someone doesn’t necessarily have to be intentionally seeking fentanyl to be exposed to it.
Source: CDC — National Fentanyl Awareness Day Toolkit, 2026
3. Counterfeit Pills Can Look Like Real Medication
One of the biggest dangers of counterfeit pills is that appearance alone cannot tell you what’s inside.
Illegally manufactured pills can be made to resemble legitimate prescription medications. The CDC reports that illegally made fentanyl is increasingly pressed into counterfeit pills that commonly resemble medications such as oxycodone or alprazolam (Xanax).
Counterfeit pills may also contain other unexpected substances.
A pill obtained outside a licensed pharmacy may look like legitimate medication, but there is no reliable way to know its contents simply by looking at it.
4. 5 Out of 10 Fake Pills Tested Can Be Potentially Deadly
Counterfeit pills don’t contain a consistent amount of fentanyl. One pill may contain little or no fentanyl, while another may contain enough to cause a fatal overdose.
According to DEA laboratory testing, 5 out of every 10 counterfeit pills tested that contained fentanyl had at least 2 milligrams of fentanyl, an amount the DEA identifies as a potentially lethal dose.
The amount that can cause an overdose varies depending on factors including a person’s body size, tolerance, previous use, and other circumstances.
This unpredictability is part of what makes counterfeit pills so dangerous.
Source: U.S. Drug Enforcement Administration
5. Counterfeit Pills Are Showing Up in Youth Overdose Deaths
Counterfeit pills aren’t only a theoretical risk.
A CDC analysis of overdose deaths among young people ages 10–19 found evidence of counterfeit pills in 24.5% of the deaths studied—nearly 1 in 4.
The same study found that approximately 84% of adolescent overdose deaths involved illegally manufactured fentanyl.
The CDC noted that the prevalence of counterfeit pills may even have been underestimated because pills found at overdose scenes were not always tested.
Source: CDC Morbidity and Mortality Weekly Report
Why This Matters
A pill’s appearance doesn’t tell you what’s actually inside it.
Counterfeit pills can closely resemble legitimate prescription medications while containing illegally made fentanyl or other unexpected substances. Fentanyl itself cannot reliably be detected by sight, smell, or taste.
For young people, understanding that risk is especially important. Someone may believe they know what they are taking when the actual contents are very different.
Learning the facts isn’t about creating fear or judging someone who uses substances. It’s about making sure young people have accurate information about today’s drug supply.
Outreach’s Commitment to Young People
At Outreach, we understand that adolescents, young adults, and their families may have difficult questions about substance use.
Our goal is to provide compassionate, evidence-based support that meets young people where they are.
Our services include:
- Substance use treatment
- Mental health services
- Individual and group counseling
- Family involvement and support
- Recovery support programs
- Specialized services for adolescents and young adults
Whether someone is beginning to question their substance use or is already experiencing challenges, support is available.
Explore Outreach Services
Fentanyl and counterfeit pills have changed the risks associated with today’s illegal drug supply, but education, support, and treatment can make a difference.
If you or someone you care about is struggling with substance use, you don’t have to wait for things to get worse before asking for help.
Visit opiny.org to learn more about Outreach’s substance use treatment and recovery services for adolescents, young adults, and families.