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That pretense faded seconds later, when she was asked for controlled medications — and got on her hands and knees to pop open a hidden panel under the counter. She rooted around for a minute and emerged with two sealed bottles. In pharmacy after pharmacy in this Mexican resort city, workers offered similar assurances, but time and again the pills proved to be fakes. There were oxycodone pills that tested positive for heroin and over-the-counter cough medicine, and Vicodin tablets that turned out to be fentanyl. Pills sold as Adderall were sometimes methamphetamine or caffeine, and sometimes simply an appetite suppressant. Others denied ever selling medications they had in fact sold just minutes or hours earlier. Last month, reporters visited dozens of drugstores in Mexico to interview pharmacy workers and piece together a fuller picture of the counterfeit medication problem The Times has been investigating for nearly a year. Despite pharmacy raids by Mexican authorities and a warning from the U. State Department, the latest round of testing found that fake medications appear even more plentiful at independent drugstores and regional chains in tourist hot spots and border towns now than earlier this year. Some of the counterfeits are now more sophisticated, and lab testing found a wider array of substances in them than previously documented. And the latest reporting in Puerto Vallarta and Cabo San Lucas found that workers at small chains and individual pharmacies alike often went to great lengths to convince potential customers of the safety and efficacy of their counterfeit wares. The Times is not naming independent pharmacies or workers due to safety concerns, including the threat of violence. After visiting 10 vacation spots and border towns across Mexico this year, reporters used drug-testing strips and later lab testingto show that travelers who shop at pharmacies there risk unwittingly buying pills tainted with powerful drugs, including fentanyl, heroin, meth and MDMA — also known as ecstasy. In February, The Times reported that some drugstores in Tijuana and the Los Cabos area were selling loose pills over the counter, passing off tablets containing fentanyl and meth as expensive brand-name medications, including Percocet and Adderall. A team of UCLA researchers, including Goodman-Meza, reported similar findings in four unnamed cities in northwestern Mexico around the same time. But U. Later, reporters showed that several stores and at least a few regional chains had begun selling tainted medications by the bottle, in elaborate packaging that was sometimes indistinguishable from the real thing. A few medications were consistently legitimate, including the opioid painkiller tramadol and the ADHD pill methylphenidate, best known as Ritalin. But some medications were almost always counterfeit. Testing showed that 9 in 10 pills sold as Adderall, six in 10 pills sold as oxycodone, and 7 in 10 pills sold as hydrocodone were fake. Overall, 26 samples contained methamphetamine and 29 contained fentanyl. In March, authorities in Mexico inspected more than pharmacies in Los Cabos and nearby La Paz, closing nine in Los Cabos for a variety of violations. In June, another series of pharmacy raids in Los Cabos resulted in four arrests and the seizure of cash and nearly 25, pills. But less than 24 hours earlier, the same store had sold three loose pills — purported to be Percocet, Vicodin and Adderall — and one bottle labeled as Adderall. Laboratory testing showed both painkillers were fentanyl, the tablet sold as Adderall was methamphetamine, and the bottle of supposed Adderall contained capsules of an appetite suppressant called clobenzorex. Finally, authorities shut down 31 pharmacies and seized more than 4, boxes of medication during recent raids in Ensenada, where officials said some of the pills probably contained fentanyl. At a Puerto Vallarta pharmacy near bustling Playa de los Muertos last month, a clerk said she had no controlled substances for sale before offering a warning. Others said they stopped offering controlled medications immediately after the sweeps, but soon resumed sales. The Times could not independently verify their claims, and officials did not respond to requests for comment. There were no opioid painkillers in stock, but reporters bought a bottle of supposed Adderall. Aside from the glut of willing sellers and suppliers, another roadblock to reining in the sale of counterfeit pills in Mexico is the constant demand — often from Americans looking for medications that may be cheaper or easier to get than in the U. He had recently been prescribed Adderall in the U. Shopping for narcotic medications in pharmacies in Mexico often means listening to workers explain that bottles stashed in hidden compartments and loose pills kept in unlabeled plastic bags contain legitimate medications. But the painkillers purchased from that pharmacy tested positive for fentanyl, and the supposed ADHD medications were made of methamphetamine. At a Puerto Vallarta outpost of a drugstore chain that sold reporters fake medications, Ed Sheeran was crooning through tinny speakers about having faith in what he sees. The clerk claimed the pharmacy did not stock counterfeit pills. On two separate trips to Puerto Vallarta, reporters visited several stores in that same regional chain, and repeatedly purchased pills sold as Adderall that tested positive for methamphetamine. Another was a bottle that a young worker pulled from a locked hiding spot. In addition to concealing illicit wares and offering empty assurances about safety, pharmacy workers seemed choosy about their customers. Several residents said the stores would sell narcotic medications over the counter only to foreign tourists. At one drugstore, when a reporter started speaking Spanish, the clerk grew suspicious. At a Puerto Vallarta location of the prominent national chain Farmacias Similares, a worker said only customers with prescriptions could buy controlled medications. Other pharmacies, she said, would sell them without a prescription — depending on who you are. Only to foreigners. Organized crime experts say that Mexican drug cartels are almost certainly involved in making the sophisticated counterfeit medications. But it is unclear exactly how the pills end up on pharmacy shelves or in hidden compartments behind the counter. Workers at other stores suggested their pills came from California, but also could not name a supplier. Most did not respond to repeated messages inquiring about the counterfeit goods or the suppliers who provided them. One worker who did respond said he knew the Cabo pharmacy where he worked did not sell opioid painkillers because he was one of only two people who worked there. When a reporter explained that the store had sold fentanyl-tainted pills weeks earlier, his tone shifted. Instead of denial, some responded with fear. Watch L. Times Today at 7 p. Before joining the Los Angeles Times in , she spent nearly seven years in Texas, first covering criminal justice for the Houston Chronicle and then covering prisons for the Marshall Project. Previously, she wrote narrative pieces with a strong emphasis on the Latino community and others that make up the diversity of L. She joined The Times in Connor Sheets is an investigative and enterprise reporter at the Los Angeles Times. De Los. Times Everywhere. For Subscribers. All Sections. About Us. B2B Publishing. Hot Property. Times Events. Times Store. Special Supplements. Share via Close extra sharing options. Many pharmacies in Puerto Vallarta and other tourist-friendly parts of Mexico continue to sell fake medications to unsuspecting foreigners. Reporters visited 10 vacation spots and border towns across Mexico this year and bought controlled prescription medications from pharmacies. Tests showed many pills were tainted with powerful drugs including fentanyl, heroin, meth and MDMA. Many pills purchased by reporters in Mexico this year were lab-tested to confirm the initial findings from testing strips. A pharmacy in Cabo San Lucas advertises its wares to English-speaking visitors. Many also sell controlled medications — or counterfeit versions of them — upon request. In Puerto Vallarta, several pharmacies were raided by Mexican authorities in recent months, drugstore employees say. Officials would not elaborate on or confirm their accounts. A Mexican pharmacy offers a wide array of powerful medications over the counter. Earlier in , drugstores in Mexico tended to sell counterfeits of controlled medications as loose pills — but the fakes are increasingly sold by the bottle in convincing packaging. VIDEO More to Read. Chinese chemical manufacturer is targeted by federal prosecutors trying to stop flow of fentanyl. Old newspaper boxes are being used to distribute the overdose reversal drug naxolone. An industrial chemical is showing up in fentanyl in the U. Keri Blakinger. Brittny Mejia. Connor Sheets. More From the Los Angeles Times. California Navy identifies two aviators killed in crash near Mt. Rainier as California natives. Defense chief promises Ukraine what it needs to fight Russia but goes no further.

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Some of the pills looked just like antibiotics. Others were unlabeled white tablets. Several mimicked well-known American pills, and a few came in sealed bottles. Earlier this year, The Times found that pharmacies in several northwestern Mexico cities were selling counterfeit pills over the counter, passing off powerful methamphetamine as Adderall and deadly fentanyl as Percocet and other opioid painkillers. But four more months of investigation showed the problem is much broader than previously understood. During five trips to Mexico, Times reporters purchased and tested 55 pills from 29 pharmacies in eight cities. More than a third of the opioid painkillers tested — 15 out of 40 — were counterfeit, the vast majority positive for fentanyl. One tested positive for a weaker medication and another tested positive for no drugs at all. Meanwhile, 12 of 15 Adderall samples tested positive for other substances, including methamphetamine and, in one case, MDMA, the designer drug commonly known as ecstasy. Others were purchased in Tijuana and Nuevo Progreso, border towns with booming medical and pharmaceutical tourism sectors. In most of those locations, the pills that tested positive came from independent pharmacies, where workers sold them over the counter, one tablet at a time. But in Puerto Vallarta, counterfeits were available even at one regional pharmacy chain — the sort of place where people might expect more quality control. Both there and in Nuevo Progreso, pills purchased in sealed bottles tested positive for more powerful drugs, a possible sign of the sophistication of fakes made by cartels, which experts say are likely the source. It is unclear how high the death toll might actually be. Times reporting confirmed that at least half a dozen Americans have overdosed or died after taking counterfeit pills purchased from pharmacies. An alert by the U. March 18, Now, given the new testing that shows how common tainted pills are in stores throughout the country, some drug-market experts worry the problem could have a far broader reach, to include tourists from outside of the Americas. Mexican government officials have ignored repeated requests for comment, except for one federal prosecutor who said this month that her office would comment only if reporters revealed the names and locations of the pharmacies they visited. The U. Drug Enforcement Administration has known about the problem since at least When asked whether she was aware of reporting about Mexican pharmacies selling fentanyl- and methamphetamine-tainted pills, she left without responding. Later, she offered comment through a spokeswoman via email, without addressing the specific questions posed. We are continuing our enforcement and education efforts on this important issue to save lives. On a late spring day in Puerto Vallarta, tourists carrying Starbucks cups and cans of Michelob Ultra strolled along the bougainvillea-lined avenues of the bustling Zona Romantica. But in between its bars and boutiques are dozens of drugstores, many willing to sell powerful medications over the counter. Mexico has long been a mecca for Americans seeking easier and cheaper access to medications that require a prescription in the U. In theory, oxycodone and amphetamines are much more tightly controlled. Between the time U. April 10, And yet, in the cities reporters visited, finding stores that would sell them without a prescription proved easy. Sometimes, reporters compiled a list of potential pharmacies to visit by scouring Reddit, following emailed tips or browsing online pharmacy reviews. Other times, the starting point was a Google Maps search for nearby pharmacies. To buy pills for testing, reporters walked into drugstores in tourist areas and asked — usually in English — for Adderall and either Percocet or oxycodone. In some cases, pharmacy employees said to come back after the daily delivery came in, or they made a quick call to have tablets brought over from off-site. Afterward, reporters ground up a portion of each pill and used test strips to determine whether they contained fentanyl or methamphetamine, following a protocol recommended by UCLA researchers who conducted their own testing earlier this year. Samples of about one-third of the medications were later tested at a laboratory with a mass spectrometer, which helped confirm initial results and identify other adulterants — including MDMA and caffeine. The results expand on findings released earlier this year by the UCLA research team, which used an infrared spectrometer to show that 20 out of 45 pills purchased in four northwestern Mexico cities were counterfeits containing fentanyl, methamphetamine or heroin. Since then, reporters have worked to answer some of those questions, first by uncovering evidence of multiple overdoses and several deaths, and now by showing the problem is far more widespread than was previously known. Though The Times found counterfeits in each of the eight cities where they did testing, there were major variations when it came to availability, cost and the odds of a given pill being fake. Farther south, in the upscale resort cities of the Riviera Maya, fewer pharmacies would sell powerful narcotics without a prescription. Pills sold as Adderall proved consistently unreliable across the country, but the odds of a tablet sold by a pharmacy as oxycodone or hydrocodone being a dangerous fake varied from city to city. Each of the several opioids reporters tested in Cabo San Lucas came up positive for fentanyl; none did in Puerto Vallarta. In Puerto Vallarta, one sample of hydrocodone — commonly known by the brand name Vicodin — turned out to be a weaker medication instead. In , the family of a man killed by a fentanyl pill from a Mexican pharmacy called on U. Dianne Feinstein and then-Sen. Kamala Harris to act. Little has been done in the intervening years. April 21, UCLA researchers earlier this year purchased one sample of supposed oxycodone that turned out to be heroin, also from a drugstore in an unnamed city along the western coast. That was partly because some stores there appeared to be getting legitimate pills from nearby Guatemala and reselling them. Several pharmacies offered purple oxycodone in blister packs bearing the name of a Guatemalan drugmaker, along with a Guatemalan drug register number. None of the blister packs reporters purchased in any city tested positive for other drugs. But in Nuevo Progreso, a sealed bottle of Percocet tested positive for fentanyl. Even more troubling, in Puerto Vallarta every sealed bottle of medication reporters purchased — including four bottles of supposed Adderall and one of supposed hydrocodone — was counterfeit, testing positive for methamphetamine and tramadol, respectively. Usually, there were obvious red flags: Several had typos in their labels, and a few were entirely in English with complete American National Drug Code, or NDC, numbers. To Felbab-Brown, the Brookings Institution cartel expert, the sophistication and prevalence of counterfeit drugs at pharmacies is reminiscent of the way Mexican criminal organizations infiltrated the fishing industry a few years ago. But because the problem is not limited to that region, it could affect a different population of visitors. Connor Sheets is an investigative and enterprise reporter at the Los Angeles Times. Before joining the Los Angeles Times in , she spent nearly seven years in Texas, first covering criminal justice for the Houston Chronicle and then covering prisons for the Marshall Project. De Los. Times Everywhere. For Subscribers. All Sections. About Us. B2B Publishing. Hot Property. Times Events. Times Store. Special Supplements. In Puerto Vallarta, every Adderall pill Times reporters purchased from pharmacies and tested was a counterfeit containing methamphetamine. By Connor Sheets and Keri Blakinger. Share via Close extra sharing options. And at least half of them were fakes. Medications are lined up on wide shelves in a pharmacy in Puerto Vallarta. Playa del Carmen is best known for its beaches, nightlife and entertainment, but Times reporters found that some of its pharmacies are passing off dangerous substances, including fentanyl and methamphetamine, as legitimate medications. California U. A nighttime scene of a city nestled among small hills. A combination pharmacy, souvenir shop and beach supply store peddles its wares in Playa del Carmen. Times reporters learned that some pharmacies in Puerto Vallarta sell bottles of fake Adderall containing methamphetamine. California Harris, Feinstein told in of American killed by fentanyl pills from Mexican pharmacy. Playa del Carmen is one of several beachfront destinations across Mexico where some pharmacies sell tainted, counterfeit medications to tourists. More to Read. Chinese chemical manufacturer is targeted by federal prosecutors trying to stop flow of fentanyl. Old newspaper boxes are being used to distribute the overdose reversal drug naxolone. An industrial chemical is showing up in fentanyl in the U. Connor Sheets. Keri Blakinger. More From the Los Angeles Times. California Navy identifies two aviators killed in crash near Mt. Rainier as California natives. Defense chief promises Ukraine what it needs to fight Russia but goes no further.

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