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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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