teen sits on floor by bed with bottle of pills closeby

Rise of counterfeit pills containing fentanyl pose deadly risk to adolescents.

KEY TAKEAWAYS

  • One pill can kill because counterfeit medications may contain fentanyl. 

  • Teens often underestimate fentanyl risks, highlighting the need for better education and awareness. 

  • Parents can be prepared by recognizing overdose signs, keeping naloxone on hand, and maintaining open communication with their children. 

More than half of American eighth-graders think trying fentanyl once or twice is no big deal. 

That statistic, from a recently released study, is sure to frighten many parents, knowing just one exposure to the highly potent synthetic opioid could prove fatal. A smaller but still concerning number of older teens also appear to be undaunted, highlighting the need for more education among adolescents about the drug and its lethality. 

WHY IS FENTANYL SO DANGEROUS? 

Fentanyl, created by pharmaceutical companies under strict government regulation, is commonly used by physicians to treat severe pain. While it is still extremely potent — 50 to 100 times more than morphine — fentanyl is typically harmless when administered in a hospital setting. According to the Centers for Disease Control and Prevention, the source of the majority of fentanyl-related overdoses is fentanyl that was made illegally. 

Like pharmaceutical fentanyl, illegally made fentanyl comes in powder form. The powder is often mixed with other illicit drugs, like heroin, cocaine, and methamphetamine. Unlike pharmaceutical fentanyl, it is also pressed into pill form and made to imitate other medications.  

Brian Wolk, MD, emergency physician and medical toxicologist at Loma Linda University Medical Center, said fentanyl contamination and counterfeit medications pose a significant danger to adolescents who are experimenting with drugs.  

"If you experiment with cocaine, and it's actually contaminated with fentanyl, you could die. So, there are not many second chances,” Wolk said. 

Is you child struggling with substance abuse? Visit our behavioral health services website to learn more about the treatments offered at the Loma Linda University Health.  

THE RISE OF COUNTERFEIT PILLS 

Sometimes, teens use fentanyl by mistake, as was the case in a recent national news story, where a 16-year-old boy took medication that he thought would help him through a late-night study session. It ended up landing him in the hospital. His emergency department physician said, “The pill looked real, same color, same shape, even the right number stamped on it. It was a counterfeit, and it carried fentanyl.” 

Counterfeit pills are becoming more common. The Drug Enforcement Administration said they seized more than 47 million fentanyl-laced counterfeit pills and nearly 10 thousand pounds of fentanyl powder in 2025, equivalent to more than 369 million lethal doses of fentanyl. Just two milligrams of fentanyl could be lethal.  

It is nearly impossible to tell whether a pill or other street drug contains fentanyl by the look, smell or taste. 

“If it's not a pharmaceutical product, you don't know what's in it without analytical testing,” Wolk said. “Or until someone ends up in the emergency department.” 

WHAT TO DO IF YOU SUSPECT A FENTANYL OVERDOSE 

A person experiencing a fentanyl overdose may appear very sleepy and have slow, shallow breathing. Their skin could become discolored due to lack of oxygen. They may make unusual sounds, like gurgling or snoring. If an overdose is suspected, 911 should be called immediately. 

Wolk said Naloxone should be administered, and he recommended every parent of a teenager keep the life-saving opioid antagonist on hand even if they do not think their kids would ever experiment with drugs. 

“Teens may not be willing to tell you if there’s an issue,” Wolk said. “So having open communication and trust is important but also making sure that if somebody were to get sick, they know where to find the Naloxone.” 
 
Even after using Naloxone, the affected person should be taken to the hospital. 

For more information about youth behavioral health programs, click here or call 909-558-9113.