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Indra Cidambi, M.D.
Indra Cidambi, M.D.
Integrative Medicine

A Risky Crackdown on Opioid Prescriptions

It could lead to a more deadly trend: "pressed pills."

The opioid epidemic sweeping across America has caused several state governments to impose limits on initial opioid prescriptions in order to avoid the potential abuse of the pain pills. This crackdown has led to the rising popularity of a more deadly scourge: “Pressed Pills.” With fewer prescription pills in circulation, drug cartels, as well as home-based do-it-yourself pill makers, have moved to fill the gap by producing pills that look almost exactly like popularly branded pills, such as Percocet and Oxycodone, with one deadly difference—they are more likely to contain fentanyl or equivalent chemical ingredients. The prevalence of pressed pills is causing a new wave of overdose deaths as people believe the “label” on these counterfeit drugs and assume they know the potency of the pills.

States such as New Jersey have moved to limit the initial supply of prescription opioid pain pills to seven days. Lawmakers believed limiting the supply of these easily abused prescription pills would reduce the number of patients becoming dependent or addicted, as well as lessen the number of unused or unwanted pills diverted for recreational use.

People turn to the streets to buy branded opioid pain medications for several reasons. Some do not want to take a chance with the varying potency of heroin. Branded pills assures such buyers that the potency is consistent. Others, who had been prescribed pain pills for regular use, may go to the street to fulfill their need for extra pills. These are just two motivations for seeking prescription pain pills on the streets; pills are abused by many more people for a range of reasons.

When these branded pills became hard to get on the street due to prescription limitations, the drug cartels and home-based operations jumped right in. Pills were made in Mexico and shipped to America, but often they are made in small home-based operations. Chemicals needed to make the pills (usually fentanyl or its analogs) are obtained over the dark web and press pills are imported from China. Confiscations of pill presses were up 19 times in 2017 as compared to 2011.

Although most of these pain pills contain fentanyl or its equivalents, they can also contain a cocktail of potent substances with unknown reactions in the body. These pills are not only marked as Oxycodone and Percocet, but also carry popular benzodiazepine brand names like Xanax. Most of these pressed pills contain fentanyl or fentanyl analogs as they are incredibly cheap: Just 2 pounds of fentanyl can produce 1 million pills.

According to the Partnership for Safe Medications (1), counterfeit medications containing fentanyl have been found in more than 40 states and have killed over a dozen people. If you or someone you know is chemically dependent on opioids and believe that branded prescription medications are safer to abuse, think again. The consequences of ingesting these “pressed pills” are unknowable. Apart from the significant risk of overdose, other risks such as organ failure are not out of the realm of possibility. Stay away from them and, instead, seek treatment.


About the Author
Indra Cidambi, M.D.

Indra Cidambi, M.D., is the founder and medical director of the Center for Network Therapy (CNT), New Jersey's first state licensed Ambulatory (Outpatient) Detoxification care and treatment facility.

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