TULUM, Mexico—The local “pharmacy” on the sun-soaked marina in Cabo San Lucas is bland and clean. There is no government license on the wall. Bottles of sun lotion stand on half-empty shelves, and hand-written signs in English, aimed at the American tourists this city is so popular with, denote some of the meds on offer, such as ibuprofen or Voltaren.
“Hello, friend,” says the short, male sales assistant, who is wearing a blue polo shirt and dark glasses, in English. “Can I help you?” the shop assistant continues.
Beyond medication intended for hangovers and colds, highly addictive opioid painkillers mimicking Oxycontin and Vicodin, as well as other prescription pills resembling Xanax and Adderrall, are also on offer in dozens of outlets like these across Mexico’s tourist towns. You just have to know that you can ask for them. No prescription needed, no questions asked, and as many pills as you want.
But an investigation by VICE News with the Bunk Police, a drug testing company, found that some of these so-called pharmacies are selling pills laced with deadly fentanyl and highly addictive meth. The adulterated nature of the pills as well as their form and fake English-language packing is a sign that they’re produced and distributed by Mexico’s powerful drug cartels and not legitimate pharmaceutical companies, according to the Drug Enforcement Administration (DEA) and experts consulted for this investigation.
Mexico’s government has done almost nothing to tackle this problem, and is ill-equipped to do so.
“Each pharmacy and each group of small-time gangsters there is affiliated either with CJNG or the Sinaloa Cartel — all turf is clearly divided,” according to a United States government official who asked not to be named as they weren’t authorized to comment on the subject. Street level drug dealers are also allied with pharmacies in some of the resorts we visited.
We visited 30 pharmacies around Mexico’s coast, which are popular with Western tourists—including American expats, many of them retirees, living in Mexico—looking to buy cheap prescription drugs, no questions asked.
“Do you have Xanax?” we asked the shop assistant in Cabo. But he had been tipped off that we’d been asking for pills all around town.
“They’ll chop your head off,” the salesman blurted out as we left the shop.
“What did you say?” we asked.
“Nothing,” he shrugged, looking off into the distance. “I didn’t say nothing.”
He was likely speaking on behalf of the producers of the groups behind the pills being sold through Mexico’s pharmacies to unsuspecting American tourists: the Sinaloa and New Generation Jalisco Cartels.
When we tested the fake “Oxycodone”, “Hydrocodone” or “Percocet”, as well as pills mimicking Adderall, using Bunk Police test kits back at our hotel, our suspicions were confirmed. Of four fake Oxys we tested, two tested positive for fentanyl. Of six fake Adderall’s we tested, four tested positive for meth.
Sales staff had fished those pills out of bottles marked with fake labels, as well as from clear plastic bags containing loose pills. Technically, the purchase of any opioids or benzos requires a special prescription issued by Mexico’s Health Ministry, according to the Federal Health Law. We saw this law flouted across the coast —only the major pharmacy chains refused to sell us the pills without a prescription.
Lab tests of the pills bought for the purpose of this investigation showed substantial rates of adulteration. Of 22 pills sold as prescription opioids, six were fake. Two out of seven of the pills sold as Hydrocodone contained fentanyl, and four out of 15 of the pills sold as Oxycodone contained fentanyl. Two of those fake pills also contained Xylazine, an animal tranquilizer known as “tranq” in the U.S.
None of the nine “Adderall” pills we purchased in Mexican pharmacies without prescriptions were genuine. Six tested positive for meth, and two of them contained an unidentifiable substance. One “Adderall” sample contained Aminorex, which was removed from the U.S. market in 1972 due to it causing pulmonary hypertension.
Our findings are backed by other reporting on the U.S-Mexico border as well as a recent UCLA study. Tiny amounts of fentanyl can kill, especially those not expecting to consume the drug or those with a low tolerance for opioids. A number of cases in which pills bought by Americans in Mexico and taken home have caused fatal overdoses have been documented in the U.S.
“These aren’t meds - these are falsified products,” said Xavier Tello, an independent health policy analyst, author and former trauma surgeon.
“Organized crime is selling its substances disguised as medications which—even if they were genuine—would still be illegal for sale in Mexico.”
Many of the fentanyl-tainted pills came from bottles labeled entirely in English with the words “Percocet” and “Painkillers Tablets Hydrocodone.”
“It’s an elaborate hoax,” said Ben Westhoff, author of Fentanyl Inc. “Somebody went to the trouble of trying to imitate what they think prescription pills bottles are supposed to look like to a U.S consumer, and although they missed the mark by a lot these bottles do have half an air of legitimacy and certainly a lot more than handing someone a baggie of pills.”
Mexico’s hyper-violent drug-trafficking organizations have infiltrated the country’s independent pharmacies with almost no government intervention, despite health warnings from the U.S State Department about the proliferation of poisonous pills across the country. “Exercise caution when purchasing medication in Mexico,” warns a travel alert published earlier this year. “These pills are sometimes represented as OxyContin, Percocet, Xanax and others, and may contain deadly doses of fentanyl,” the U.S State Department warned
Reporting by VICE News showed that small, licensed pharmacies as well as tourist stores with no legal permit to distribute such medications are selling these pills to tourists without prescriptions. Many of the pills bought in Mexico during reporting for this article looked clearly fake, and crumbled under the slightest pressure between two fingers.
“U.S. citizens have become seriously ill or died in Mexico after using synthetic drugs or adulterated prescription pills,” warned another U.S State Department travel alert in March.
A DEA spokesperson told VICE News that counterfeit pills are “one of the greatest threats to the safety and health of Americans today.” Last year, nearly 110,000 people died of drug overdoses in the U.S, 75,000 of them from synthetic opioids like fentanyl. In 2022, the DEA seized more than double the amount of fentanyl-laced, fake prescription pills in the U.S than it seized in 2021.
“The only safe medications are ones prescribed directly to you by a trusted medical professional and dispensed by a licensed pharmacist,” said the DEA spokesperson.
But most Americans are likely unaware that the pills they’re buying are fake – never mind contain illegal drugs such as fentanyl and meth.
“I don’t think Americans realize that their life could be on the line purchasing something from here. I think people trust pharmacies to keep them safe and I want Americans traveling in Mexico to know that pharmacies in Mexico are not safe,” said Adam Auctor, the founder of the Bunk Police, which functions as a harm reduction organization through the research, manufacture, and distribution of substance test kits.
“There are several different types of people being affected by this. There is a very large number of older American expats that are living in Mexico to take advantage of the lower cost of living and they do trust the medical system and these pharmacies. I think they are a large customer base for these pharmacies. Beyond that, there are people who take this back to the U.S. for themselves and there are a large number of people who take it back for their relatives and their children. “Adderall” is used to treat ADHD and I am certain that American children are being given meth-tainted “Adderall” bought in from Mexico,” said Auctor.
The poisoned pills being sold out of Mexican shops and pharmacies are likely the same pills produced by the Sinaloa Cartel and the New Generation Jalisco Cartel that have flooded the U.S, which include counterfeit, adulterated “Mexican Blues” as well as counterfeit versions of Xanax and Adderall. Six out of every ten of those counterfeit Mexican Blue pills seized in the U.S containing fentanyl carried a lethal dose of the opioid, according to the DEA.
“The kind of pills that are turning up in busts in the U.S. pretty much exactly match the pills you turned up in your investigation, so to me it seems likely that all these pills are coming from the same place,” said Westhoff.
No prescription needed
The sun-drenched town of Tulum in the Mexican state of Quintana Roo is smaller and has more of a hippy feel to it than Los Cabos in the north. Some of its roads are unpaved, but the main street going through the town hosts more than two dozen pharmacies, some chain stores and others independent. Many of them have signs outside that say “drugstore” in English, and list the painkillers and tranquilizers that they have for sale outside, as well as on menus standing on counters inside, which list names of meds in English such as Percodan, Xanax, and Clonazepam. Other sellers are small counters placed in shops otherwise selling tourist tat such as sandals and clothes.
Neither of those types of establishments asked us for a prescription to buy either opioid or benzo pills. But the very first pharmacy we entered on arriving in the town sold us two “Oxys” and two “Adderall” pills – all of which later tested positive for fentanyl and meth respectively. On the wall hung a government pharmacy license.
An hour’s drive away in Playa Del Carmen, drug dealers beckoned us off the main tourist strip at night, which is lined with restaurants, ice-cream shops and bars, to offer us cocaine and weed. “Got any Oxys?” I asked one of them, who was short and squat, and insisted he was a “dealer not a stealer.” Sure, he said, and led me next door to the nearest pharmacy which had bottles of 10 “Percocets” on offer, without prescription, for a couple hundred dollars. “What do they do? How do they feel?” asked the dealer, who said that he was seeing people ask for the pills more and more.
An hour’s ride on a ferry from Playa Del Carmen across the deep, blue Caribbean is the laid back island of Cozumel. With its ocean promenade along a rocky beach, parts of the island feel closer to Cuba than Mexico. But within five minutes of passing through a security checkpoint and stepping off the boat, a man in a tourist shop selling clothes, sandals and sun cream had offered us bottles of both “Percocet” and “Xanax” with no prescription for just a hundred dollars each.
Down a quiet street a few blocks from where we bought the bottles, another dealer gestured to us, again offering us weed and cocaine. My companion was a young, blue-eyed, blonde haired American–the archetype of their typical client, I conclude. The dealer, who is short and wearing a Mexican World Cup football shirt, placed a small tray of cocaine wraps under my nose when we got to the counter inside a small narrow shop that’s selling chip packets and not much else. He urges me to sniff the coke to understand the quality– it smells of gasoline. I asked him for “Xanax” or “Oxy” pills, and his friend–who looked as though he had seen better days–disappeared out the back door into a yard scattered with junk. He reappeared with a bottle of “Percocets”, and offered to sell us two pills each at $5 bucks a pop.
Lack of regulation
It’s not hard to go around the bureaucracy designed to regulate Mexico’s pharmaceutical ecosystem.
Some of the pharmacies selling the adulterated pills had the necessary government license - issued by the federal agency known by its acronym COFEPRIS that is charged with regulating the country’s pharmacies - framed and on display on the walls. Others had no such documentation. But both types of pharmacies sold us the cartel-made, opioid painkillers adulterated with fentanyl without prescriptions, as well as fake Adderall meds adulterated with meth. Many of those pharmacies offered to sell us pills in the thousands. Some stores said we could purchase as many as we wanted.
The plastic bottles in which they were sold were sealed and labeled, but the print on the labels was of poor quality and the brands and lettering all in English, with U.S brands, aimed at the only group that really buys these pills: American and Canadian tourists. Pill presses used by the cartels can be bought on Amazon here in Mexico, and Tello - the healthy policy analyst - said that small bottles like the ones we bought pills in are easy to buy, label and seal.
“That’s absurd and idiotic,” he said when he saw pictures of the pill bottles VICE News picked up at Mexican pharmacies. “That’s totally illegal. Every COFEPRIS inspector who sees that is going to close that business. It’s absolutely illegal.”
But these pharmacies are operating in broad daylight, selling products at raised prices to American visitors with no prescription with no interference from the authorities.
Repeated requests to interview Alejandro Svarch, the commissioner who oversees the sanitation agency COFEPRIS charged with policing Mexico’s pharmacies, were not granted.
COFEPRIS, like many government entities, is under-funded. It lacks the necessary number of agents to effectively police all of the pharmacies in Mexico. Corruption is also a problem— 11 agents were relieved of their duties last year following an investigation into a corruption ring by Mexico's Marines.
But the biggest factor contributing to the fact that agents aren’t closing down shops and pharmacies selling these fake, potentially deadly, pills is likely fear of the repercussions for doing so. The role of organized crime in producing, packaging and distributing these pills around Mexico brings with it the threat of violence, as VICE News and the Bunk Police experienced first hand during the reporting of this story. Closing down “pharmacies”, legal or not, interferes with cartel profits and brings consequences. Tulum, Playa Del Carmen (or Playa del Crimen as it is now often referred to), Cancun, Los Cabos and Tijuana have for years been convulsed by drug-related violence which many locals have seen up close, and if not, on local media.
“It’s not that every single pharmacy is controlled by the Sinaloa Cartel or Jalisco, but the extent of the sales across so many parts of Mexico of these pills, and the ease with which they can be obtained, means this is now a major strategy for the cartels,” said Vanda Felbab-Brown, a senior fellow in the Strobe Talbott Center for Security, Strategy, and Technology in the Foreign Policy program at the Brookings Institution, a nonprofit public policy organization based in Washington, DC.
“It also creates an augmented threat to public health.”
It’s likely that Americans are dying in Mexico from overdoses caused by these pills, but the lack of accurate registration of drug overdoses makes it hard to know. Mexico’s forensics system is overwhelmed by the country’s murder rate - bodies pile up at the morgue and toxicology reports determining drug deaths are rare. When drug overdoses occur, they are usually not registered as such on death certificates - opioid overdoses on the border tend to be registered as respiratory failure, according to Alfonso Chavez from the harm reduction center PrevenCasa in Tijuana that works with fentanyl users.
Fentanyl overdoses have been growing in Mexico in recent years, but mostly because of the presence of fentanyl-laced heroin—known locally as China White—and meth. Mexicans have not embraced the use of pain meds and the transition to fentanyl-laced heroin or fentanyl pills and powder that has been seen in the U.S as a consequence of the opioid epidemic. The majority of the 110,000-plus overdose deaths in the U.S last year were caused by illicit fentanyl, according to the country’s Centers for Disease Control and Prevention.
Much of the fentanyl killing Americans at home is being produced by the Sinaloa Cartel, according to the U.S Department of Justice. Now, Americans are at risk of overdosing on fake pills bought in Mexico too, given the widespread proliferation of these cartel-made counterfeit, adulterated pills available for purchase across the country. And Mexico’s authorities seem unwilling, or unable, to protect them.
Back in Tulum, on the Mexican coast, tourists could be forgiven for buying these medications without suspecting they might be fake. A middle-aged shop attendant who had short, purple hair that had been shaved on one side of her head and wore red lipstick cheerfully sold us a purple “Oxy” and orange “Adderall.” “Are these safe to take?” I asked her. “Yes!” she smiled. But there’s no way she could know for sure.
Outside was a sign that said “We Care About Your Health” in English.