The Role of Non-Pharmaceutical Fentanyl-Contaminated Counterfeit Oxycodone in Increasing Opioid Overdoses: A Commentary Review.

Importance: Opioid misuse/abuse is a pervasive problem in the United States, and the growing use of fentanyl-contaminated products is adding fuel to the opioid crisis. Objective: To review the rising prevalence of nonprescription fentanyl in counterfeit oxycodone, paying specific attention to oxycodone for cost analysis. Evidence Review: A literature search was performed using 3 databases (Google Scholar, PubMed, and Clinical Key) to identify English-language articles published from January 2010 to October 2022. Search terms were street oxycodone and prescription oxycodone, street oxycodone. An additional search of fentanyl was performed to gather more information about the pharmacology behind fentanyl overdoses. Studies and articles were selected based on information related to the presence of non-prescription fentanyl in illicit supplies of oxycodone. Additional articles were included to demonstrate the cost, manufacturing, and overdose rates of fentanyl-laced counterfeit opioids. A total of 13 articles were included in the final review. Findings: The demand for illicit oxycodone provides an opportunity in which counterfeiters can thrive, using dangerous adulterating agents such as fentanyl to maximize their profits. Those purchasing oxycodone illicitly may or may not be aware of the presence of fentanyl in their tablets, which has clearly resulted in rising overdose numbers. Conclusion: Clinicians should counsel patients at risk for opioid misuse on the risks of counterfeit oxycodone. Prim Care Companion CNS Disord 2023;25(6):22nr03433. Author affiliations are listed at the end of this article.