State health department warns Mississippians to be on alert for prepackaged, counterfeit drugs

The Mississippi State Department of Health is sounding the alarm to make the public aware of the dangers and unpredictable risks that come from taking counterfeit pills, illicitly manufactured drugs, and other psychoactive products.

The warning follows the reported deaths of two Ole Miss students. Found near the bodies of the victims were two pre-packaged remains of kratom. Although it has not been listed as the official cause of death during the active investigation, officials with the MSDH are strongly warning Mississippians to avoid counterfeit pills.

“The most important message for Mississippians is that you cannot determine what is in an unregulated product simply by looking at it,” Jon Hubanks, director of the Center for Injury Prevention & Recovery, said. “A familiar appearance, professional packaging or even previous experience with a product does not guarantee that the next product contains the same substances or the same concentration.”

According to the MSDH, a product’s labeling and appearance, as well as where you buy it, may not reliably indicate what the pill contains. Counterfeit pills can be manufactured to closely resemble legitimate prescription medications.

The MSDH also noted that tablets, gummies, liquids, shots, and other unregulated psychoactive products are being warned against, as consumers will likely not be able to determine the product’s actual ingredients, concentration, purity, or potential effects with the naked eye.

Changing drug environment

In the past, the Centers for Disease Control and Prevention (CDC) has warned that pills obtained illegally or without a prescription may contain highly potent substances, including illegally manufactured fentanyl. The CDC describes the pills as resembling legitimate medication and notes that they may contain harmful substances that the person taking the pill did not intend to consume.

“At the same time, emerging risks are not limited to counterfeit prescription pills or drugs obtained through traditional illicit markets. Federal agencies have identified potent psychoactive substances in commercially packaged products available online and through retail locations,” a release from the MSDH reads.

“The U.S. Food and Drug Administration (FDA) has warned consumers about concentrated 7-hydroxymitragynine, or 7-OH, products sold as tablets, gummies, drink mixes, and shots, including products available at gas stations, smoke shops, and corner stores. The FDA states that 7-OH is not approved for medical use and cannot lawfully be marketed as a dietary supplement or added to conventional foods.”

More recently, the U.S. Department of Justice announced the emergency scheduling of three manufactured compounds related to mitragynine or 7-OH: mitragynine pseudoindoxyl (MGPI) and two other compounds. The department described the action as a response to a rapidly developing market for manufactured opioid compounds.

These developments illustrate a broader public health concern: the unregulated drug market can evolve rapidly, and new substances, formulations, and combinations may emerge faster than consumers recognize them, leading to more future harm.

Retail availability does not ensure safety

MSDH cautions consumers against assuming that a psychoactive product is safe simply because it is professionally packaged, labeled, or available for purchase at a retailer or online.

According to the FDA, documented concentrated 7-OH products are being sold through ordinary retail channels despite not being approved for medical use. The agency has also taken enforcement action against concentrated 7-OH products sold as foods and dietary supplements, and it is working to crack down on them.

“Today’s drug environment requires us to think beyond the traditional image of an illicit drug,” Hubanks said. “A potentially dangerous substance may resemble a prescription medication, or it may be sold in professional-looking consumer packaging. Where something is sold or how it looks cannot tell you everything you need to know about what is in it.”

MSDH Recommends

Mississippians can reduce the risk of overdose and other serious adverse effects by taking several precautions:

• Take prescription medications only when they are prescribed to you and obtained from a licensed pharmacy.
• Do not assume a pill is legitimate based on its color, shape, markings, or packaging.
• Use caution with psychoactive products obtained from unregulated or unverifiable sources.
• Do not assume that commercial packaging or availability in a store or online means a product has been evaluated or approved by the FDA for safety, effectiveness, quality, or consistency.
• Keep naloxone available. Naloxone can rapidly reverse an opioid overdose, including an overdose involving fentanyl.
• Consider fentanyl test strips when appropriate. Fentanyl test strips can detect fentanyl in many drug products but do not identify every potentially dangerous substance. A negative result should not be interpreted as proof that a product is safe.
• Avoid using unknown or unregulated substances.
• Call 911 immediately if an overdose or serious adverse reaction is suspected.

A Message for Students and Young People

According to the MSDH, young people can play an important role in preventing overdose, even if they do not use drugs themselves. The MSDH urges students to carry naloxone. They noted that it does not mean a student uses drugs themselves, but keeping it in a backpack, car, or dorm room could potentially save someone who uses drugs and needs saving from an opioid or fentanyl overdose.

“Having naloxone with you can be a simple way to be prepared,” Hubanks said. “You may never need to use it, but if you are with someone experiencing an opioid overdose, having naloxone could save that person’s life.”

Signs of a possible opioid overdose include: