Protecting Patients from Counterfeit Medicines & Illicit Pharmacies

Osteopathic physicians are trusted by their patients to provide important health information. Patients look to their physician for guidance on health and potential threats to their overall well-being. One rapidly growing threat is the proliferation of counterfeit medicines and unregulated “Canadian” pharmacies.

Interpol’s Operation Pangea XVI 2025 underscored the magnitude of this issue: 

• 50.4 million doses of counterfeit and unapproved medicines were seized worldwide,
• 769 suspects were arrested for selling counterfeit or unapproved medicines, and
• 123 criminal groups dismantled for selling counterfeit products. 

Counterfeit versions of medicines have even been identified in developed countries like Canada, Australia, and here in the United States. Because these illegitimate substances are not produced under regulated conditions, patients can unknowingly ingest harmful or even lethal substances.

The risks for patients are real. Counterfeit antibiotics may lack the active ingredient, delaying treatment and leading to worsening illness. In more life-threatening cases, unregulated and untested pills can be unknowingly laced with lethal substances, such as fentanyl. In 2024, the U.S. Drug Enforcement Administration (DEA) seized more than 60 million fentanyl-laced counterfeit pills and nearly 8,000 pounds of fentanyl powder. In 2025, the DEA fentanyl seizures have represented over 232 million deadly doses. And according to Interpol, “some fake medicines have been found to contain mercury, arsenic, rat poison, or cement.” 

Educating patients and staff about these could be lifesaving. 

Unfortunately, many patients are lured by online offers promising “Canadian” or “cheaper” medications without realizing that more than 95% of online pharmacies operate illegally. These operations often bypass U.S. pharmaceutical standards and safeguards that protect consumers, including prescriptions verified by a licensed physician, clear labeling, and transparent sourcing. 

In addition to unsafe drugs, patients face the risks of identity theft and financial fraud when purchasing from unverified networks. 

What can we, as physicians, do to help protect our patients? We must educate our patients to:

• Buy only from reputable pharmacies — ideally brick-and-mortar or verified online pharmacies approved through the National Association of Boards of Pharmacy (NABP) “Buy-Safely” program.
• Avoid websites or social media sellers that do not require a prescription.
• Contact your pharmacist or doctor if you have any questions, concerns, or experience unusual effects. 

Counterfeit medicine remains a global public health threat. As osteopathic physicians, we can remain vigilant, help raise awareness, and guide patients to trusted sources. Safe medicine is effective medicine.