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Setting aside conscience, there are few barriers to entry for the aspiring counterfeit pill-presser.

One needn't be rich. A kilogram of fentanyl — a synthetic opioid that resembles powdered heroin and is 50 times as powerful — sells for $3,500 to $5,000 in online black markets. That's enough to make up to 1 million phony pain pills.

A $1,000 press will pop out 5,000 pills per hour, according to a Drug Enforcement Administration report. The DEA tracks these, but foreign vendors avoid detection by shipping presses that are mislabeled or disassembled. A die mold that will brand the fakes as 30 milligram oxycodone pills costs a little over $100.

Brian Besser, assistant special agent in charge of the DEA's Salt Lake City District Office, said the above investment can net a distributor between $6 million and $22 million in profits, and prosecutors allege that at least two Utahns couldn't resist the opportunity.

A team of agencies last month seized nearly 100,000 counterfeit pills, a powder believed to be fentanyl, three presses and $1.2 million in cash from a Cottonwood Heights home and South Jordan "stash house" linked to 26-year-old Aaron Shamo.

In June, officers said they arrived at a Sandy motel to find 21-year-old Nathan Jetter with a pill press, die molds, a grinder, funnel and other tools needed to combine fentanyl with other substances to create knockoff oxycodone and Xanax.

Both men pled not guilty and will be tried in the new year.

Although Utah officials say they have yet to see the spate of overdose deaths that have characterized the introduction of counterfeit pain pills in other drug markets, law enforcers and lawmakers are working to combat a harrowing reality.

Anybody with a laptop and physical address can acquire bulk quantities of a drug that can be fatal even to touch.

It's not the first fentanyl crisis. The drug was deemed responsible for more than 1,000 deaths between 2005 and 2007, when it was mixed with heroin at a lab in Toluca, Mexico. Seizure of that lab put an end to the epidemic.

And it's not unprecedented that drugs are being sent by mail. What's new, Besser said, is that people are using hard-to-trace virtual currencies to buy fentanyl and other synthetic opioids on websites that can't be tied to physical addresses.

Both Shamo and Jetter are accused of making such orders, as is a 15-year-old boy suspected to have given U-47700 (or "pink") to two 13-year-old Park City boys who died from an overdose in September. Pink also has been blamed in deaths in Salt Lake and Iron counties.

Some importers still use the drugs to punch up their heroin, while others mimic sought-after pain or anxiety pills that they then can sell in the same online markets — the so-called "dark web" — with categories labeled "Fraud," "Weapons," and "Drugs & Chemicals."

Distributors even have ratings like those on Amazon or eBay.

On a Reddit message board, one buyer reviewed a shipment as "pressed very nicely" with "no chalky residue" and including four extra pills ("!"). Another gave an "A++" to a seller who had admitted their oxycodone replicas contained "a dose of fentanyl."

Besser describes these pills as "little Russian roulette games."

Fentanyl is so dangerous that officers raiding Shamo's home wore hazmat suits to avoid absorption through the skin or inhalation, and the discovery of Jetter's alleged operation led police to evacuate the whole motel.

Two milligrams — roughly a few grains of sugar — is considered a fatal dose for non-addicts. Besser said "mom and pop" pill-pressers have the problem that one might encounter with a batch of chocolate chip cookies: Some cookies have almost no chips. Others have a bunch.

While many pills are nearly indistinguishable from the prescription stuff, homemade mixes using coffee grinders and blenders have resulted in some that are almost pure fentanyl, Besser said, "and the person that takes that tablet will almost certainly die."

Counterfeit hydrocodone pills that caused 10 fatal overdoses in Sacramento, Calif., this spring were shown to contain between 0.6 and 6.9 milligrams of the drug. Investigators found similar pills at the Minnesota home of pop icon Prince after he died of a fentanyl overdose in April.

It's a "lethal and greed-based trade with no regard for people's safety or life," Besser said, and its operatives can expect no mercy from law enforcement if they are caught.

"We're committed to tracking you down, finding you and prosecuting you to the fullest extent of the law."


As the nation's first secretary for homeland security, Tom Ridge said it was natural that he be approached about an effort to secure U.S. borders.

Ridge now advises a bipartisan coalition trying to close a loophole that each day allows almost a million packages to enter the nation without electronic security data. Among them, says Americans for Securing All Packages: fentanyl, pink and even more potent synthetic opioids.

"We don't necessarily know where the next terrorist attack is coming from, but we certainly know where the opioids are coming from, and if you have that knowledge, shame on you if you don't act on it," Ridge said.

Under the Trade Act of 2002, Congress authorized U.S. Customs to receive data on all packages, but only the private sector has conformed. Packages entering the U.S. via many foreign postal services offer few clues about their contents.

A DEA report says some fentanyl is shipped by Chinese labs that are otherwise aboveboard chemical providers, and packages can be difficult to track because they often change hands multiple times before they even leave the country.

In May 2015, Chinese customs officials seized nearly 50 kilograms of fentanyl and 25 kilograms of a related drug that had been transferred through five freight forwarders. Six customs officials fell ill after handling the drug, and one went into a coma.

Ridge, who is also a former governor of Pennsylvania and U.S. representative, spoke on behalf of legislation introduced in both the Senate and House that would have required electronic data from foreign posts. In September, Utah Sens. Orrin Hatch and Mike Lee signed a letter from the Senate Finance Committee urging Secretary of State John Kerry to "engage with other nations directly to work to prevent bad actors from using international mail to evade U.S. law."

"I can't imagine any congressional opposition, or I don't know how you'd explain it," Ridge said. "It's a dramatic, painful, evil loophole."

President-elect Donald Trump has pledged to cinch it. In October, Trump said his administration would "crack down on this abuse, and give law enforcement the tools they need to accomplish the mission."

Besser said he's aware of the legislative effort. The DEA is working with officials in Beijing and Hong Kong to step up regulations on the production and sale of synthetic opioids, he added, and China has announced controls on fentanyl and 18 related compounds.

"The Chinese government is seeing that many, many Americans are dying," Besser said. "That is considered shameful. They don't want that to happen."

But Besser likened the DEA's charge to a game of whack-a-mole. In a "pill-for-every-ill society" that "doesn't want to deal at all with pain in any way, shape or form," he said, something always rises to meet the demand.

Officials have seized a fentanyl precursor that was being transported southward across the U.S.-Mexico border.

One theory holds that cartels are stockpiling them, in case regulations cause the Chinese supply to dry up.

Twitter: @matthew_piper Reverse an overdose

Naloxone can reverse an overdose caused by fentanyl and related synthetic opioids, though law enforcement officials have observed that multiple doses have been required for people who have consumed especially large quantities.

The state Department of Health issued a standing order Thursday to allow pharmacies to give the drug to people who don't have a prescription.

Utah most recently ranked fourth in the nation in deaths from drug overdoses, with six dying each week from opioid overdoses.

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