Online sales of counterfeit prescription pills containing fentanyl are on the rise, and experts say social media apps like Snapchat and TikTok are driving the surge, including in Tennessee.

Shabbir Safdar, executive director of the Partnership for Safe Medicines, said an alarming number of counterfeit prescription drug pills containing fentanyl are being bought online by teens and young adults.

"And in fact, just in the last four years, we've tracked fatalities in 19 different states from people who've met a drug trafficker on Snapchat and then bought a fake pill," Safdar reported.

According to the Tennessee Department of Mental Health and Substance Abuse Services, more than 2,000 Tennesseans died of fentanyl-related drug overdoses in 2020, more than double the number in 2019.

Tennessee is one of many states recently passing laws decriminalizing fentanyl test strips in an effort to reduce deaths. The tests work by dipping the strip in water containing dissolved drugs.

Safdar noted he believes strips should be legal, but pointed out they do not always detect fentanyl in large batches.

"In fact, there's a young man in Tennessee that we profiled in the last couple of years, who he and his friends all order Xanax off the dark Web, and they each took a pill," Safdar recounted. "It was only this young man's that had the fatal amount of fentanyl in it."

Safdar pointed out more Americans are turning to online pharmacies for acetaminophen, aspirin, blood thinners and other routine medications, but said there's risk in buying products from any source other than a licensed pharmacy.

"During the pandemic, as many as one in seven Americans went online to purchase medication, and many of them went to these fake Canadian pharmacy websites," Safdar emphasized.

According to a study in the Journal of the American Pharmacies Association, there are more than 11,000 websites based in the U.S. and Canada calling themselves "pharmacies" and selling drugs online.

By Kyla Russell for WISH-TV.
Broadcast version by Joe Ulery for Indiana News Service reporting for the WISH-TV-Free Press Indiana-Public News Service Collaboration

After they were long considered paraphernalia, fentanyl test strips are now officially legal in Indiana.

According to recent data, fentanyl is responsible for over 70% of overdose deaths in the state. Until this month, if someone was found with the lifesaving strips, it would be up to the local prosecutor to decide if they would face charges for violating the state's paraphernalia laws.

A bipartisan effort changed that reality by passing House Enrolled Act No. 1167.

"Any resident should and can access test strips," Director of Harm Reduction at Overdose Lifeline Breanna Hicks said. "Our former paraphernalia law said that anything that tests the 'presence, efficacy or effectiveness of a substance, an illicit substance,' could be considered paraphernalia. So, while fentanyl test strips only test for presence, that was a gray area in law in jurisdictions across Indiana."

Local harm reduction organizations say the law fueled fear for people hoping to distribute the strips. The concern prompted them to push for change.

"There's this false narrative that access to test strips are going to encourage substance use or encourage drug use, in general, especially to populations that are younger," Hicks said. "However, that's just not true, harm reduction is a proven practice that allows for individuals to make healthier and better decisions."

Hicks says the strips can be used to test drugs purchased off the street.

When the small strips are submerged in water, they can detect the synthetic drug in 30 seconds to two minutes. According to the Marion County Coroner, the drug was found in over 90% of opioid overdoses in Indianapolis last year.

"Fentanyl overdoses are now the number one cause of death for anybody age 18 to 45," Hicks said. "Indiana falls in that range as well, to where we're seeing fentanyl being the most prevalent cause of accidental overdose death."

Overdose Lifeline is one of the organizations distributing the test strips. To request strips, click here.


Kyla Russell wrote this article for WISH-TV.


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Kentucky's latest drug overdose fatality report showed a drop in deaths and for the first time, a decline in deaths among Black Kentuckians.

Groups across the Commonwealth have been working to increase access to harm reduction services.

Latosha Perry, executive director of the Louisville-based nonprofit EmpowHer with Open Arms, said her organization provides prevention services to adolescents as well as group and individual therapy for adults who are typically required to be in therapy in order to see their children.

"Some struggling with addiction or just now coming out of incarceration, they don't have the money to cover those expenses," Perry explained. "It typically decreases the rate of them reunifying with their family."

Overdose deaths in the Commonwealth decreased for the third year in a row, with a slightly more than 30% decrease in 2024, compared with the previous year. Still, more than 1,400 Kentuckians died of a drug overdose.

Ashley Smith, founder and executive director of the nonprofit agribusiness Black Soil Kentucky, said her organization has distributed Narcan units and provided training to farmers so they are equipped to act as first responders.

"We have worked to pair education outreach and technical assistance with direct produce distributions across rural and urban communities," Smith pointed out.

Both organizations received grant funding from the Foundation for a Healthy Kentucky for their harm reduction efforts.

If you or a loved one is struggling with addiction, call 833-8KY-HELP (833-859-4357) to get assistance connecting with a treatment center. Information about treatment programs is available at FindHelpNowKy.org, and information about how to obtain naloxone is available at FindNaloxoneNowKy.org.


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As Women's Health Month winds down, public health officials in Minnesota are joining the chorus of professionals warning about the prevalence of alcohol misuse, and the added health risks for women.

Problem drinking among women is on the rise, according to the National Institutes of Health.

When compared to men, women have had larger increases in alcohol-related emergency room visits, hospitalizations, and deaths in the past two decades.

Division of Epidemiology & Community Health at the University of Minnesota Professor Toben Nelson said men still drink more, but agrees it's a pressing issue for women.

He noted the significant health consequences if they develop a problem.

"A real concern for younger women - when alcohol is involved, the risks for interpersonal violence are very significant," said Nelson. "Also, injuries related to falling, that is certainly a concern as one ages."

According to federal health agencies, frequent alcohol consumption is also linked to a greater chance of developing breast cancer.

It's recommended that adult women of legal drinking age limit their alcohol intake to one drink or fewer each day.

The NIH website Rethinking Drinking has information on signs of a problem, and how to manage and respond to these situations.

For broader prevention work, Nelson encouraged bars, restaurants, and policymakers to embrace effective strategies.

"Responsible beverage service training in places that serve alcohol," said Nelson, "and also restrictions on alcohol outlet density."

He was referring to limits on approving the number of liquor stores and similar outlets in a given area.

UnitedHealthcare's Chief Medical Officer for Women's Health Dr. Lisa Saul pointed to how alcohol is marketed toward women these days.

"Terminology," said Saul, "like 'it's wine o'clock,' or 'mommy juice,' - those sorts of things have really normalized the consumption of alcohol in ways that we didn't really see before."