Counterfeit Norco Causing Death in California

APRIL 12, 2016
The California Department of Public Health (CDPH) has issued a drug overdose alert concerning deaths related to a fentanyl-contaminated tablet that looks remarkably similar to Norco.
Officials in the County of Sacramento have reported 48 overdoses and 10 deaths related to this illicit street drug. Even though the tablets appear to be Norco, they actually contain an amount of fentanyl that has yet to be determined. 
In addition to Sacramento County, the CDPH has received reports from other counties around the state with similar overdose and death scenarios. 
In order to gather more information and help prevent further deaths from this deadly street drug, California officials have prepared the following guidelines for health care facilities to follow in order to help officials track the magnitude of this crisis.
  1. Voluntarily report suspected and confirmed fentanyl overdose cases to their local health department for reporting to the state. The information submitted will be used solely for public health surveillance. The reports should include name, date of birth, age, and address of residence.
  2. Test for fentanyl when ordering drug screening for cases of suspected overdose.
  3. Be aware that naloxone is effective in reversing the effects of fentanyl; however, the CDPH has received reports that it may take repeated doses of naloxone over several hours to adequately treat fentanyl overdose, likely because of fentanyl’s long half-life.
  4. Warn patients with a history of substance abuse about the risks of purchasing street drugs at this time. Fentanyl is colorless and odorless and can’t be readily detected in laboratory analysis.
This is an excellent opportunity for pharmacists to help educate patients about the safe storage of personal medications and the danger of taking any medication that isn’t prescribed by their physician and dispensed by their pharmacist.

Steve Leuck, PharmD
Steve Leuck, PharmD
Steve Leuck, PharmD, has been practicing both hospital and community pharmacy for over 30 years. He founded AudibleRx, in 2011, which provides Consumer Medication Information which is both Useful and Accessible. Content designed to meet health literacy guidelines. Format designed to "read along" with the audio presentation in a simple to use web application. More information at