Outlines how to tell fake Xanax bars vs real ones, what they really contain, and what to do if you taken the fake Xanax bars — or a friend has — and are experiencing an adverse reaction or an overdose.
Find more Fake Check guides, tips and advice
Find more health guides, tips and advice
The number of deaths linked to fake Xanax bars tripled over the past 12 months, officials have said.
Although being sold as genuine Xanax, (the brand name for alprazolam), which is prescribed for anxiety or panic attacks, the counterfeit Xanax actually contain fentanyl — a heavy duty painkiller — or etizolam, a psychoactive chemical responsible for hundreds of deaths every year.
The Drug Enforcement Administration said fentanyl, a synthetic drug, is 50 to 100 times more potent than morphine. Doses as small as 2 milligrams can be fatal to most people, and there is no way for a buyer to calculate how many milligrams of fentanyl would be in the fake Xanax bars they are buying.
The fentanyl and other ingredients in the fake Xanax bars have also caused cases of permanent brain damage and permanent mental illness problems, with users and overdose survivors alike continuing to be ‘hearing voices’ or attacking friends or random people.
The fentanyl also is a risk for first responders and emergency workers attending an overdose, as the drug is absorbed through the skin and can cause ‘contact overdoses’.
In some instances, the false pills have been sold in boxes and bottles with authentic-looking branding and labelling from the genuine Xanax manufacturer, Pfizer.
Instead of alprazolam (which is expensive to produce and buy), what the fake Xanax bars actually contain is cheap fentanyl from China — often manufactured in backyard labs and unsanitary conditions similar to that of methamphetamine labs.
There is a growing problem with school-age children buying fake Xanax bars — commonly referred to as ‘school buses’. However, none of the Xanax on the street is actually Xanax. It will either contain fentanyl (most common), other new synthetics, such as U-4700. The buyers don’t know what they’re getting. News reports of just one example tell of multiple students who purchased Xanax from a classmate and they all overdosed.
Other tested versions of fake Xanax bars have shown the presence of etizolam, a psychoactive chemical responsible for the deaths of 548 people just in Scotland in a single year. There have been similar reports in the US, as well as England, Australia and New Zealand.
Overdose deaths involving opioids in the USA have skyrocketed 41.5% since 2010, with a provisional count of over 47,105 deaths from August 2018 to August 2019. Synthetic opioids, particularly fentanyl, have driven deaths in recent years due to their high potency and low overdose threshold.
Some children taking the fake Xanax have been reported to be as young as 11 years old.
How to tell fake Xanax bars vs real ones

The common counterfeit versions of Xanax try to mimic the genuine Xanax bars as closely as possible, although some (see Example 3 below) use different colours.
Example 1: White, rectangular, counterfeit Xanax bars with name ‘Xanax’ stamped on one side and 2 on the reverse side. They have three break lines delineating four sections.
Example 2: Yellow, rectangular counterfeit Xanax bars with R039 stamped on one side. They have three break lines delineating four sections.
Example 3: Red, rectangular fake Xanax bars with R666 stamped on one side. They have three break lines delineating four sections.
Example 4: Pale green, rectangular counterfeit Xanax bars with R039 stamped on one side. They have three break lines delineating four sections.
There are other versions as well, some of which are oval or round pills claiming to be generic brands of Xanax.
The best way to tell if it is fake Xanax bars is of course if it is not being sold by a pharmacy but instead by somebody on the street, in a bar or at school. Even if the seller tries to convince you that it is genuine Xanax, unless they can produce proof that they have a prescription, they are lying to you.
If in doubt, also examine the packaging and the bars themselves very closely. Fake packaging will have a printing quality that often looks a bit faded or blurred compared to the genuine Xanax.
The fake Xanax bars will often also not be as sharply marked and stamped as the genuine Xanax, as they are made in inferior pill presses. However, as the market increases, the backyard makers are upgrading their pill pressing equipment, and the difference is becoming harder to tell except under extreme magnification. A 40x magnifier such as those sold for hobbyists and jewelry crafters can usually spot the difference.
How to tell fake Raw Garden carts: clues to identify counterfeits
What to do about an overdose from fake Xanax bars
First of all, call for help if at all possible. The faster you get the overdose patient to medical help, the better their chances of surviving — and not suffering permanent problems.
Because of first responders feeling they could be at risk from a ‘contact overdose’ there are some areas of the USA where it has been said that their arrival at the scene might be delayed because of their reluctance to attend. We have not seen confirmed reports of this, but if you think it would be faster to get the overdose patient to a hospital, do that, but keep 911 on the line while you’re in transit — it’s possible an ambulance might be able to meet you on the way.
If caught in time, and first responders get to you or you get to a hospital in time, overdoses can be reversed through the correct medical application of naloxone or Narcan. And no it is NOT injected into the heart like the overdose scene in Pulp Fiction. It is administered intravenously or intramuscularly, and there is also an oral version.
How to tell fake vs genuine Viagra Cialis
Can you give somebody overdosing on opioids a shot of coke or speed?
Does speedballing fix an opioid overdose? No. It actually increases the risk of the person dying. Stimulants suppress the urge to breathe and constrict blood vessels — which makes the heart beat race and depletes the body of oxygen just at the time it most needs it.
Speedballing — any combination of a stimulant (upper) and a depressant (downer) taken together — also makes it much harder for the body to try and process the drugs in its fight to stay alive.