She thought it was Xanax. How are Ohioans are playing Russian roulette with their cabinets.

One fake pill.

Just one can be enough to kill you.

U.S. deaths from drug overdose remain historically high with more than 105,000 estimated fatalities in 2022. The crisis continues to be largely fueled by fentanyl, a highly addictive synthetic opioid that is deadly in the tiniest dose.

And now a new type of drug is pushing overdose deaths higher: fake or counterfeit pills. Not the kind of illicit drug you buy from a dealer on a dark street corner.

These are marketed as real prescription drugs for patients being treated for ailments like cancer, diabetes or depression. But they are largely unregulated and sold online, through social media, or in foreign pharmacies at a cheaper price than at your neighborhood pharmacy.

At best, these fake pills don’t work. At worse, they can kill you.

While working on House Bill 230, legislation to increase the penalties for trafficking fentanyl, heroin and other illegal street drugs, I met a father who lost his 21-year-old daughter to fentanyl poisoning. She took what she thought was Xanax and died of fentanyl poisoning.

I told him I can’t imagine what your family has gone through, and he said you should imagine because it could happen to you.

Then, a friend told me that during a visit to Arizona, she crossed the border into Mexico to buy prescriptions.

I was blown away.

We must educate our kids, our friends and our neighbors about this drug epidemic and how they can unwittingly be exposed to fentanyl. Just like an illegal drug user who buy pills on the street, when you turn to questionable sources to buy legitimate-use prescription drugs you are literally playing Russian roulette, and the consequences for families can be devastating.

According to a recent report by the Centers for Disease Control and Prevention, overdose deaths involving counterfeit pills more than doubled between the summer of 2019 and late 2021.

The CDC analysis found that 4.7% of overdose deaths from October to December 2021, had evidence of counterfeit pill use. That was up from 2 percent from July to September 2019.

Public health and law enforcement officials warn that the fake pills are made to look like legitimate pharmaceutical pills like Percocet, Vicodin, Viagra and Adderall.

Consumers think they are getting a needed medication at a cheaper price. But instead, they are unknowingly taking a poor-quality drug that is less effective, or a sugar pill of no use at all, or worst of all, one that has been laced with fentanyl.

The spike comes as the nation’s Drug Enforcement Agency (DEA) for the first time in 6 years - issued a public safety alert to warn of widespread drug trafficking of fentanyl-laced pills made by Mexican drug cartels to look like real prescription drugs - the same size, same color, same markings. Federal agents have seized millions of fake pills in all 50 states.

Last year, DEA officials said more than half of fentanyl-laced prescriptions analyzed in 2022 - 6 out of 10 - contained potentially lethal doses of fentanyl, “a dramatic increase” from 4 out of 10 in 2021.

The message is clear. Never take a medication that wasn’t prescribed for you. Don’t take a pill bought online. The only safe medication is one prescribed by a doctor or health care professional and dispensed by a licensed pharmacist.

Just one fake pill can be dangerous. Just one can kill.