JACKSONVILLE, Fla. – Authorities are asking people not to buy or use prescription painkillers unless they're from a doctor or a pharmacist.
Deputies said at least nine people died a year ago in the Tampa area after taking fake Xanax pills. That news came as doctors and paramedics told the I-TEAM that opioids -- painkillers like codeine, fentanyl, even heroin -- are involved in more deaths locally than ever.
News4Jax has learned that investigators believe there's a record number of tools use to make the counterfeit, and potentially lethal, medicine.
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"It's almost like playing Russian roulette. It's extremely dangerous," said Special Agent John Martin of the Drug Enforcement Administration.
It’s a deadly game -- buying pain killers on the streets is costing thousands of Americans their lives, and federal agents are sounding the alarm.
"People have died from ingesting what they think is a legitimate painkiller, and it's a counterfeit pill that contains fentanyl," Martin said.
According to CNN, most of the drugs come from China, where much of the illegal fentanyl is manufactured as well. Clandestine Chinese labs manufacture a synthetic version of fentanyl that is easily bought on the so-called "dark web." Mexican drug cartels later began to buy it and resell it across the border.
Fentanyl is making its way onto the streets at an alarming rate, experts said. It’s mixed with counterfeit pills that can be 50 times stronger than heroin.
Pill presses allow someone to take powder and press it into a pill that looks like prescription medication. And with the machines easily available, the demand high and the setup easier than ever, it means that the potential profits are huge.
"They are actually are pressing fentanyl tablets and calling them other names like Xanax or hydrocodone. There's been several deaths reported," said Gary Roberts of Roberts South Bank Pharmacy.
Roberts told News4Jax on Monday that no one is safe if they take a pill that's not straight from a real pharmacy.
"We're seeing more of it today than we probably have ever seen before," Roberts said.
The dosage must be precise for pain pills. Too little and it's not going to do the job; too much and it could prove deadly. That's why sterile compounding labs are heavily regulated and the people who work at them are highly trained and licensed.
Roberts described counterfeit pills as "poison," and he said he's worried that more people will die.
"(You'll) have respiratory arrest, and it will stop your heart from beating quite quickly," Roberts said.
CNN contributed to this report.