The opioid epidemic has claimed countless lives over the last 2 decades, and the government has been working with physicians’ organizations, pharmaceutical companies and law enforcement agencies to limit the misuse of prescription medications. However, dealers continue to get around these efforts by pressing pills and selling them as if they were real medications. Counterfeit Xanax pills, also known as “xans,” are sold as if they’re Xanax but may contain other dangerous ingredients. This article covers what you need to know to avoid these dangerous counterfeits.
What Are Pressed Pills?
In short: Pressed pills are counterfeit tablets made to look like real prescription drugs such as Xanax, Percocet or Adderall. They’re made in illegal labs with no quality control and often contain fentanyl, which makes even a single pill potentially deadly.
As more doctors become hesitant to prescribe controlled medications, drug dealers have come up with other ways to supply the market. Counterfeit Xanax pills go by several names, including xans, z-bars, white boys, bricks, blue footballs, planks, benzos and pressed bars. These pills are commonly sold on the street and through social media. Pressed xans can look identical to prescription Xanax, and there’s no way to verify their purity or whether they’ve been mixed with drugs such as fentanyl or methamphetamine.
The devices needed to manufacture pressed pills are easy to get and hard to trace. This has allowed criminal networks to market counterfeit versions of medications such as Xanax, Vicodin, OxyContin and Adderall online. According to the Drug Enforcement Administration (DEA), more than 98% of the 35 million-plus pills with pharmaceutical imprints its labs analyzed in 2025 were counterfeits.
Because of the other substances in pressed pills, they carry a higher risk of addiction and overdose. Fentanyl in particular increases the risk of a deadly overdose. Sometimes a single pill is enough to cause a fatal overdose.
Can You Tell If a Pill Is Pressed?
Where a pill comes from matters more than what it looks like. Counterfeits are rare in the legitimate U.S. pharmacy supply. A review by the Centers for Disease Control and Prevention (CDC) found that counterfeits make up between 9% and 41% of medicines in some low- and middle-income countries but less than 1% in high-income countries like the United States. Outside of a pharmacy, it’s a very different story, as the DEA’s findings above show.
Without lab testing, it’s very hard to identify pressed pills. A visual inspection can flag pills that are obviously fake, such as those with discoloration or incorrect imprint codes. But counterfeiters who copy the right shape, color and identification code can fool a simple visual check.
One possible difference between pressed pills and real medications is how durable they are. Pressed pills may be more likely to crumble or break apart under pressure, while genuine pills tend to be more robust. Still, that’s not a reliable test.
| Genuine Prescription Pill | Pressed (Counterfeit) Pill | |
|---|---|---|
| Where it comes from | A licensed pharmacy, with a prescription | The street, social media or websites that don’t require a prescription |
| What’s inside | The exact medication and dose on the label | Unknown; may contain fentanyl, other benzodiazepines or methamphetamine |
| Quality control | FDA-regulated manufacturing | None |
| Can you verify it by looking? | Imprint matches pharmacy records | Imprints are copied; only a lab test can confirm what’s inside |
For safety reasons, never get medications from any source other than a licensed pharmacy. Any website that claims to sell prescription medications without requiring a prescription is a probable scam.
What Do Pressed Xans and Other Pressed Pills Do?
Physicians prescribe Xanax for people with anxiety disorders. If someone experiences panic attacks, for example, they may take Xanax to reduce how often or how severely they happen. The medication works on the brain and nervous system to produce a sense of calm. Because Xanax is a benzodiazepine, however, doctors need to monitor these prescriptions to make sure patients don’t become dependent.
If someone becomes physically or psychologically dependent on Xanax, they may need a higher dose or more frequent doses to get the same effect. As dependence grows, withdrawal symptoms can feed the urge to take more. The problem with pressed xans is that they often don’t contain only Xanax — or any Xanax at all. In addition to common Xanax side effects, you run the risk of other complications.
Fentanyl is the most common substance mixed into counterfeit pills. It’s a powerful synthetic opioid. While doctors use pharmaceutical fentanyl under close medical supervision, the fentanyl in pressed pills is illegally made, and the amount in each pill is unknown.
Fentanyl Side Effects
Fentanyl is up to 100 times as strong as morphine, which is why pharmaceutical fentanyl is reserved for severe pain under close medical supervision. Possible side effects include:
- Blurred vision
- Seizures
- Rapid heartbeat
- Loss of appetite
- Sexual dysfunction
- Hallucinations
- Anxiety and depression
- Hives
- Breathing problems
- Difficulty swallowing
- Confusion
- Fainting
Some of these side effects can be fatal. Fentanyl is also highly addictive, and dependence can develop quickly. Learn more about what fentanyl looks like and how it’s hidden in other drugs.
Fentanyl in Pressed Pills
The DEA seizes tens of millions of fentanyl-laced fake pills each year, and its pill press resources show how widespread the problem has become. DEA lab testing found that 16% of pills containing fentanyl held a potentially lethal dose — and there’s no way to tell which ones by looking at them.
Criminals make these pills by pressing drug powder in a die and stamping a realistic-looking imprint, making it difficult for anyone without a lab to spot that they’re fake.
Addiction to Pressed Xanax
Both Xanax and fentanyl can be addictive. It doesn’t take much fentanyl to cause an overdose, and combining it with a benzodiazepine raises the risk further. Even someone who has only used pressed bars for a short time can show signs of addiction or overdose. Warning signs of an overdose include:
- Slow, weak or stopped breathing
- Pinpoint pupils
- Falling asleep, losing consciousness or not responding
- Choking or gurgling sounds
- A limp body
- Cold, clammy skin
- Blue or purple lips and fingernails
Call 911 if you think someone is showing these signs or may have overdosed.
Aside from overdose symptoms, you can often tell someone is addicted to pressed pills by changes in their behavior. They may become more withdrawn or stop participating in activities they once enjoyed. They might seem anxious or start seeking more of the drug in risky ways, including theft to get money for more pills.
Treatment for Pressed Bars and Pills
Naloxone (Narcan) can reverse an opioid overdose, including one caused by fentanyl. It won’t reverse the effects of benzodiazepines on its own, but because pressed xans so often contain fentanyl, give naloxone if you suspect an overdose and call 911. Many public places now keep naloxone in their first aid kits, and you can buy it over the counter without a prescription.
A bystander can give naloxone as a nasal spray or injection, and in an emergency, it may save a life. Naloxone won’t harm someone who isn’t using opioids, so it’s a worthwhile addition to your personal first aid kit. Learn more about what to know about Narcan.
Once someone is under the care of a hospital or doctor, medical professionals can provide medications to help manage withdrawal symptoms as they come off the drug. This is only the beginning of recovery. Many people benefit from medically supervised detox, followed by therapy and, for opioid use disorder, medication-assisted treatment to address the root causes of addiction.
Frequently Asked Questions
Recovery Is Possible
Pressed pills can be highly addictive, especially when they contain fentanyl. If you or someone you care about is struggling with addiction, it’s easy to feel a long way from a normal life. The good news is that many people have faced their addictions and built a better life. The first step is working with professionals experienced in benzodiazepine addiction treatment and fentanyl addiction treatment.
At Sunlight Recovery, we provide support for addiction, detox and recovery at every stage of your journey. Call our 24/7 admissions line at (855) 625-6684 or fill out our contact form to learn more about our treatment programs. Every call is confidential, with no obligation.
