(HealthDay News) — Counterfeit medications from online pharmacies pose significant risks to patients, including overdose and death, according to a warning issued by the US Centers for Disease Control and Prevention.

The warning follows a federal indictment announced last week against 18 individuals who are accused of running a massive illegal online pharmacy operation.

“The victims of the scheme include people from all walks of life — people of all ages and occupations — from all 50 states, the US Virgin Islands, Puerto Rico, Germany and Slovenia,” the US Department of Justice said in a statement announcing the indictment. “At least nine victims who purchased counterfeit pills from the defendants died of narcotics poisoning, including a 45-year-old army veteran who thought she was purchasing real oxycodone.”

In its warning, the CDC noted that the counterfeit pills frequently contained fentanyl and methamphetamine.

The problem is pervasive: According to the National Association of Boards of Pharmacy, almost 95% of online pharmacies operate illegally and 24% of Americans who have used an online pharmacy have been exposed to harmful, counterfeit, or substandard medications.

In light of that, people should only take medications prescribed by a licensed health care provider and dispensed by a licensed pharmacy, the CDC said.

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