Mysterious meds arrive in the mail

Dear Alice,

My boyfriend received a package of unknown white pills in the mail with no return address. He doesn't know who sent them or what the pills are. To my horror he took one while out drinking one night but there was no noticeable effect. How/where can I find out what these pills are? They are round white tablets thicker than aspirin and have the numbers 54 543 imprinted on one side. I'm afraid to ask my pharmacist in case this might actually be a controlled substance. Can you help?

Dear Reader,

A random box of pills showing up at your doorstep can certainly be a cause for concern. As you suggest, taking any unknown medications could be harmful, but taking it in addition to alcohol may exacerbate those risks. While it’s helpful to find out more details about the meds and their origin, it’s also worth talking to your boyfriend about how this situation has you worried. Not only are there tools available to help you identify what the pills are, there are also some strategies you may find useful to starting a conversation with your boyfriend about taking these pills.

Though these medications seem to randomly have come into your boyfriend’s possession, could there be more to the story? Is it possible that the parcel was a practical joke from a friend? Could your boyfriend have a medical condition that you don’t know about? Does he share the same name as a family member? Could your boyfriend be dabbling in illicit drug use and trying to keep it a secret? If you’re not sure about the answers to these questions, it might be time to have a talk with your beau. As you alluded to, mixing alcohol with unknown pills or even known drugs (prescription and over-the-counter) can be risky and could lead to unexpected and potentially dangerous consequences. For instance, using opioid painkillers in ways that aren't indicated by a health care provider can lead to quite serious, long-lasting, or even life-threatening effects. Not to mention, some medications contain more than one active ingredient, which may complicate the effects even further. It’s recommended that prescription drugs are only taken as directed and aren’t shared with other people. Not only is it illegal, but it also it could have unpredictable and potentially serious side effects.

It’s good to share your concerns about the potential risks associated with taking unknown medication, especially with alcohol. That said, if you decide to go that route, it could be helpful to try and approach the discussion with a calm but curious tone to move the conversation along instead having of a threatening and interrogating one. Doing so may help you get more information about the medication in question and a better understanding about the situation at hand. Some ideas for conversation starters are:

  • "I'm concerned that you took one of those pills. I care about you and wouldn't want anything bad to happen to you."
  • "I'm curious about what made you decide to pop one of those pills the other night."
  • "I'm confused about this whole situation. How are you feeling about it?"
  • "When you took that pill the other night, what were you hoping would happen?"

If after the conversation you’re still concerned and wanting more information, it may be time to solicit outside help. A pharmacist may be able to identify the pills if you take them to a pharmacy in a secure container along with the original envelope. If you’re more concerned about their origin, you could report them to the postal service or the police, who might be able to help track down the sender.

Since it seems the pills aren’t in their original bottle, you might also consult a few other resources. The series of numbers you spotted (54 543) could be helpful in your investigation. In fact, the United States Food and Drug Administration (FDA) requires all solid, oral drugs intended for human consumption and sold in the United States to have a unique marker or an identifier on each pill (with some exceptions) that informs its dosage strength and active ingredient. Since you were able to take note of its shape, color, and approximate size, these descriptors can further narrow down your search. One possible resource to help is the FDA Center for Drug Evaluation and Research, which is run by the Division of Drug Information (DDI) within the FDA. This helps identify drugs based on physical appearance (color, shape, size, etc.) and markings.

Hopefully after some dialogue with your partner and sleuthing on your part, you’ll get some answers and actionable steps to address this situation.  

Good luck with your investigation,

Last updated Jun 12, 2020
Originally published Mar 10, 2000