The U.S. State Department issued a warning Friday for Americans to “exercise caution” when buying medications from drug stores in Mexico, posting the health alert a week after a letter from two lawmakers and an investigation by the Los Angeles Times.

“The U.S. Department of State is aware of recent media reports regarding counterfeit pharmaceuticals available at pharmacies in Mexico, including those tainted with fentanyl and methamphetamine,” the alert said. “Counterfeit pills are readily advertised on social media and can be purchased at small, non-chain pharmacies in Mexico along the border and in tourist areas.”

The new notice is stronger than previous language on the department’s website, which warned that counterfeit pills were common in the country. It did not specify that they could be purchased at legitimate pharmacies or that they might contain such potent and deadly substances.

“The State Department warning is a good and necessary step,” said Chelsea Shover, a University of California, Los Angeles researcher whose team documented the problem this year. “But there’s still a lot we don’t know about the scope of this issue, and I think finding that will be critical to issuing more precise warnings and taking action.”

The department did not answer a list of questions about the advisory, instead sending a statement.

On Friday, “the U.S. Embassy in Mexico City issued a Health Alert informing U.S. citizens of the danger of counterfeit pharmaceuticals available at pharmacies in Mexico, including those potentially tainted with fentanyl and methamphetamine,” the statement said.

Mexican agencies and officials did not respond to requests for comment. In recent weeks, President Andres Manuel Lopez Obrador has denied that his country is involved in the fentanyl trade, despite ample evidence.

The State Department’s warning comes one week after Sen. Edward J. Markey, D-Mass., and Rep. David Trone, D-Md., sent a letter asking the department to immediately “warn Americans traveling to Mexico of the danger they face when purchasing pills from Mexican pharmacies.”

The letter cited the Los Angeles Times’ investigation and the UCLA researchers’ findings, both of which documented dangerous counterfeit pills being sold over the counter at drug stores in northwestern Mexico.

“U.S. tourists who unwittingly purchase counterfeit pills from Mexican pharmacies — both with and without a prescription, according to the Los Angeles Times — face deadly risks from medications that have effectively been poisoned,” the lawmakers wrote.

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