MEXICO CITY (AP) — The U.S. State Department issued a travel advisory on Wednesday for Americans planning to spend spring break in Mexico.

The advisory warns travelers to exercise extra caution, especially after dark, in several Mexican Caribbean tourist destinations that have been hit by drug cartel violence.

The alert warns U.S. citizens “to exercise extreme caution in downtown areas of the busiest locations during spring break, including Cancun, Playa del Carmen and Tulum, especially after dark.”

The State Department also noted that several US citizens “became seriously ill or died in Mexico after taking synthetic drugs or counterfeit prescription pills.”

The warning follows reports that some Mexican pharmacies offer free sedatives and other drugs that can only be sold by prescription in the United States. Mexican pills may be counterfeit and contain fentanyl, a deadly synthetic opioid.

The alert also noted that “unregulated alcohol may be adulterated” and that “US citizens have reported losing consciousness or being injured after consuming possibly adulterated alcohol.”

There has been a series of egregious acts of violence along the Caribbean coast, the crown jewel of Mexico’s tourism sector.

In 2022, two Canadians were murdered in Playa del Carmen, apparently over debts between international drug and arms trafficking gangs.

In 2021, further south in the sleepy destination of Tulum, two tourists – an Indian-born Californian travel blogger and a German woman – were caught in the crossfire by rival drug traffickers and killed.

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