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Most people say that they just throw the letters away and they never hear of anything again, however, if it were me, I'd be darn curious what that letter all had to say!
I would imagine if it wasn't a very large amount, Customs probably wouldn't proceed any further as long as you didn't respond to the letter trying to claim your package. Although there are others who will report that they have gone through tremendous amounts of BS with the DEA showing up at their door, etc. But I really think it all has to do with the quantity. I don't see how they would want to spend thousands and thousands of dollars prosecuting a small amount of prescription drugs, but I could be wrong.