The other drug trade

Move over cocaine, heroin, marijuana, ecstasy and methamphetamine, the latest illegal drug activity is upwards of $200 billion, seemingly easier for the criminally-minded to navigate and more difficult to detect. There is no suspiciouslooking powder or rocks, no high-smelling herb or psychedelic pills. Instead, this drug activity could be far more dangerous because persons exposed to it are unaware.

According to a report released by the World Health Organisation (WHO) late last month, the billion-dollar counterfeit drug industry, just like the other illegal drugs mentioned above, is killing tens of thousands of people annually. How? Well, counterfeit drugs do not have the ingredients they claim to have. The persons manufacturing them usually replace approved drugs with substances like chalk or starch. In effect, such drugs, if they can be called that, are placebos. They will not cure what ails you, but if the fake additive is edible, they will not harm you either.

Let’s say someone has a headache and purchases what he/she believes to be acetaminophen, but it turns out that it was actually edible chalk. There will be no headache relief, of course, at least not from drinking those tablets. And the worst that might occur might be a bout of annoyance. However, if for instance that person has a bacterial infection or malaria and the tablets unwittingly purchased are made of chalk or starch, then he/she is drinking pills that cannot help, while the disease is likely progressing. Not good.

It gets worse. According to research and reports, some counterfeiters manage to get their hands on expired drugs, which they repurpose and repackage, getting even the foil seals right. Some of these so-called drugs are full of dangerous contaminants, including heavy metals, rat poison and even toxic highway paint. These will definitely kill any unsuspecting user. What’s more, once someone has bought and ingested the pills, the evidence is gone. That person might be assumed to have died from his/her ailment.

Mounting deaths from curable ailments, even when patients had been prescribed medication proven to work, prompted studies which have uncovered the mock drugs which proliferate developing countries. According to the WHO report, “after examining 100 studies of more than 48,000 medicines, experts found that one in 10 medicines in poor countries are fake...” It found that 40 per cent of reports of fake medicine originated from Africa, 21 per cent came from Europe and 21 per cent from the Americas.

And while the bulk of the reports of fake drugs originate in developing countries, separate studies and busts have found them in the United States, which has one of the toughest drug regulators in the world, though in limited quantities. In the US, the counterfeit drug traffickers target

the population that uses medication like Botox and Viagra. But recently, they have also turned to others including those used to treat cancer, high cholesterol and mental health conditions. Also, to no one’s surprise, federal agents have found links to mafia and criminal networks, though some of the biggest players are American white-collar criminals. The counterfeiting of a blockbuster drug generates a profit of US$500,000 for an initial investment of US$1,000.

So how do these counterfeit drug traffickers even get patients to buy their trash? Well, there’s the internet, where they sell them at a lower price. In the US, they pretend that the drugs are from Canada, where American elders have traditionally gone to buy cheaper medicines. In other countries, people are just happier to get what they believe to be the same medication at a cheaper price.

The WHO report said many of the sham medications go unreported, and its findings do not fully show how large the problem has become. The problem is fed by the lack of drug regulation in many countries or the fact that in many places where such legislation exists it is not properly applied. The high costs of brand name drugs also contribute to the problem. Patients go for the cheaper option, which sometimes is the generic

drug, but could very well be the counterfeit one.

Globalisation and the anonymity of the internet do not help at all. Persons who are not savvy enough to dig deeper than what they see on one page are often the ones scammed.

Individuals are not the only ones caught. Governments looking to cut costs can also be trapped by fake drug traffickers if sufficient due diligence is not done or, as is the case in many places, corruption exists. In some developing countries, fake drugs have found their way into hospitals, nursing homes and retail pharmacies.

In countries such as Guyana, where there is a lack of proper monitoring of food and drugs the threat of this industry blossoming and doing damage is very real. The Government Analyst – Food and Drug Administration needs much more support than it currently receives to properly monitor the private sector, and government needs to up its game as regards drug purchases.