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Pill Presses and Counterfeit Prescription Narcotics: Supporting the STEER Act

In their opposition to drug importation legislation, the myriad “non-profit” groups funded by drug companies often cynically invoke the evils of counterfeit drugs. We’ve seen this as recently as this week, when an importation bill triumphantly passed in Florida (Prescription Drug Importation Programs HB19). One such group, the Partnership for Safe Medicines, was called out by PolitiFact for essentially lying that the new state law would “allow” imports from China “without FDA inspection,” tacking on that “too many have already died from counterfeit drugs.”

The Florida drug importation bill builds in so many regulatory checks that it may in fact make importation from Canada into Florida safer than our “regular” drug supply chain, but that’s for another post. As it happens, no one has ever been reported killed by a non-controlled prescription drug imported from a pharmacy that required a valid prescription.

PolitiFact is right to call out PSM, but I’m sad to report that, yes, there is a very real counterfeit drug problem in the United States. But, unlike the fake counterfeit drug facts propagated by groups like PSM to scare people away from buying lower-cost medicines online, it comes in the form of illegal fentanyl ingredients used to make counterfeit prescription narcotics.

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Prescription Opioids are Needed to Quell the Opioid Crisis

Prescription opioids needed to combat opioid crisis

This week Purdue Pharma settled with the state of Oklahoma for $270 million to avoid a trial charging the company with what I call opioid drug dealing. Purdue Pharma and members of the Sackler family–founders and managers of the company–are enmeshed in 1,600 cases throughout the U.S. They are accused of illegal marketing activities that led to over-prescribing and rampant distribution of Oxycontin, which paved the way for millions to the addiction of opioids, with hundreds of thousands dying over the last decade.

It was not just Purdue but many drug companies—and the entire drug supply chain—that fueled the opioid death spiral. As drug companies and their allies in the drug supply chain continue to use the opioid crisis as a means to oppose prescription drug importation to lower drug prices in the U.S., we can only look on with amazement at their audacity.

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Want to go to jail for illegal drug importation? Here’s how…

People buying medications to fill prescriptions in Canada or other countries because prices are too high domestically don’t get prosecuted for it. But people who import drugs illegally and resell them—especially controlled drugs, like prescription opioids, benzodiazepines, and amphetamines— get busted and go to jail for a pretty long time. Even seemingly small-time drug dealers.

As reported in Madawaska, Maine’s local news WABI5, Tristan Nelson was sentenced to a year and a half behind bars for illegally importing 950 pills of Ritalin (an amphetamine) and 450 pills of Xanax (a benzodiazepine) from the Philippines with intent to sell.

Of note is that neither of the medications was a prescription opioid, which is the highest enforcement priority of the U.S. FDA. Addiction to non-opioid controlled drugs, however, is also a public health problem, and clearly law enforcement takes illegal imports of them seriously.

The short story reported in WABI5 simply noted: “Nelson admitted to investigators he ordered the pills and planned to sell them.” It did not say how he ordered them, such as from a rogue online pharmacy, but perhaps I’ll find his court documents later this month to find out more.

Rogue online pharmacies selling controlled drugs for import, and domestic drug dealing, menace the Internet. But according to government data, they are not a major factor in the nation’s crisis with drug addiction and overdose.

FDA enforcement actions leading to prosecution, fines and/or jail for illegal drug importation focus on illegal wholesale importation of all prescription drugs, whether controlled or non-controlled prescription drugs. While it prioritizes counterfeit drugs, the illegal imports can be lawfully-manufactured, safe and effective. Recently, its focus is on stopping imports of fentanyl, mostly its ingredients. Part of that battle is stopping Internet activity that leads to the illegal fentanyl trade. Such ingredients, ordered online and then imported, are used to make fake opioid prescription drugs, which have exacerbated our nation’s crisis with drug addiction and overdose.

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