The timing of the United States Drug Enforcement Administration’s One Pill Can Kill campaign is crucial, considering the recent Carrollton teen tragedy in which Fentanyl-laced pills posing as oxycodone were distributed through a “juvenile dealer” to high school students who then sold the deadly drugs to high school and middle school students. Commenting on the dramatic increase in drugs laced with Fentanyl in North Texas, Nexus Recovery Center’s chief clinical officer Julie Pittman told CBS News, “We used to make mistakes when we were young and dumb, but those mistakes are deadly now.”
Deaths may occur due to overdose, such as the Fentanyl-laced pills consumed by the teens, or due to the drugs’ being devoid of any therapeutic ingredient, such as the recent FDA recall of counterfeit antimalarial Combiart tablets. The WHO’s estimate that low- and middle-income countries spend an estimated $30.5 billion on substandard or falsified medicine implies hundreds of thousands of preventable deaths, often occurring in children in low-income countries, due to treatable illnesses such as malaria and acute pneumonia. One estimate cites a counterfeit drug prevalence in some parts of Africa and Asia as high as 70 percent. The use of falsified and poor-quality medicines also contributes to rising antimicrobial resistance and future treatment failure.
Meanwhile in developed nations, the “Viagra” a patient purchased online may contain anything from printer ink to arsenic. Or a patient may face treatment failure after consuming a “cheaper chemotherapeutic from Canada” that lacked any therapeutic ingredient. The “closed” drug distribution system designed to prevent harmful drugs from entering the U.S. supply chain fails to protect patients who venture online for convenience or cost savings. According to the National Association of Boards of Pharmacy (NABP), potentially 95 percent of websites offering prescription drugs operate illegally. Expensive drugs in high demand, including erectile dysfunction drugs, weight loss aids, hormones, steroids, antihistamines, antivirals, antianxiety drugs, and even chemotherapeutics, antibiotics, antivirals, and vaccines are common targets. Greater demand for a drug paired with limited supply—such as for Tamiflu during flu season—creates a hole that criminal opportunists may try to fill with fakes.
As the online pharmacy industry continues to lure uninformed consumers with competitive prices and convenience, providers may consider educating patients during Medication Safety Week about the tremendous risks of purchasing commonly counterfeited drugs online or while traveling abroad.
Emily Kahoud is a medical student.
