> The FDA said it found 33 packages of opioids and no fentanyl sent by mail in 2022 out of nearly 53,000 drug shipments its inspectors examined at international mail facilities. That’s about 0.06% of examined packages.
More often, to save $150 for a PCP visit. Nobody is ordering black market viagra/cialis because they can't find a doctor who will prescribe it. It's because they can't visit any doctor.
Or it's tacked onto another order. For example, Asmanex is $400/mo under my insurance, or I can order another inhaler with the same active ingredient from India for $10. Then I'd likely just put in another $10 of viagra/cialis because why not.
Most likely, men are just adding non-FDA approved viagra/cialis to their actual international medication orders "because why not".
Viagra is often abused in combination with alcohol or opiods (this may be the more boring codeine type abuse, not meth, etc) since it can allow you to have an erection when your body might not normally allow.
Thus if you are at a house party, consuming drugs and intend to get laid, you need to have viagra.
Smarter drug dealers include viagra as an addon to "party packages" for an upcharge. For obvious reasons it is desirable to buy in bulk.
It's because people rightfully don't want to go to a doctor when they want to have a good time.
UAE and UK have Viagra/Cialis availible OTC. Spain, Italy, Portugal and Greece is de-facto OTC (you can go to a pharmacy with an A4 blank piece of paper and 'be your own doctor' by writing in what you need by hand and signing it off still as 'your own doctor' with a fantasy name and a cool autograph).
In the Land of the Free you have to go through all sorts of BS if you want to try how does it feel to do it 7 times in a night.
Even recreational use is very low risk, not to mention people will do the 7 times/night things a bunch of sessions , cross it from their bucket list and they'd move on with the next item on the list.
>Spain, Italy, Portugal and Greece is de-facto OTC (you can go to a pharmacy with an A4 blank piece of paper and 'be your own doctor' by writing in what you need by hand and signing it off still as 'your own doctor' with a fantasy name and a cool autograph).
Cannot say in the other countries, but in Italy you definitely cannot do that, the pharmacist wants a valid prescription (usually by a known MD, you may have even issues in getting some medicines with a valid prescription signed by a doctor in another city/region).
It is the first time that I hear about "invented" prescriptions, though probably making fake ones is not difficult.
> > Cannot say in the other countries, but in Italy you definitely cannot do that, the pharmacist wants a valid prescription (usually by a known MD, you may have even issues in getting some medicines with a valid prescription signed by a doctor in another city/region).
My experience was always that if you begged for something without prescription it was always a no go, as soon as you have a semi-valid piece of white paper with maybe some intestation etc. then you don't even have to beg
>semi-valid piece of white paper with maybe some intestation
is more like a fake prescription, and doesn't sound like:
>A4 blank piece of paper and 'be your own doctor' by writing in what you need by hand and signing it off still as 'your own doctor' with a fantasy name and a cool autograph
It may depend on the specific medicine you needed/wanted, and of course there may be more or less strict pharmacists, but you won't normally get any non-OTC medicines without a proper prescription in Italy.
> > is more like a fake prescription, and doesn't sound like:
So the 'fake' treshold for you would be surpassed by the act of using a PC and a printer, whereas the 'writing what you need and signing off with a cool authograph' doesn't get you over the line?
In any event, just semantics compared to what is going on in the US, Germany, The Netherlands and essentially de-facto the same scenario as the UK and the UAE (at least for people who are not extremely poor or unable to use Word.
Look, you stated that drugs (such as Viagra) were easily available ("de-facto OTC") in several countries, I can only report the actual situation, to the best of my knowledge, for the country I live in (Italy) which is that without a prescription you won't get it.
> Spain, Italy, Portugal and Greece is de-facto OTC (you can go to a pharmacy with an A4 blank piece of paper and 'be your own doctor' by writing in what you need by hand and signing it off still as 'your own doctor' with a fantasy name and a cool autograph).
In Spain, things were quite lenient 10-15 years ago (basically, many pharmacies would sell you Viagra/Cialis without prescription, it was just a matter of trying and finding a lenient one) but not anymore AFAIK.
You do need an official prescription, and there seems to be a lot of control so no pharmacy seems to sell without prescription now (maybe some do and I don't know, but if that's the case, they're definitely not easy to find).
The situation is getting more and more ludicrous, as now you can't even get 1 g paracetamol pills without a prescription... but you can still get as many boxes of 500 mg pills as you like. Excellent measure to protect people who don't know basic addition.
I'm in Europe and I order tadalafil by mail from shady websites because:
1) Getting it from the pharmacy (with prescription) is too expensive, about 3x what I pay when ordering online. And this is for a generic, Cialis is not even available.
2) I can get at most 80mg in one visit to pharmacy, and need to visit a doctor for prescription renewal after 5 visits to pharmacy. All that for the privilege of paying through the nose for a generic, widely available medication.
No lab testing or paperwork, they often just resell generics from India. Luckily, the quality seems to be good but I had no guarantees when first trying it.
I basically need it permanently, one 10 mg pill every 2-3 days.
I wouldn't even mind paying through the nose to get it from less shady sources, I understand quality control is important and can have a cost. But for some reason pharmacies only sell boxes of 8 pills, and IIRC in my country (Spain) you can use the prescription only 5 or 6 times. So I would basically need to go to the doctor every 2-3 months.
It's not that I can't go, free healthcare works fine here, but I'm a busy person. I just don't want to waste time going to the doctor 5 or 6 times a year for something that I already know I need. Plus, the chance of meeting people at the clinic and getting ashamed inventing some excuse 5 or 6 times a year.
The fact that on the shady sites I can get it literally 4x cheaper (not an hyperbole) just makes the decision even clearer.
Unfortunately, the customs here are also getting progressively more annoying. My last order was intercepted.
This is detailing a report from the FDA about packages they inspected. However, I wonder if there's no overlap with packages inspected by the DEA and/or CBP.
The FDA might not see many opiate packages if most of the "hot leads" for which packages likely contain opiates are routed to the DEA for inspection and the FDA never sees them. Similarly for any other Schedule 2/3 drugs.
That could be why the FDA mostly sees "asthma" drugs. Though...I do believe that international orders would mirror domestic prevalence and lots of people need asthma medication. I myself have ordered asthma medications from India to save hundreds of dollars per month.
Anyways, the article states "The FDA said it found 33 packages of opioids and no fentanyl sent by mail in 2022". This was out of 53,000 packages inspected. However, the CBP reports finding 239 mail parcels with fentanyl at just JFK airport alone in 2018[0]. It's unclear how many packages the DEA has seized but it also sounds like a lot more than 33.
If so, it sounds like there's even less reason for the FDA to be involved if the DEA is already catching the truly illicit stuff. The issue the article takes is that the FDA keeps asking for more and more money to inspect packages for opioids/fentanyl, but is using that money to mostly destroy legitimate medicine. If they had to say what they were actually doing with the money, they might not get it.
FDA seizing drugs that aren't in the NIDA-5 (cocaine/opiates/amphetamines/etc) will get a lot more contentious when the TikTok generation figures out how to skirt domestic shortages of tirzepatide and semaglutide by getting it from non-FDA approved facilities overseas.
However, asthma/cancer/ED/heart medications are probably for now more what the critical voting blocks care about.
I'm seeing them very available in "bulk" out of China. Not much "pseudo-branded" out of India/elsewhere yet. Specifically looking at:
- Semaglutide: $10/month
- Tirzepatide: $60/month
- Liraglutide: $87/month
For unbranded/unlabeled Chinese "bulk" material, but packaged into consumer-ready vials, 2mg-10mg per vial. BYO QA/QC though, as with all non-FDA drugs. That's the huge catch, and it sucks for consumers. Testing just for active ingredient is >$100 and takes about a month. Testing for proper buffering agents, harmful contaminants, microbial contamination, etc is essentially unavailable at all.
Default answer for Americans: “Yes it is still illegal, technically it’s smuggling, assuming it’s not a controlled substance.”
Nuanced answer: There is a loophole where Americans can get medicine from overseas if it is the exact same drug/brand/dose as their prescription AND the imported drug was produced under FDA supervision and is labeled for sale in the USA. This used to be a situation where you could get big discounts for the same brand name drug but now they have different brand names for different price markets and they don’t distribute the FDA drugs to India/Turkey/etc or do so at the same wholesale price; so this loophole doesn’t help much. You might find 10-20% discount off domestic retail price but not 80-90%.
Not a lawyer, but AFAIK if one has a valid rx for e.g. adderall, it's still illegal to make it (or even to buy it from a friend who got it via their own valid rx). I'd expect the situation to be similar.
Yes, otherwise everyone with a prescription that costs more than a few dollars a month would be ordering from these services and US pharmacies & drug-makers would go out of business (or be forced to cut prices dramatically)
[EDIT] As pointed out by another poster, unless the drugs are valid for import to the US and such and it's all done above-board—obviously, the US doesn't manufacture all its own drugs. But those aren't the cheap options.
> FDA spokesperson Devin Koontz said the figures don’t reflect the full picture because U.S. Customs and Border Protection is the primary screener at the mail facilities.
> But data obtained from the customs agency shows it likewise found few opioids: Of more than 30,000 drugs it intercepted in 2022 at the international mail facilities, only 111 were fentanyl and 116 were other opioids.
People getting small-fry otherwise legitimate Rx drugs aren't bribing the right people to let it through. And why would they, the stakes are much smaller.
People getting ordinary Rx packages seized are being struck by lightning. There's absolutely no need to bribe a customs official (major crime!) to import some unscheduled pharma (not even a crime). The vast, vast majority of imported pharmaceuticals aren't seized.
Criminals importing scheduled substances aren't bribing US customs either.
>This is detailing a report from the FDA about packages they inspected. However, I wonder if there's no overlap with packages inspected by the DEA and/or CBP.
>Anyways, the article states "The FDA said it found 33 packages of opioids and no fentanyl sent by mail in 2022". This was out of 53,000 packages inspected. However, the CBP reports finding 239 mail parcels with fentanyl at just JFK airport alone in 2018[0]. It's unclear how many packages the DEA has seized but it also sounds like a lot more than 33.
It has these CBP numbers in the article:
>the figures don’t reflect the full picture because U.S. Customs and Border Protection is the primary screener at the mail facilities. But data obtained from the customs agency shows it likewise found few opioids: Of more than 30,000 drugs it intercepted in 2022 at the international mail facilities, only 111 were fentanyl and 116 were other opioids.
Brian Krebs book, Spam Nation, which dissected 2 leaked Russian "online pharmacy" databases, has the same sort of breakdown for US drug orders. European orders had less health related drugs and more "recreational" drugs like erectile pills. If I recall, the online pharmacies would throw in a handful of Viagra in most orders.
"But the agency’s own data from recent years on its confiscation of packages containing drugs coming through international mail provides scant evidence that a significant number of opioids enters this way."
No shit. Who is sending opioids via international mail?! How stupid does CNN think we are? How stupid does CNN think drug smugglers are?! They are being waltzed across our porous southern border.
Oh, you mean the border where the seizures of fentanyl are at record level and almost of what comes in, comes through the ports of entry in trucks and not some random spot on the border on somebody's back just like you'd expect?
What gets confiscated at ports of entry is only a small fraction of the total that is out there. It is very easy to purchase fentanyl from illegal dealer right now and cheap. That is probably the best way to measure how porous the border truly is.
I talked to this old hippie drug dealer who was talking about all of these things he wouldn’t touch any more because the chance of fentanyl was too high and he’d had friends killed by fentanyl. Exactly the opposite kind of person to be susceptible to that kind of moral panic.
Locally they recently did a bust and found enough raw fentanyl for a million lethal doses or enough to get every single person in the extended metro area high.
A cheap drug where an amount equal to a few grains of sand can kill is indeed worth the concern.
Sure, but the "public face" of this is stories about fentanyl in kids' candy and cops having seizures after someone tells them they were within ten meters of some fentanyl. That aspect (i.e. the bullshit) is textbook moral-panic stuff.
The hyperbole might be intentional, because it might be the only way to get the word out to the marginalised elements of society that are at greatest risk. I agree is not ideal, because it might lead people to ignore it. But the danger is very real.
The target of those stories isn't marginalized elements, it's boring straight-laced suburban America. That's how you build enthusiasm for cracking down on illicit drug imports—which crackdown apparently mostly results in stopping prescription drugs that aren't fent, which may explain why this is being pushed so hard.
The target is mothers and fathers who have a child that might be susceptible to using recreational drugs. So, that they are aware and take extra notice. And maybe even have some narcan on hand just in case.
Sorry for the fox news link (the WaPo source is paywalled) but there's a lawsuit being filed against airbnb and renters because someone's baby died of a fentanyl overdose after being laid down for a nap in a rental:
Does that mean you're likely to die of exposure to fentanyl tomorrow? Almost certainly not (unless you're doing drugs cut with it, like a friend of mine did). Does that mean we should sit back and let it happen? No, not at all.
What's "really happening" is not in line with how it's being reported. It's being reported like the Tide Pod thing, which was (surprise, surprise) 99% made-up with a nugget of truth (which was not enough material to drive months of coverage, certainly) at the core, while news organizations pointedly failed to look into it (the actual news, to the extent there is any, isn't that teenagers were doing it—which barely happened—but that toddlers and old people with dementia eat them at many times the rate of what was happening in that not-actually-a-fad—but "people without full mental faculties sometimes consume cleaning products" isn't a story, it's just normal life).
Yes, of course fent is dangerous. Yes, if a kid finds a little in an AirBnB and ingests it, that could kill them. The angle the news is taking is largely bullshit, though, and it's bullshit very much on purpose, like all the other times this happens. They're not doing it to inform.
[EDIT] The most important aspect of how the media are covering this is probably that their focus is on stories (real or otherwise) that will tend to get the broad, dull middle class to support more import enforcement—not on coverage that might, say, tend to build support for proven harm-reduction like safe use sites w/ drug purity testing and distributing narcan more widely. Evidently, that stepped-up import enforcement largely stops other drugs—like asthma medicine. Which raises the very real possibility that this panic and the tone & shape it's taken—which, again, isn't promoting actual safety for the people most-affected by this—is driven, at least in part, by trade interest groups & their PR firms/departments.
Fentanyl is scary shit normal people wouldn't touch with a ten foot pole, and its derivates like carfentanyl are even worse.
It's one thing if you get a legit supply of the stuff diverted from, say, a veterinary practice. At least the dosage won't be random. But street dealers? Do you think these people have the slightest idea how to properly mix stuff together? Fuck up with carfentanyl and out of 100 pills you end up with half the supply duds, half the supply containing the expected amount and one that's going to kill the consumer. (Obviously, YMMV depending on how competent the dealer is)
So, why do dealers end up using carfentanyl anyway? Easy: the stuff is up to many thousand times more effective than heroin [1], so it's easier to smuggle large quantities of it across borders.
That being said: The campaigns of fentanyl or generally drug-laced helloween sweets are complete and utter BS, although I expect more incidences of cannabis edibles in the future given the growth of the industry.
JFC, why are people taking this comment as claiming fentanyl is safe? There's, specifically, a moral-panic-style media campaign around fentanyl, it's the main way it's making it to the probably-Sinclair-owned local evening news that your mom and dad watch, and the bullshit stories they share with one another on Facebook. In that world, danger to addicts is secondary to "ARE THE CHINESE TRYING TO POISON YOUR KIDS WITH FENTANYL CANDY?" and "police say touching one millionth of a gram of fentanyl can cause seizures and death" and crap like that. That's, very explicitly, what I was writing about.
One reason the media drive these kinds of panics is because it gets them attention, which is what they sell. This story brings to mind the possibility that it's also being driven by prescription drug manufacturer industry associations and interest groups, who don't give a fuck about fent but would very much like a strong, popular push to more strongly police prescription drug imports (as a side-effect—but, apparently, maybe the main effect—of targeting fent)
> being driven by prescription drug manufacturer industry associations and interest groups
You do know those groups are currently profiting off selling fentanyl for medical uses? Fentanyl is very commonly used in US medicine - particularly surgeries - today.
Yes, of course. But illicit fent imports aren't a threat to that business—hospitals aren't buying fent from Joey "Slick" Williams on the corner, or mail-ordering it from shady sites based out of Russia. Importing very-cheap asthma medicine and boner pills, however, might affect their business, and the safer & more reliable those imports are perceived to be, the more business on more kinds of drugs they lose, and the more that folks realized how cheap drugs can be, the more support legislation allowing a larger legal import market might gain, and they really don't want that.
[EDIT] Now, fent imports might threaten their ability to sell other opioids to addicts, but my impression is that cash-cow's rather less-lucrative now than it had been, for reasons largely unrelated to fentanyl smuggling.
fascinating there is a private company accrediting foreign pharmacies (pharmacychecker, they guy they quote in the middle)
private accreditation feels simultaneously problematic, and something that will fill huge voids left by public licensing systems that have gotten slow or otherwise bad
mirrors uber / crypto in that the opportunity is working around something the state wants to own
Quick reminder for the younger readers: Customs and Border Patrol has doubled in size in the last 25 years, relative to the size of the population, and in my lifetime has increased the number of agents by 500%. I personally think these losers should get a real job and stop poking around in my mail. The explosion of third-tier fringe law enforcement agencies has not been good for Americans.
Yeah, that and HSI is now like half the size of the FBI. CBP has 60k people and patrols even the interior of the US, they're basically the modern day gestapo complete with suspension of the constitution within 100 miles of the border (which is where most people live).
>Quick reminder for the younger readers: Customs and Border Patrol has doubled in size in the last 25 years, relative to the size of the population, and in my lifetime has increased the number of agents by 500%.
I'm no fan of the CBP but this seems like a flimsy objection. There's no reason to believe why their staffing levels will grow linearly with population. They're tasked with protecting the border, so we'd expect their staffing levels to grow linearly with the amount of border that needs protecting. If there's more stuff coming in (eg. aliexpress shipments from china), or more border crossings (legal or otherwise), we'd expect their numbers to grow faster relative to population.
"Needs protecting" is a policy choice. Mexicans used to just come and go. Then, as an economic policy choice, we decided to close up the border, now migrants only want to come and not leave.
There are not "more border crossings" today, there are fewer. The Border Patrol is massive and bloated but the peak border interdiction rates of the 80s and 90s remain the records.
Could you please provide evidence that population growth adjusted this number to under a record high? Until then I am going to actual believe the real numbers and not how you feel.
> There are not "more border crossings" today, there are fewer.
less than uh, 2010 maybe. there were less than a million mexican nationals in the US in 1970. there has been an unprecedented explosion in migration from latam in the last three decades, to the point that latinos are on track to become the largest ethnic group in the US.
The job description of the CBP has expanded way beyond protection the border and customs. For instance, they were deployed to Portland and have been featured patrolling interior cities under the auspices of catching domestic drug trade. They have become also a domestic police force at the convenience of the executive branch.
The authority they claimed for their deployment was 40 U.S. Code § 1315, protection of "federal property and persons", not anything customs and border related. The law providing the authorization was part of one of the many knee-jerk post 9/11 bills.
If you read the next sentence you'd see they addressed that.
> If there's more stuff coming in (eg. aliexpress shipments from china), or more border crossings (legal or otherwise), we'd expect their numbers to grow faster relative to population.
Thinking of every inbound package as "extending the amount of border" is mission creep nonsense IMO - it's propaganda mostly for the benefit of legislators holding the purse strings.
Regardless, it doesn't justify the extensive CBP expansion outside of mailrooms.
> Thinking of every inbound package as "extending the amount of border" is mission creep nonsense IMO - it's propaganda mostly for the benefit of legislators holding the purse strings.
How is it mission creep? Isn't inspecting inbound packages (ie. "customs") literally part of "Customs and Border Protection"?
>Regardless, it doesn't justify the extensive CBP expansion outside of mailrooms.
There are many other plausible reasons for expanding CBP outside of mailrooms, eg. war on drugs, illegal immigration, terrorists, etc.
Our prescription drug system needs an overhaul. This isn't a matter of all drugs are illegal to import because of quality control issues. You can import aspirin, if you are so inclined. This is asthma and cancer medication being seized because of an overly tight control of prescription drugs. I understand that some drugs sold overseas are not suitable for human consumption. I understand that some drugs require close supervision. I argue that many medications are quite safe to take without supervision and using doctors as gatekeepers functions primarily to increase the billings generated by sick people. I think the bar for what medications are prescription and which medications are OTC needs to be reevaluated. Perhaps the way in which we market drugs and disclose there risks should be reevaluated simultaneously.
Imagine taking away someone's asthma medication and thinking you are making America a safer, better place.
The international pharmaceutical trade market is already under fire with contamination and fraud issues as it is. 300.000 to 1 million people are estimated to die each year from that per the WHO [1] - that's frankly insane, and it's not just fake penis enlargement pills that people buy on random spam platforms, but the fraudsters even manage to penetrate into the legitimate supply chain of German pharmacies.
The solution is obvious: more domestic production, and for the US to get their shit together. You don't need to throw pills for every little cough, the fact that y'all have ads for prescription medicine is completely mind-blowing. Like, I go to the doctor with symptoms, not with a shopping list of stuff shilled in yesterday's cable news.
Anytime the topic of the FDA/customs seizing pharma drugs imported by Americans comes up, big pharma and confused citizens conflate the amount of counterfeit branded drugs with actually dangerous drugs. No one is fighting for the right to be able to buy fake Cialis. They are fighting for the right to buy generic Tadalafil manufactured by billion-dollar Indian companies trusted by over a billion people with the proper FDA certifications in India. Those who mislabel their brand should still be prosecuted. That's barely relevant. Yes, we take too many drugs. But we also don't take enough, because we can't afford it, because we're all being squeezed by big pharma. (You're also conflating the Americans who have decent health insurance with those who don't.) And almost no health insurance covers dick pills and no adult should have to explain to a stranger that their dick doesn't work to get their permission to take a super safe drug with a few clearly-described risks. (The truth is, half the online pharma business is literally just dick pills. Half.)
I've been interested in this topic for 15+ years. The good news is, despite what this article may lead a casual reader to believe, 99% of the DEA-uncontrolled medications imported are not seized. You can order them safely, and if they are seized, they shipper will probably send them again for free, and you won't have any legal issues.
>They are fighting for the right to buy generic Tadalafil manufactured by billion-dollar Indian companies trusted by over a billion people with the proper FDA certifications in India.
The revenue of a pharma manufacturer is not necessarily an indicator of quality. Many international pharma firms of supposed good repute have repeatedly been found to be committing egregious levels of good manufacturing practice (GMP) violations, and even when they have production lines that stand up to FDA audits, parallel production lines in the same firm that aren't subject to FDA scrutiny (as they produce for non-US markets) often are churning out very suspicious products for local / developing world consumption. And even US-based production lines can be churning out product with potential defect for quite some time during gaps between FDA audits - it happens all the time.
I understand where you’re coming from because our medical system IS lazy and DOES overprescribe, but the knee-jerky “pills bad” thing is frustrating for those of us who are necessarily on a lot of medications.
This cultural phenomenon has roots so deep that I’ve had actual medical professionals (usually nurses) tell me that I’m on too many pills. On a few occasions I’ve invited them to tell me which ones I should get rid of and, of course, they don’t know because all of the medications are currently doing something important.
It’s an attitude that mystifies me. Pharmaceuticals have side effects, do people think I want to take this stuff?
I'm referring to antibiotics prescriptions for clear-as-day viral infections (~~strep~~, influenza, covid). That shit is one of the largest contributors to multi- or omniresistant superbugs, right behind the even worse practice of using human reserve antibiotics routinely in industrial farming.
Actually, that's hard to say. Many people don't completely take the antibiotics prescribed to them. They don't take them when they are supposed to and take them for a few days or less than the total time they are supposed to. The bug can then become resistant to the antibiotic, so they have to switch to something else. Problem is, there are only so many types of antibiotics, which may or may not work on that specific bug. This foolishness leads to resistant superbugs as well.
Oh, I'm with you on this one. Antibiotics and opioids are special categories when it comes to overprescription.
On the bright side, I think in recent years American doctors have been much better about waiting until an infection is likely to be bacterial before prescribing antibiotics. There's probably still room to improve but at least it feels like we're working on that.
The farming thing, though, is a huge problem and an international embarrassment.
I get strep every 2-3 years and go through 4-5 days of misery before paying to see a doctor, paying >$50 for a strep test, waiting another day for that to come back, just so I can finally get antibiotics from which I'm feeling much better (not "well", but much better) in under 8 hours.
The system sucks and strep is a bacterial infection. And big ag will hire whatever vet that says their cows need more antibiotics so it's not like my super expensive human system is really impacting the rate of superbugs.
Superbugs are a general class. Each disease evolves its own resistance (though, it does get around - https://academic.oup.com/cid/article/34/Supplement_3/S78/292... ). You are creating antibiotic resistant strep in your own body. At some point, the antibiotics won't be able to knock it down to the asymptomatic form.
Antibiotic resistance isn't a joke. Take the full course.
How on earth am I creating antibiotic resistant strep in my own body? I do take the full proscribed course of antibiotics. I don't see what that has to do with having to spend at least $150 (consultation + lab test) just to get permission to get the antibiotics I need, which then cost additional money. While big ag gets whatever antibiotics they want.
Thank heavens I work in tech and $150 isn't like a whole month's worth of groceries to me. But there's no way to look at this and think "Yup, that's the system working as intended."
how would they possibly know what the full course length is for each bug. I've always gotten the same length and dose, how is that the prefect length and dose when the doctor doesn't even know that exact bug that i have.
> This is asthma and cancer medication being seized because of an overly tight control of prescription drugs.
Actually, many of these are medications (even life saving ones) being seized to protect inflated pharmaceutical pricing and profits at the expense of poorer Americans (and those lacking health care). Significant numbers of people are ordering the medications out of desperation.
Funny you see the theft in one direction and not the other. Isn't the black market just a natural expression of agents engaging in free market principles?
Because there is no actual theft going on? Are you suggesting that local “legitimate” users pay higher costs to recoup R&D expenses? I’d love to hear the evidence - it sounds a lot to me like the “piracy is theft” argument which has not been proved or well supported.
> Are you suggesting that local “legitimate” users pay higher costs to recoup R&D expenses? I’d love to hear the evidence
Yes ? Are you suggesting they that comes out of pharma profits?
> it sounds a lot to me like the “piracy is theft” argument which has not been proved or well supported.
No because not taking medication isn't an option like not watching a pirated movie.
Perhaps a closer analogy is shoplifting . Sure some amount of stealing is accounted for in the system but large scale shoplifting gets passed on to consumers.
I think the pricing is based on the maximum amount each individual can bear, independent of costs. If your hypothesis was accurate, we should see prices go up when sales go down (independent of the cause of the sales drop). I don't think that is clear, but open to evidence if you have it handy.
There might be a long term impact where fewer drugs are developed because there are lower profits, but even that feels awfully close to the "piracy hurts creative industries" argument that has been proven inconclusive at best and directionally wrong at worst.
Wow thats a big assumption that the system the user is circumnavigating is legitimate. Their are 2 "official" reasons for that system, safety and patent protection. While both have their merits they don't legitimatize the current state of that system. By your definition the only difference in its status of legality is the location those drugs are purchased and used. This is a very flaky foundation for your argument of legitimacy and the outcome of theft. Most of the time any legitimate protest against what you believe is wrong elicits shouts of "theft", "illegitimate", "think of the children", "safety". This conversation would be much more productive if you provided any examples of that theft or support for why the system is legitimate to begin with.
That being said I do think the system has a place but it desperately needs overhauled and people seeking alternatives to the system aren't the problem but the canary in the coal mine signalling the weakest of our fellow citizens can't make do with the system that should be serving them.
thats the reason gp is doing it. has nothing to do with all the stuff you've written. Gp doesn't care about 'weakest fellow citizens' plight or whatever, infact they don't care that prices for 'weakest citizens' might go up from his actions.
I think your misguided in thinking someone who purchases outside the system is contributing to higher costs when you have fraud like this taking place in the government run systems let alone the private systems.
https://www.cnbc.com/2023/03/09/how-medicare-and-medicaid-fr...
… because stealing would require something being taken away from one person and being possessed by another?
The drugs are paid for, they’re not stolen, and they’re not taken from the people who are buying the drugs another way - they’re separate systems. That’s actually more ridiculous than calling media piracy ‘theft’ and that’s a high bar. I honestly don’t see how you could possibly see the illegal drug trade as ‘stealing’
Because capital expects profits. Why on earth would anyone invest capital in biotech if its losing money.
> If anything I'm reducing demand for "legitimate" avenues, which should reduce the price.
These aren't stale muffins at your local grocery store to induce demand by lowering prices. These are supposedly life saving 800/month drugs, what would be the motivation for lowering prices.
They're drugs. The market in America wants $800/mo. The international online market wants what comes out to $34/mo.
It's the same drug. It costs $34 online because that's how much it costs for the factory to produce it and make a profit. It costs $800 in America because that's how much my insurance company decided I'm going to pay for it. It would be idiotic for me, with my extremely limited funds, to pay for the American one.
> to protect inflated pharmaceutical pricing and profits
If federal laws were created with sole purpose of inflating pharma profits then you would just invest your life savings in these pharma companies and be set for life. You've literally found the golden goose if you really belive what you wrote there.
> I understand that some drugs sold overseas are not suitable for human consumption
Frankly, a lot of FDA-approved drugs sold in the US aren't suitable for consumption, especially generics manufactured outside the US. The FDA simply doesn't have the resources to enforce good manufacturing practices and product consistency, so a lot of subpar medication manages to slip under the radar and into the US market. The situation is much more grim for non-US buyers, who often get products of significantly worse quality.
'Bottle of Lies' by Katherine Eban[1] provides a thorough and very unsettling exposé on the issue.
Prescription drugs are barred from being imported for a different reason than quality control because non prescription drugs are allowed to be imported.
Buying affordable medicine is a crime not because there is a health risk, but because you are engaging in copyright infringement. You aren’t paying your toll to the Nice Men who bought their right to monopoly.
The FDA has rules limiting the import of all prescription drugs, and does not distinguish between drugs with an active patent and those with an expired patent. In addition, it's possible to purchase patented drugs that are manufactured legally overseas. I think you are conflating illegally manufactured medicine and laws for importing medicine.
You can see the FDA makes no mention on if the medicine is under a patent when setting it's rules for which prescription drugs can be imported [0].
'Buying affordable medicine' in your argument begins false premise.
Whether or not many cheap generic substances produced for sale primarily in the developing world actually qualify as 'medicine' by US/EU standards is a very serious problem, and it's very common that these generic drugs don't live up to the standard for various reasons. Issues like under-dosing of the active compound, contamination, and use of unsafe additives are all frequent issues with drugs not intended for sale in the North America/The EU/markets that follow US/CA/EU approval in lieu of strong local standards.
In reality, the 'crime' here is buying something that may, or often may not qualify as medicine per leading standards, for which there are both safety and intellectual property concerns.
Yes, primarily for a few well justified reasons: 1) usage of prescription drugs usually entails significantly greater risks of adverse effects compared to OTC drugs (barring some grandfathered-in legacy substances like acetaminophen, which would probably not be approved for OTC use today), 2) relative to usage of OTC drugs, the stakes associated with usage of an under-performing prescription drug are much greater in magnitude, and 3) there is an economic incentive to produce counterfeit or otherwise subpar prescription drugs that doesn't exist for OTC drugs, the wholesale value of which can be often be measured in fractions of a penny.
Counterfeits are also a lot more common in the developing world than people would expect, and this stuff frequently ends up in online pharmacies. Manufacturers of drugs bound for international markets do implement measures that you usually don't see in the US (e.g. consumer-accessible websites/phone lines to verify a lot number and unique serial printed on counterfeit-resistant holograms), but even that doesn't do a lot of good. I've personally purchased antibiotics from a pharmacy in Vietnam that had convincing anti-counterfeit labels - but shame on me for not paying attention to the serial numbers. I bought two boxes with lot numbers and serials that checked out on the manufacturer website...but both boxes had the same serial, which shouldn't have been possible. The hologram stickers were indistinguishable from images of legitimate ones portrayed on the manufacturer website. I'm assuming everything the pharmacy had on hand for that drug (amoxicillin + potassium clavulanate) had the same serial on the label.
> I argue that many medications are quite safe to take without supervision and using doctors as gatekeepers functions primarily to increase the billings generated by sick people.
A may be safe. B may be safe. A + B may very well be deadly.
C may be safe, but in combination with grapefruit is ineffective.
D may be safe, but interactions with E and F need to be balanced and monitored to ensure that the body's systems don't get out of whack.
G may be safe, but it has recreational use (and abuse) possibilities.
H may be safe, but is a precursor to creating Z which is heavily regulated.
... and the list goes on.
Most drugs have a "this can go wrong" and with the prevalence of people taking whatever they find or people are talking about (see hydroxychloroquine and ivermectin for some widely popularized examples), I am hesitant to suggest that the common person is sufficiently informed about drugs to take that aspect of their medical care into their own hands without oversight.
> I am hesitant to suggest that the common person is sufficiently informed about drugs to take that aspect of their medical care into their own hands without oversight.
I generally agree that there are cases where prescription medications should be controlled. My argument is that too many medications are prescription. Several OTC medications are inappropriate to mix with other OTC medications, require monitoring with long term use, or have interactions with grapefruit. People make fatal decisions with OTC medications. Some OTC medications have recreational potential. These concerns are not unique to prescription medication.
I am not persuaded by the argument that individuals are not capable of making their own medical decisions. A doctor can advise a patient which OTC medications to take, and this type of consultation will still be available. Pharmacists will also answer questions about OTC medications they sell. I think there is an ocean of difference between "Medical advise is available to you if you choose this treatment" and "Medical advise is required to even choose this treatment." We are using the later too frequently, and I suspect many want to keep it this way to drive up healthcare costs.
I've never had a doctor tell me what drugs are safe or unsafe to take with others, almost never had a doctor ask what drugs I already take.
You grossly overestimate healthcare providers, and there are many things much more dangerous that people are just freely allowed to risk their lives doing.
> I've never had a doctor tell me what drugs are safe or unsafe to take with others, almost never had a doctor ask what drugs I already take.
The doctors in my system constantly are reviewing the drugs I'm taking. It helps that the computer system that they use actually captures the drugs I'm taking from all the doctors I see.
Before a procedure, the surgeon even went over the supplements that my wife takes. I applaud that surgeon for going above and beyond the call of duty--my wife brought in two huge ziploc baggies of all the crap she takes.
It can be annoying as sometimes it takes a couple rounds of "No, I'm not on that anymore" to actually pull the thing from the system record, but I actually approve of it overall.
The FDA model is broken. It is pretty much a Nazi model where private industry is protected from competition and also dictated to by heavy handed government pencil pushers. Good things wont come out of it.
The claims like "foreign drugs might be dangerous" is simply dumbing down of reality of world and false. While your average joe wont know if the insulin he got from Tijuana is good or not, denying him the insulin entirely is even bigger threat to Joe's life. Not just that but now you have insulin smugglers who are even bigger threat as they are totally off the legal scrutiny.
But American Diabetic Association can do a better job of importing insulin from world over at cheaper prices and distributing it to their members while ensuring reasonable quality. Unlike FDA, ADA can actually work with insurance companies to compensate the victims if things go wrong.
The Nazis have nothing to do with this, it's bog-standard regulatory capture, which is a thing everywhere but extremely prevalent in the US.
Take a look at the F500 (or F50) list and see how many large insurance and healthcare companies are on there. None of them are Nazis; most of those companies have straight-up woke policies. But they lobby hard, and that's why the model is broken.
This feels like a "streetlight effect" where they're searching where it's easy to search. Obviously fentanyl is a serious problem in the USA and needs to be tackled, but this kind of indicates that the mail is not the main vector for it getting into the USA, rather comparatively harmless stuff.
> Obviously fentanyl is a serious problem in the USA and needs to be tackled
But for some reason it's politically untenable to tackle it in ways that actually help people -- by providing free test strips at corner stores. Being able to easily and reliably test drugs for fentanyl would make using it as an additive worthless.
The US really said "abstinence only" with no self-awareness that it doesn't work for sex, drugs, or rock and roll. Any solution that doesn't involve "no drug use" even if it saves lives is is of no interest. Which is surprising because the people I know who snort cocaine like Dysons are well to do white folks.
Those easy test kits have their own false positive/false negative error rates. So, it give a false sense of security. More effective to just raise the alarm that it could be in most illegal drugs, because it most likely is.
Raising the alarm isn't actionable though. Okay great you know that there's a not insignificant chance that the bag of bag of molly you just bought is laced with fentanyl, what do you do about it?
Because I promise you everyone who does party drugs knows about fentanyl, doesn't stop them though.
Are people really dying because of an epidemic of asthma drugs and cancer drugs and penis pills being improperly prescribed and mailed? No. The public health issue is centered around opioids. This is like saying, oh gee, never mind dioxin, so many more people die in car wrecks.
Yellow journalism probably paid for by big pharma.
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[ 2.9 ms ] story [ 225 ms ] thread> Asthma, cancer, erectile drugs sent from abroad make up are most confiscations, despite opioid claims
> The No. 1 item was cheap erectile dysfunction pills, like generic Viagra.
I don't think they were ordering viagra online to save a dollar...
Or it's tacked onto another order. For example, Asmanex is $400/mo under my insurance, or I can order another inhaler with the same active ingredient from India for $10. Then I'd likely just put in another $10 of viagra/cialis because why not.
Most likely, men are just adding non-FDA approved viagra/cialis to their actual international medication orders "because why not".
Thus if you are at a house party, consuming drugs and intend to get laid, you need to have viagra.
Smarter drug dealers include viagra as an addon to "party packages" for an upcharge. For obvious reasons it is desirable to buy in bulk.
It's because people rightfully don't want to go to a doctor when they want to have a good time.
UAE and UK have Viagra/Cialis availible OTC. Spain, Italy, Portugal and Greece is de-facto OTC (you can go to a pharmacy with an A4 blank piece of paper and 'be your own doctor' by writing in what you need by hand and signing it off still as 'your own doctor' with a fantasy name and a cool autograph).
In the Land of the Free you have to go through all sorts of BS if you want to try how does it feel to do it 7 times in a night.
Even recreational use is very low risk, not to mention people will do the 7 times/night things a bunch of sessions , cross it from their bucket list and they'd move on with the next item on the list.
Cannot say in the other countries, but in Italy you definitely cannot do that, the pharmacist wants a valid prescription (usually by a known MD, you may have even issues in getting some medicines with a valid prescription signed by a doctor in another city/region).
It is the first time that I hear about "invented" prescriptions, though probably making fake ones is not difficult.
My experience was always that if you begged for something without prescription it was always a no go, as soon as you have a semi-valid piece of white paper with maybe some intestation etc. then you don't even have to beg
>semi-valid piece of white paper with maybe some intestation
is more like a fake prescription, and doesn't sound like:
>A4 blank piece of paper and 'be your own doctor' by writing in what you need by hand and signing it off still as 'your own doctor' with a fantasy name and a cool autograph
It may depend on the specific medicine you needed/wanted, and of course there may be more or less strict pharmacists, but you won't normally get any non-OTC medicines without a proper prescription in Italy.
So the 'fake' treshold for you would be surpassed by the act of using a PC and a printer, whereas the 'writing what you need and signing off with a cool authograph' doesn't get you over the line?
In any event, just semantics compared to what is going on in the US, Germany, The Netherlands and essentially de-facto the same scenario as the UK and the UAE (at least for people who are not extremely poor or unable to use Word.
In Spain, things were quite lenient 10-15 years ago (basically, many pharmacies would sell you Viagra/Cialis without prescription, it was just a matter of trying and finding a lenient one) but not anymore AFAIK.
You do need an official prescription, and there seems to be a lot of control so no pharmacy seems to sell without prescription now (maybe some do and I don't know, but if that's the case, they're definitely not easy to find).
The situation is getting more and more ludicrous, as now you can't even get 1 g paracetamol pills without a prescription... but you can still get as many boxes of 500 mg pills as you like. Excellent measure to protect people who don't know basic addition.
1) Getting it from the pharmacy (with prescription) is too expensive, about 3x what I pay when ordering online. And this is for a generic, Cialis is not even available.
2) I can get at most 80mg in one visit to pharmacy, and need to visit a doctor for prescription renewal after 5 visits to pharmacy. All that for the privilege of paying through the nose for a generic, widely available medication.
I basically need it permanently, one 10 mg pill every 2-3 days.
I wouldn't even mind paying through the nose to get it from less shady sources, I understand quality control is important and can have a cost. But for some reason pharmacies only sell boxes of 8 pills, and IIRC in my country (Spain) you can use the prescription only 5 or 6 times. So I would basically need to go to the doctor every 2-3 months.
It's not that I can't go, free healthcare works fine here, but I'm a busy person. I just don't want to waste time going to the doctor 5 or 6 times a year for something that I already know I need. Plus, the chance of meeting people at the clinic and getting ashamed inventing some excuse 5 or 6 times a year.
The fact that on the shady sites I can get it literally 4x cheaper (not an hyperbole) just makes the decision even clearer.
Unfortunately, the customs here are also getting progressively more annoying. My last order was intercepted.
The FDA might not see many opiate packages if most of the "hot leads" for which packages likely contain opiates are routed to the DEA for inspection and the FDA never sees them. Similarly for any other Schedule 2/3 drugs.
That could be why the FDA mostly sees "asthma" drugs. Though...I do believe that international orders would mirror domestic prevalence and lots of people need asthma medication. I myself have ordered asthma medications from India to save hundreds of dollars per month.
Anyways, the article states "The FDA said it found 33 packages of opioids and no fentanyl sent by mail in 2022". This was out of 53,000 packages inspected. However, the CBP reports finding 239 mail parcels with fentanyl at just JFK airport alone in 2018[0]. It's unclear how many packages the DEA has seized but it also sounds like a lot more than 33.
0: https://www.cbp.gov/frontline/crisis-control
However, asthma/cancer/ED/heart medications are probably for now more what the critical voting blocks care about.
- Semaglutide: $10/month
- Tirzepatide: $60/month
- Liraglutide: $87/month
For unbranded/unlabeled Chinese "bulk" material, but packaged into consumer-ready vials, 2mg-10mg per vial. BYO QA/QC though, as with all non-FDA drugs. That's the huge catch, and it sucks for consumers. Testing just for active ingredient is >$100 and takes about a month. Testing for proper buffering agents, harmful contaminants, microbial contamination, etc is essentially unavailable at all.
Nuanced answer: There is a loophole where Americans can get medicine from overseas if it is the exact same drug/brand/dose as their prescription AND the imported drug was produced under FDA supervision and is labeled for sale in the USA. This used to be a situation where you could get big discounts for the same brand name drug but now they have different brand names for different price markets and they don’t distribute the FDA drugs to India/Turkey/etc or do so at the same wholesale price; so this loophole doesn’t help much. You might find 10-20% discount off domestic retail price but not 80-90%.
[EDIT] As pointed out by another poster, unless the drugs are valid for import to the US and such and it's all done above-board—obviously, the US doesn't manufacture all its own drugs. But those aren't the cheap options.
> FDA spokesperson Devin Koontz said the figures don’t reflect the full picture because U.S. Customs and Border Protection is the primary screener at the mail facilities.
> But data obtained from the customs agency shows it likewise found few opioids: Of more than 30,000 drugs it intercepted in 2022 at the international mail facilities, only 111 were fentanyl and 116 were other opioids.
Criminals importing scheduled substances aren't bribing US customs either.
>Anyways, the article states "The FDA said it found 33 packages of opioids and no fentanyl sent by mail in 2022". This was out of 53,000 packages inspected. However, the CBP reports finding 239 mail parcels with fentanyl at just JFK airport alone in 2018[0]. It's unclear how many packages the DEA has seized but it also sounds like a lot more than 33.
It has these CBP numbers in the article:
>the figures don’t reflect the full picture because U.S. Customs and Border Protection is the primary screener at the mail facilities. But data obtained from the customs agency shows it likewise found few opioids: Of more than 30,000 drugs it intercepted in 2022 at the international mail facilities, only 111 were fentanyl and 116 were other opioids.
"But the agency’s own data from recent years on its confiscation of packages containing drugs coming through international mail provides scant evidence that a significant number of opioids enters this way."
No shit. Who is sending opioids via international mail?! How stupid does CNN think we are? How stupid does CNN think drug smugglers are?! They are being waltzed across our porous southern border.
If you think this is just a “moral panic” then you’re wrong. It’s a severe problem and it’s only getting worse.
Locally they recently did a bust and found enough raw fentanyl for a million lethal doses or enough to get every single person in the extended metro area high.
A cheap drug where an amount equal to a few grains of sand can kill is indeed worth the concern.
https://www.foxnews.com/media/baby-dies-florida-airbnb-fenta...
It's not bullshit when it is really happening. Lots of people on the internet want to pretend it's not real, but there's actual video footage of it:
https://www.wfla.com/news/florida/video-florida-cop-treated-...
Does that mean you're likely to die of exposure to fentanyl tomorrow? Almost certainly not (unless you're doing drugs cut with it, like a friend of mine did). Does that mean we should sit back and let it happen? No, not at all.
Yes, of course fent is dangerous. Yes, if a kid finds a little in an AirBnB and ingests it, that could kill them. The angle the news is taking is largely bullshit, though, and it's bullshit very much on purpose, like all the other times this happens. They're not doing it to inform.
[EDIT] The most important aspect of how the media are covering this is probably that their focus is on stories (real or otherwise) that will tend to get the broad, dull middle class to support more import enforcement—not on coverage that might, say, tend to build support for proven harm-reduction like safe use sites w/ drug purity testing and distributing narcan more widely. Evidently, that stepped-up import enforcement largely stops other drugs—like asthma medicine. Which raises the very real possibility that this panic and the tone & shape it's taken—which, again, isn't promoting actual safety for the people most-affected by this—is driven, at least in part, by trade interest groups & their PR firms/departments.
Their toddler took a nap in an Airbnb — and fentanyl killed her https://wapo.st/3mvOXmi
It's one thing if you get a legit supply of the stuff diverted from, say, a veterinary practice. At least the dosage won't be random. But street dealers? Do you think these people have the slightest idea how to properly mix stuff together? Fuck up with carfentanyl and out of 100 pills you end up with half the supply duds, half the supply containing the expected amount and one that's going to kill the consumer. (Obviously, YMMV depending on how competent the dealer is)
So, why do dealers end up using carfentanyl anyway? Easy: the stuff is up to many thousand times more effective than heroin [1], so it's easier to smuggle large quantities of it across borders.
That being said: The campaigns of fentanyl or generally drug-laced helloween sweets are complete and utter BS, although I expect more incidences of cannabis edibles in the future given the growth of the industry.
[1] https://en.wikipedia.org/wiki/Carfentanil#Pharmacodynamics
One reason the media drive these kinds of panics is because it gets them attention, which is what they sell. This story brings to mind the possibility that it's also being driven by prescription drug manufacturer industry associations and interest groups, who don't give a fuck about fent but would very much like a strong, popular push to more strongly police prescription drug imports (as a side-effect—but, apparently, maybe the main effect—of targeting fent)
You do know those groups are currently profiting off selling fentanyl for medical uses? Fentanyl is very commonly used in US medicine - particularly surgeries - today.
[EDIT] Now, fent imports might threaten their ability to sell other opioids to addicts, but my impression is that cash-cow's rather less-lucrative now than it had been, for reasons largely unrelated to fentanyl smuggling.
private accreditation feels simultaneously problematic, and something that will fill huge voids left by public licensing systems that have gotten slow or otherwise bad
mirrors uber / crypto in that the opportunity is working around something the state wants to own
I'm no fan of the CBP but this seems like a flimsy objection. There's no reason to believe why their staffing levels will grow linearly with population. They're tasked with protecting the border, so we'd expect their staffing levels to grow linearly with the amount of border that needs protecting. If there's more stuff coming in (eg. aliexpress shipments from china), or more border crossings (legal or otherwise), we'd expect their numbers to grow faster relative to population.
There are not "more border crossings" today, there are fewer. The Border Patrol is massive and bloated but the peak border interdiction rates of the 80s and 90s remain the records.
"In fiscal year 2022, federal officials along the southern border stopped migrants over 2.3 million times, a record high."
https://www.cbsnews.com/news/jan-6-arrests-new-accusations-s...
Could you please provide evidence that population growth adjusted this number to under a record high? Until then I am going to actual believe the real numbers and not how you feel.
less than uh, 2010 maybe. there were less than a million mexican nationals in the US in 1970. there has been an unprecedented explosion in migration from latam in the last three decades, to the point that latinos are on track to become the largest ethnic group in the US.
Portland may not feel close to the sea, but it is.
Have the geographic borders changed in the last 25 years?
> If there's more stuff coming in (eg. aliexpress shipments from china), or more border crossings (legal or otherwise), we'd expect their numbers to grow faster relative to population.
Regardless, it doesn't justify the extensive CBP expansion outside of mailrooms.
How is it mission creep? Isn't inspecting inbound packages (ie. "customs") literally part of "Customs and Border Protection"?
>Regardless, it doesn't justify the extensive CBP expansion outside of mailrooms.
There are many other plausible reasons for expanding CBP outside of mailrooms, eg. war on drugs, illegal immigration, terrorists, etc.
Imagine taking away someone's asthma medication and thinking you are making America a safer, better place.
The solution is obvious: more domestic production, and for the US to get their shit together. You don't need to throw pills for every little cough, the fact that y'all have ads for prescription medicine is completely mind-blowing. Like, I go to the doctor with symptoms, not with a shopping list of stuff shilled in yesterday's cable news.
[1] https://www.tagesschau.de/inland/securpharm-101.html
I've been interested in this topic for 15+ years. The good news is, despite what this article may lead a casual reader to believe, 99% of the DEA-uncontrolled medications imported are not seized. You can order them safely, and if they are seized, they shipper will probably send them again for free, and you won't have any legal issues.
The revenue of a pharma manufacturer is not necessarily an indicator of quality. Many international pharma firms of supposed good repute have repeatedly been found to be committing egregious levels of good manufacturing practice (GMP) violations, and even when they have production lines that stand up to FDA audits, parallel production lines in the same firm that aren't subject to FDA scrutiny (as they produce for non-US markets) often are churning out very suspicious products for local / developing world consumption. And even US-based production lines can be churning out product with potential defect for quite some time during gaps between FDA audits - it happens all the time.
A really eye opening read on the global pharma quality situation: https://www.nytimes.com/2019/05/13/books/review/bottle-of-li...
This cultural phenomenon has roots so deep that I’ve had actual medical professionals (usually nurses) tell me that I’m on too many pills. On a few occasions I’ve invited them to tell me which ones I should get rid of and, of course, they don’t know because all of the medications are currently doing something important.
It’s an attitude that mystifies me. Pharmaceuticals have side effects, do people think I want to take this stuff?
On the bright side, I think in recent years American doctors have been much better about waiting until an infection is likely to be bacterial before prescribing antibiotics. There's probably still room to improve but at least it feels like we're working on that.
The farming thing, though, is a huge problem and an international embarrassment.
The system sucks and strep is a bacterial infection. And big ag will hire whatever vet that says their cows need more antibiotics so it's not like my super expensive human system is really impacting the rate of superbugs.
Antibiotic resistance isn't a joke. Take the full course.
Thank heavens I work in tech and $150 isn't like a whole month's worth of groceries to me. But there's no way to look at this and think "Yup, that's the system working as intended."
https://www.bmj.com/content/358/bmj.j3418
Actually, many of these are medications (even life saving ones) being seized to protect inflated pharmaceutical pricing and profits at the expense of poorer Americans (and those lacking health care). Significant numbers of people are ordering the medications out of desperation.
Yes ? Are you suggesting they that comes out of pharma profits?
> it sounds a lot to me like the “piracy is theft” argument which has not been proved or well supported.
No because not taking medication isn't an option like not watching a pirated movie.
Perhaps a closer analogy is shoplifting . Sure some amount of stealing is accounted for in the system but large scale shoplifting gets passed on to consumers.
Just not through the non-free American prescription drug market.
There might be a long term impact where fewer drugs are developed because there are lower profits, but even that feels awfully close to the "piracy hurts creative industries" argument that has been proven inconclusive at best and directionally wrong at worst.
thats the reason gp is doing it. has nothing to do with all the stuff you've written. Gp doesn't care about 'weakest fellow citizens' plight or whatever, infact they don't care that prices for 'weakest citizens' might go up from his actions.
The drugs are paid for, they’re not stolen, and they’re not taken from the people who are buying the drugs another way - they’re separate systems. That’s actually more ridiculous than calling media piracy ‘theft’ and that’s a high bar. I honestly don’t see how you could possibly see the illegal drug trade as ‘stealing’
wouldn't it raise prices for legitimate buyers? ( ppl not willing to commit a federal crime) , hence taking money away from them.
> If anything I'm reducing demand for "legitimate" avenues, which should reduce the price.
These aren't stale muffins at your local grocery store to induce demand by lowering prices. These are supposedly life saving 800/month drugs, what would be the motivation for lowering prices.
It's the same drug. It costs $34 online because that's how much it costs for the factory to produce it and make a profit. It costs $800 in America because that's how much my insurance company decided I'm going to pay for it. It would be idiotic for me, with my extremely limited funds, to pay for the American one.
If federal laws were created with sole purpose of inflating pharma profits then you would just invest your life savings in these pharma companies and be set for life. You've literally found the golden goose if you really belive what you wrote there.
Frankly, a lot of FDA-approved drugs sold in the US aren't suitable for consumption, especially generics manufactured outside the US. The FDA simply doesn't have the resources to enforce good manufacturing practices and product consistency, so a lot of subpar medication manages to slip under the radar and into the US market. The situation is much more grim for non-US buyers, who often get products of significantly worse quality.
'Bottle of Lies' by Katherine Eban[1] provides a thorough and very unsettling exposé on the issue.
[1]https://www.nytimes.com/2019/05/13/books/review/bottle-of-li...
You can see the FDA makes no mention on if the medicine is under a patent when setting it's rules for which prescription drugs can be imported [0].
[0] https://www.fda.gov/industry/import-basics/personal-importat...
Whether or not many cheap generic substances produced for sale primarily in the developing world actually qualify as 'medicine' by US/EU standards is a very serious problem, and it's very common that these generic drugs don't live up to the standard for various reasons. Issues like under-dosing of the active compound, contamination, and use of unsafe additives are all frequent issues with drugs not intended for sale in the North America/The EU/markets that follow US/CA/EU approval in lieu of strong local standards.
In reality, the 'crime' here is buying something that may, or often may not qualify as medicine per leading standards, for which there are both safety and intellectual property concerns.
Counterfeits are also a lot more common in the developing world than people would expect, and this stuff frequently ends up in online pharmacies. Manufacturers of drugs bound for international markets do implement measures that you usually don't see in the US (e.g. consumer-accessible websites/phone lines to verify a lot number and unique serial printed on counterfeit-resistant holograms), but even that doesn't do a lot of good. I've personally purchased antibiotics from a pharmacy in Vietnam that had convincing anti-counterfeit labels - but shame on me for not paying attention to the serial numbers. I bought two boxes with lot numbers and serials that checked out on the manufacturer website...but both boxes had the same serial, which shouldn't have been possible. The hologram stickers were indistinguishable from images of legitimate ones portrayed on the manufacturer website. I'm assuming everything the pharmacy had on hand for that drug (amoxicillin + potassium clavulanate) had the same serial on the label.
Teenage girls.
People who live with teensge girls should treat paracetamol like firearms.
OR
Just regulate that, whatever? 100mg of n-acetyl-cystiene be in each tablet, thereby rendering the overdose potential significantly reduced.
A may be safe. B may be safe. A + B may very well be deadly.
C may be safe, but in combination with grapefruit is ineffective.
D may be safe, but interactions with E and F need to be balanced and monitored to ensure that the body's systems don't get out of whack.
G may be safe, but it has recreational use (and abuse) possibilities.
H may be safe, but is a precursor to creating Z which is heavily regulated.
... and the list goes on.
Most drugs have a "this can go wrong" and with the prevalence of people taking whatever they find or people are talking about (see hydroxychloroquine and ivermectin for some widely popularized examples), I am hesitant to suggest that the common person is sufficiently informed about drugs to take that aspect of their medical care into their own hands without oversight.
How do you make sure that the person is coming in to have bloodwork done if they're on D, E, and F?
If a person is buying A over the counter and you prescribe B - where is that check being done?
I generally agree that there are cases where prescription medications should be controlled. My argument is that too many medications are prescription. Several OTC medications are inappropriate to mix with other OTC medications, require monitoring with long term use, or have interactions with grapefruit. People make fatal decisions with OTC medications. Some OTC medications have recreational potential. These concerns are not unique to prescription medication.
I am not persuaded by the argument that individuals are not capable of making their own medical decisions. A doctor can advise a patient which OTC medications to take, and this type of consultation will still be available. Pharmacists will also answer questions about OTC medications they sell. I think there is an ocean of difference between "Medical advise is available to you if you choose this treatment" and "Medical advise is required to even choose this treatment." We are using the later too frequently, and I suspect many want to keep it this way to drive up healthcare costs.
You grossly overestimate healthcare providers, and there are many things much more dangerous that people are just freely allowed to risk their lives doing.
The doctors in my system constantly are reviewing the drugs I'm taking. It helps that the computer system that they use actually captures the drugs I'm taking from all the doctors I see.
Before a procedure, the surgeon even went over the supplements that my wife takes. I applaud that surgeon for going above and beyond the call of duty--my wife brought in two huge ziploc baggies of all the crap she takes.
It can be annoying as sometimes it takes a couple rounds of "No, I'm not on that anymore" to actually pull the thing from the system record, but I actually approve of it overall.
Healthcare quality varies.
The claims like "foreign drugs might be dangerous" is simply dumbing down of reality of world and false. While your average joe wont know if the insulin he got from Tijuana is good or not, denying him the insulin entirely is even bigger threat to Joe's life. Not just that but now you have insulin smugglers who are even bigger threat as they are totally off the legal scrutiny.
But American Diabetic Association can do a better job of importing insulin from world over at cheaper prices and distributing it to their members while ensuring reasonable quality. Unlike FDA, ADA can actually work with insurance companies to compensate the victims if things go wrong.
The Nazis have nothing to do with this, it's bog-standard regulatory capture, which is a thing everywhere but extremely prevalent in the US.
Take a look at the F500 (or F50) list and see how many large insurance and healthcare companies are on there. None of them are Nazis; most of those companies have straight-up woke policies. But they lobby hard, and that's why the model is broken.
But for some reason it's politically untenable to tackle it in ways that actually help people -- by providing free test strips at corner stores. Being able to easily and reliably test drugs for fentanyl would make using it as an additive worthless.
The US really said "abstinence only" with no self-awareness that it doesn't work for sex, drugs, or rock and roll. Any solution that doesn't involve "no drug use" even if it saves lives is is of no interest. Which is surprising because the people I know who snort cocaine like Dysons are well to do white folks.
Because I promise you everyone who does party drugs knows about fentanyl, doesn't stop them though.
Yellow journalism probably paid for by big pharma.