Mailed asthma, cancer, erectile drugs are seized the most, despite opioid claims
cnn.com
cnn.com
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.
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."
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.
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.
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.
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.
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
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.
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.
> 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.
> Asthma, cancer, erectile drugs sent from abroad make up are most confiscations, despite opioid claims
"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.
Yellow journalism probably paid for by big pharma.