The recent Arizona seizure of 73,000 counterfeit pills containing fentanyl by the U.S. Drug Enforcement Administration (DEA) is a microcosm of what is fueling the nationwide opioid crises. President Trump recently touted that 17 percent fewer opioid prescriptions were written this year compared to last year. With the reduction of opioid prescriptions, one would conclude there would be a corresponding reduction of prescription opioid abusers. To the contrary, opioid addiction and overdose incidents continue at epidemic proportions, with no end in sight.
As part of a national strategy, DEA’s tactical diversion squads pursued pharmaceutical manufacturers, distributors, pharmacies, pharmacists, and doctors, whom the DEA determined were abusing their DEA registration when marketing and over-prescribing opioid medication. Criminal, civil, and administrative sanctions have, and continue to reign in the industry. Gov. Doug Ducey signed Arizona’s “Opioid Epidemic Act” enacting stricter controls on the medical industry’s prescribing of opioids, mandatory participation in a prescription monitoring program, limiting the number of prescription opioid pills for first-time patients, and educating the medical industry on opioid addiction.
It appears government successes in reducing available “legal” pain medication generated an unintended consequence. Mexican drug trafficking organizations filled the void, flooding America with foreign counterfeit prescription drugs, fueling the opioid crises. According to the Center for Disease Control and Prevention, U.S. prescription drug overdoses reached a record 72,000 deaths in 2018. What is disturbing is that more than half of the opioid overdose deaths were from fentanyl, a synthetic heroin manufactured in China.
Fentanyl contained in foreign counterfeit medications, sourced in China and smuggled across the Southwest border by Mexican drug trafficking organizations, supplies millions of addicted Americans. With the precipitous reduction of legal prescription pain medication, patients have turned to the black market to get their pain medications. Patients unwittingly purchase foreign counterfeit drugs disguised as low-level pain medication, unaware of the dangers – they end up as an overdose statistic. There is no question, foreign counterfeit opioid drugs are responsible for thousands of deaths. Despite what we are experiencing with the counterfeit opioid crisis, there are proposals to “legally” allow foreign prescription medications to be imported and sold in the U.S.
We are fortunate the U.S. Food and Drug Administration and the DEA have strict policies and controls over the U.S. pharmaceutical industry. From the manufacturer to the end-user, the FDA and DEA ensure Americans their prescription drugs are legitimate, free from contamination, and safe. These government and industry safeguards in the U.S. do not apply to pharmaceutical drugs of foreign origin. According to the World Customs Organization, pharmaceutical drugs are the No. 1 counterfeited item in the world – a $200 billion a year industry.
International drug trafficking organizations have exploited substandard quality management, unwitting suppliers, and corruption to infiltrate international pharmaceutical supply chains and pharmacies. In many countries, patients risk taking prescription medication with the wrong ingredients, no ingredients, or harmful formulations.
While the impulse of lawmakers to search for ways to address prescription drug availability and costs is understandable, policies allowing foreign prescription drug importation fail to address the bureaucratic complexities of creating an international supply chain; requiring large-scale changes in vetting, screening, packaging, labeling, storing, and security practices.
Not unlike the situation with counterfeit opioid drugs, the unwitting public will gravitate to what is most affordable and available, unaware of the risks that “legally” imported pharmaceutical drugs may be counterfeit.
Introducing legal access to foreign pharmaceutical drugs are not solutions, but vulnerabilities easily exploited and viewed by international criminal organizations as new opportunities to expand their counterfeit drug trade in the U.S. market. Americans are experiencing the realities of insufficient border security and addictions fueled by smuggled foreign counterfeit opioid medications.
Based on our counterfeit opioid drug crises, it’s important to “know your source” when it comes to your medication and beware of advertisers offering large discounts on foreign prescription drugs. Lawmakers and citizens should be skeptical of any proposals to “legally” allow the foreign importation of prescription drugs into the U.S. and placing Americans at risk.
— Douglas Hebert is a retired special agent in charge with the Phoenix bureau of the U.S. Drug Enforcement Administration and a senior investigator with the Arizona Department of Economic Security. Hebert wrote this commentary as a private citizen.