30 Nov Overseas Online Pharmacies Make Buying Opioids a Breeze While US Regulators Struggle to Find a Solution
Nearly as easy as reordering laundry detergent from Amazon, non-prescription opioids can be bought online and shipped directly to your doorstep. The frightening reality is that it is cheap and some of the synthetic formulations can be up to eight times more potent than morphine. The death toll from opioids purchased through an internet pharmacy is estimated to be 50 and rising.
It is without a doubt that the United States is currently in the throes of a drug crisis and the dangerousness of continuing to allow these highly addictive drugs to be readily available via the internet is underscored by two recent deaths in Utah. Ryan Ainsworth, and his friend Grant Seaver, both 13 years old, attended junior high school together in Park City, Utah.1 According to the Washington Post, in September 2016 the two boys died within 48 hours of one another owing to acute drug intoxication from a synthetic opioid known as: U-47700. Also known as “pink” or “pinky,” the boys acquired U-47700 online from Shanghai and had it shipped to a friend’s house. At the time of the boys’ deaths, it was legal in the United States for them to own U-47700.
According to data from the Centers for Disease Control and Prevention (CDC) and the National Center for Health Statistics (NCHS), nearly 19,000 deaths were attributable to an overdose of prescription pain medication.2 This number surpassed the more than 10,500 deaths attributable to heroin overdose that same year.
Some of these destructive impacts that opioid abuse has on public health and safety across the United States is attributable to the overprescribing habits of health care providers. In fact, among other grave findings from the 2014 White House Summit, it was noted that in 2012, health care providers in the United States wrote 259 million prescriptions for pain medication.3 To put this number in perspective, it would be enough to provide every adult in America with a bottle of pills.
The overprescribing habits of physicians, unfortunately, is not the only problem when it comes to the opioid epidemic, as opioid medications are readily available online through overseas websites – without even having a prescription.4 The list of drugs available is ever-growing and includes U-47700, as well as multiple forms of fentanyl, which is an opioid drug whose potency is estimated to be more than 50 times that of morphine.
The emergence of new synthetic forms of opioids is occurring so rapidly that neither state nor federal enforcement can keep up.5 As regulators place bans on opioids that emerge in popularity among its users, new forms of the drug appear on the market to replace them. Foreign laboratories respond to every ban by chemically modifying the drug’s formula just enough to deem the drug legal in the United States.
A large portion of these foreign drugs are considered legal for the purpose of research and have not yet undergone approval for use as medical treatment. According to the Drug Enforcement Administration (DEA), most of the synthetic drugs ending up in the United States originated in China. Usually, these Chinese laboratories will rely on patent records available online, as well as information from scientific journals to create the compounds.
At this time, both state and federal regulators are unable to come up with an ideal solution to control these new and dangerous drugs from entering the country. One problem in keeping up with continuing development of new opioid drugs is that there is no uniform clearinghouse for crime laboratories, law enforcement authorities, health care professionals, and medical examiners to share information that they acquire on these new drugs. It has been suggested by the National Governors Association (NGA) that the El Paso Intelligence Center, which is a division of the Department of Homeland Security (DHS) that is responsible for collecting and analyzing information on the identification of drug traffickers, would serve as a first step in initializing this type of clearinghouse.
It is clear that state and federal officials must identify a more effective method of pinpointing new versions of opioid drugs as they find their way into the country. As has been done in the past with several types of fentanyl, this would allow the United States federal government to demand that China cease production of the drug. The opioid epidemic in the United States has grown exponentially, while the race to turn the tide against it continues to lag behind.
1 Guarino B. Synthetic opioid nicknamed ‘pink’ blamed for deaths of two 13-year-old Utah boys. The Washington Post. Nov 2016. Accessed from: https://www.washingtonpost.com/news/morning-mix/wp/2016/11/04/synthetic-opioid-nicknamed-pink-blamed-for-deaths-of-two-13-year-old-utah-boys/?utm_term=.2842c69823af.
2 Centers for Disease Control and Prevention, National Center for Health Statistics. Multiple Cause of Death 1999-2014 on CDC WONDER Online Database, released 2015. Data are from the Multiple Cause of Death Files, 1999-2014, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed from: http://wonder.cdc.gov/mcd-icd10.html.
3 Centers for Disease Control and Prevention. CDC Vital Signs. Opioid painkillers prescribing: where you live makes a difference. July 2014. Accessed from: http://www.cdc.gov/vitalsigns/opioid-prescribing/.
4 Paoli L, Greenfield VA & Reuter P. Change is possible: The history of the international drug control regime and implications for future policymaking. Subst Use Misuse. 2012;47(8-9):923-35.
5 Wood D. Drug Diversion. Aust Prescr. 2015;38(5):164-6.