Fake Drugs Threaten Global Health
It is now hugely more profitable for a criminal to counterfeit prescription drugs than it is to sell illegal drugs on the market. An investment in counterfeit drugs can return more then 10 times the profit in the same investment in heroin. Moreover, the risk of being caught and the severity of prosecution is significantly less than street drugs such that the risk/reward ratio has caused the fake drug industry to become a global epidemic. It is estimated that criminal counterfeiting of prescription drugs exceeds $75 billion yearly.
Counterfeit drugs are packaged and labeled to look exactly like the actual brand name or generic drugs that it is difficult even for experts to tell them apart. However, their ingredients may be inactive, incorrect or harmful. The following are the health risks associated with taking a counterfeit prescription drug:
- can be contaminated with harmful substances such as arsenic, highway paint, floor wax, printer's ink, anti-depressants, diethylene glycol, horse medication, boric acid to mention just a few. This can result in symptoms making diagnosis difficult. In some cases, these ingredients have caused death.
- contain the wrong active ingredient which does not treat your condition and present itself with adverse side effects
- contain too little or none of the active ingredient sufficient to treat your condition
- contain too much of the active ingredient which can cause serious adverse side effects
- be packaged in phoney wrapping which may have incorrect directions on proper use of the medication
In 2009, the New England Journal of Medicine reported that glyburide, a powerful diabetes drug to lower blood sugar, was used in fake versions of sexual enhancement and erectile dysfunction drugs. As a result, in Singapore alone on 2008, 149 men were hospitalized with severe low blood sugars, seven went into comas and four subsequently died. Since Viagra and Cialis came to market, they have been one of the most widely counterfeited drugs especially with their ease to be found on the internet for sale. It is estimated in Japan that the counterfeit market for these drugs is 2.5 times larger than their genuine counterparts according to Environmental Health and Preventative Medicine in 2010.
According to Tropical Medicine & International Health in 2010, an 2008 investigation revealed that 50% of malaria drugs collected from parts of Southeast Asia were counterfeit. Also reported was that more than 4% of intestinal parasite drugs in Cambodia were fake. Around the world, there are few drugs that are not chosen to be counterfeited. Knockoffs include aspirin, heparin, antibiotics, vaccines, cardiac drugs, hepatitis B and HIV drugs, teething medications, iron injections with no end in sight as to what is chosen to be faked. It seems that only until folks die and diligent research reveals that a counterfeit drug is responsible that the drug being faked is the discovered to be the target of the counterfeiting.
It is estimated that more than 10% of the drugs worldwide are counterfeited with some countries experiencing 50% or more of their drug supply faked. Countries vary in the severity of the problem relative to the regulatory and enforcement efforts within that country. China, India, Nigeria, Russia, Egypt are examples of such countries. According to the Organization for Economic Co-operation and Development, 75% of counterfeit drugs come from India which has no prohibition on the export of counterfeit drugs. Forty percent of world prescription drugs sales occur in the US with 80% of the active ingredients for these drugs coming from foreign countries with the counterfeiting problems. The complicated web of manufacturing and distribution makes the counterfeit problem difficult to police at best. You have to wonder what percentage of the drugs in your local pharmacy are counterfeit!
Detecting Fake Drugs is Challenging
Researchers are discovering easier ways to determine a material's constituents. New technologies such as Direct Analysis in Real Time-Mass Spectrometry (DART-MS), Desorption Electrospray Ionization ( DESI) and Spatially Offset Raman Spectroscopy (SORS) have made significant advances in detecting fakes even without removing the medication from its packaging. Counterfeiters have been known to produced fake medicines with sophistication rivaling a manufacturer to those counterfeiters producing in clandestine ramshackle labs with squalid conditions. The counterfeiters are extremely resourceful and motivated by the phenomenal profits illegal medicines generate. Catching them isn't easy. Even the identification of the contaminants remains elusive for certain fakes such as the contaminated heparin problem wherein the agent responsible still has not been identified since 80 people died in 2008. The war against counterfeit drugs is feeble at best in a globalized world where all kinds of products come from around the world. This certainly seems like fertile ground for terrorist activity to take advantage if they haven't already.
The Solution to the Global Counterfeit Drug Epidemic...Medicines That Can Not Be Counterfeited.
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