Presidential Viewpoint BY MICHAEL JACKSON, RPH DANIEL E. BUFFINGTON, PHARMD, MBA, FAPHA
Pharmacists Beware: Increased Prevalence and Accessibility of Counterfeit Medications
T
he U.S. Dr ug En forcement A g e n c y ( D E A) a n d l a w enforcement have reported an increase in the number of counterfeit medications being sold on the internet by illegal vendors and websites. On September 27, 2021, the DEA issued a public safety alert warning of the increase in the number of counterfeit p i l l s c o n t a i n i n g f e n t a nyl a n d methamphetamine across the United States. Previous public notices by the DEA occurred in 2014 and 2015 relating to the surge in synthetic fentanyl and synthetic fentanyl analogs. In 2021, a single DEA sting operation confiscated nearly 2 million fraudulent medications that contained fentanyl and over 1,500 pounds of raw fentanyl. They estimate that nearly 10 million fraudulent pills were confiscated in 2021. Additionally, DEA lab tests revealed that approximately 40% or more of the pills contained quantities of fentanyl capable of producing severe adverse side effects or death. Law enforcement data shows that people attempting to abuse or purchase illicit substances are encountering products from clandestine vendors i n Ch i na a nd Mexico t hat have increasingly tested positive for fentanyl and methamphetamine. These vendors have then sold the products to U.S. citizens attempting to illegally purchase products on websites and social media sites such as Facebook and Snapchat. These social media platforms could be considered accountable if they provided services to t hose vendors while knowing that the services constituted healthcare fraud. The ease with which consumers
were able to illegally shop for and purchase counterfeit pills revealed the magnitude of the problem arising from the ability to circumvent the DEA and other law enforcement. The illegal vendors go to great lengths to make the fake products appear similar (including shape, color, size, and established
Daniel E. Buffington, PharmD, MBA, FAPhA
markings) to legitimate FDA-approved and commercially available products such as benzodiazepines, opioids, and amphetamines (i.e., alprazolam (Xanax®), hydrocodone (Vicodin®), oxycodone (Oxycontin®, Percocet®), h yd r o c o d o n e ( V i c o d i n ®), a n d amphetamines (Adderall®)). It is apparent that the DEA is not doing enough to collaborate with healthcare practitioners and web-based companies to help them understand the public safety risk and methods of distributing fraudulent pharmaceutical substances. The DEA Administrator, Anne Milgram, admitted that the DEA is aware that individuals intent on substance abuse are purchasing illegal substances online every day. Frank Pallone, Jr., the Chairman of the U.S. Energy & Commerce Committee, stated, “These platforms are not passive bystanders - they are knowingly
choosing profits over people, and our country is paying the price.” The House of Representatives, E&C Committee proposed a bill to amend Section 230 to remove legal immunity in cases where social media platforms, in cases where they “knowingly” and “recklessly” promote illegal drug distribution. This creates a significant duty for DEA and other law enforcement to work more directly with healthcare providers, including pharmacists, and social media or other web-based platforms, to protect the public. Many people attempt to circumvent licensed pharmacies (physical or online) by purchasing substances for illicit use from non-licensed vendors. In some cases, legitimate patients may be confused by or unaware of the risks of purchasing medications from nonlicensed online sources. Patients should be educated on the importance of using DECEMBER 2021
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