| Purpose
of this Issue Briefing:
This Briefing’s purpose is to 1) open
dialogue on problems in the U.S.-Mexico Border
Region related to cross-border transport of
prescription drugs for illegal sale and use in
the U.S., specifically in Southern California
and 2) provide an overview of the problems
along with proposed strategies and tactics. |
| Problem:
For decades, pharmacies located in border
cities in Mexico have been destination spots
for many U.S. residents seeking low-priced or
familiar medications. This practice, however,
has evolved into an illegal business for
people on both sides of the border and has
become a significant public health and safety
problem. |
| Large
quantities of both legal and illegal
pharmaceuticals are smuggled into the U.S.
from Mexico and find their way into shops in
the U.S. These unlicensed facilities, or
illegal clinics, have become centers where the
practice of diagnosing illnesses and
prescribing medications by unlicensed
pharmacists and doctors is common.
Contributing to the problem is the smuggling
of banned or highly restricted medications in
the U.S. that are smuggled in from Mexico and
resold in the U.S. As a result, several
children have died in Orange County after
receiving injections by unlicensed
pharmacists. A recent series in the L.A. Times
also reported that health officials fear
numerous children and adults are becoming ill
after using medications without anyone
connecting their symptoms to the drugs.
Another problem is the increasing use of
pharmaceuticals, especially banned medications
such as Rohypnol, by many youths who cross
into Mexico to purchase them. |
| Discussion:
The
cross-border transport of prescription drugs
for illegal sale and use in the U.S. raises
several public health and safety issues. Many
U.S. residents either lack sufficient access
to health, are accustomed to purchasing
remedies they used back in their home
countries or are accustomed to getting
medications without a prescription. As such,
they rely on illegal back-door clinics or
shops to fulfill their prescription drug
needs. |
| ROHYPNOL
(Flunitrazapam):Also known as
roofies, ruffies, R-2, roachies, rope,
rib or roche. |
- Is 10
times more potent than valium
- Is
odorless, colorless and tasteless
- Banned
in the U.S. but used in 60 countries
to treat severe insomnia including
Mexico
- Effects
include impaired judgement and motor
skills, amnesia, blackouts, and
seizures
- Increasingly
being used by high school and
college students as an "alcohol
extender"
- Young
people are attracted by the low
cost, usually below $5 per tablet
Has been associated with dozens of
sexual assault and rape cases
throughout the U.S.: Unsuspecting
women are slipped rohypnol into
their drinks, minutes later they
begin to have "blackouts."
The women wake up 6 to 8 hours later
and often have been sexually
assaulted. However, they cannot
remember any of the events due to
the amnesia effects of rohypnol.- The
Drug Enforcement Agency (DEA) is
currently trying to get the drug
re-classified as a drug with no
medical purpose, like heroin and
LSD. Rohypnol is currently in the
same class of drugs as marijuana.
|
|
| Another
issue is enforcement at the U.S.-Mexico
border, in Mexico, and in U.S. communities
such as Los Angeles and Orange Counties.
Frequently changing federal laws and
regulations often lead to confusing
information about what can be brought into the
U.S. and in what amounts. In some local U.S.
communities like Los Angeles, increased
coordination between health officials and law
enforcement has led to investigations of
illegal back-door shops and arrests of people
illegally selling prescription medications. |
| Strategies
toward Binational Collaboration and
Solutions:
The public health and safety problems
related to the illegal sale and use of
pharmaceuticals can be reduced through
the implementation of several
strategies. Among those are: |
- Increase
Collaboration among Various
Organizations to Improve Access to
Healthcare: A
large portion of the population
lacks access to adequate healthcare
and various health and community
organizations are striving to
improve people’s access to
appropriate health care. At the same
time, there are several alcohol and
other drug programs who also wish to
reduce the public health and safety
problems associated with the unsafe
use of prescription drugs. Through
increased collaboration, these two
groups can work together to promote
access to healthcare through a
variety of methods such as
increasing the dissemination of
information on which health
facilities distribute low-cost
prescription drugs to those sectors
of society who rely on unlicensed
clinics to obtain medications.
- Provide
Support for Binational Enforcement
of Existing Laws:
- Support
federal officials
by placing the smuggling of
prescription drugs higher on the
drug war agenda and to improve
the detection of the smuggling
of illegal prescription
medicines.
- Support
the efforts of public health
officials, law enforcement, and
community organizations’
efforts
to investigate and prosecute
those that knowingly sell or
smuggle illegal prescription
drugs. In addition, support
state and local legislation that
will increase the penalties to
those caught illegally selling
or smuggling prescription drugs.
- Support
Mexican Health officials who
have begun to implement pharmacy
training programs, public
awareness campaigns and who have
attempted to adopt a code of
good practice including a strict
ban on sales of controlled drugs
without a prescription.
- Promote
Mexican Businesses:
Many recent immigrants, those
without sufficient health care
and others looking to purchase
cheaper medication legally
purchase prescription drugs in
Mexico. The safe business
practice by pharmacies that
legally sell pharmaceuticals
should be promoted and
information on those businesses
that are safe should be provided
to consumers.
- Create
a web site where information can
be obtained:
A bilingual web site can expand
availability of information to
the public and law enforcement
agencies at the Border and local
communities. The web site will
be a simple-to-access site where
people can obtain information on
the types of pharmaceuticals
that can be allowed into the
U.S. and quantities permitted as
well as the manufacturer names.
- Promote
a Resource Center:
Develop a resource center to
work throughout the Border
Region to coordinate information
and collaboration. The resource
center can develop a web-site
and collect data and
information. The resource center
will be a central area where
regional groups can access
information regarding problems,
action steps and policies
regarding the illegal sale and
use of prescription medications
throughout the Border Region.
- Community
Advocacy through Newsmaking:
Use media advocacy to encourage
public and policy- maker
discussion and action on the
transport of prescription drugs
to the U.S. for illegal sale and
use. By strategically using the
media, public health officials,
law enforcement and community
organizations can place this
issue higher on the public
agenda, begin to change
community norms regarding
prescription drugs, and provide
support to policy-makers and
officials who move to enact
effective policies.
|
|
| The
problems with the illegal sales of
pharmaceuticals is growing in Southern
California: |
- In
Orange County, two toddlers died
after receiving injections from an
unlicensed physician
- Doctors
and health officials state that the
scope of the problem of unsafe and
illegal use of drugs purchased
through back-door clinics is
difficult to assess because the
majority of these cases are not part
of any official reporting system
- Several
locations where people purchase
prescription medications include
swap meets, unlicensed clinics, and
markets
|
|
| How
to Participate |
| Participate
in the Binational Business Policy Council:
The Council is a policy-focused work group
that includes business leaders, trade
associations, enforcement agencies, public
health officials, community organizations and
policy makers from the U.S. and Baja
California. The Council formed to make policy
recommendations that will reduce the health
and safety impact of cross-border transport of
prescription drugs for illegal sale and use in
the U.S. and to promote safe business
practices in Mexico. Meetings of the Policy
Council are open to anyone interested in
helping to reduce and prevent health and
safety problems related to unsafe use of
prescription drugs. Call IHA at (619) 474-8844
to be added to the mailing list and notified
of future meetings of the Binational Business
Policy Council. |
| Join
the growing team of skilled newsmakers:
Attend media advocacy workshops in English or
Spanish and participate in newsmaking
opportunities. Participants learn how to
develop high volume community-based news
generation as a central public information
strategy to send policy-focused messages and
support law enforcement activities. Workshops
are open to anyone interested in learning how
to become an effective newsmaker on this and
other issues. |
| Be
part of the solution and contribute yours
ideas! |
| Policies
and Action Steps Taken: |
- In
Los Angeles County, law enforcement
and public health officials have
created a task force that has led to
the arrest of more than 50 people
and have conducted more than 150
investigations of unlicensed shops
that sell prescription drugs
- California
State Assembly Health Committee
Chairman Martin Gallegos is pushing
for a bill that would make it a
felony to illegally sell
pharmaceuticals in California
- California
County Governments now have more
authority to create task forces to
investigate unlicensed clinics and
back-door shops
- Penalties
have been strengthened by increasing
fines and allowing county officials
to close a business after an
owner’s second conviction
- The
Pharmaceutical Association of
Tijuana is working in collaboration
with Tijuana’s Chamber of
Commerce, state health officials,
and Baja California’s Secretary of
Economic Development to stop the
growth of pharmacies in Tijuana and
to enforce existing law and
regulations.
|
|
|
| This
issue briefing was prepared by Anthony Ramirez
of the Institute for Health Advocacy (IHA)
with funding from San Diego County Health and
Human Services Agency, Alcohol and Drug
Services. |
