| 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. Call
IPS/IHA’s Communication Department at (619)
296-3311 for a calendar of upcoming newsmaker workshops. |
| Be
part of the solution and contribute yours ideas! Call
(619) 296-3311to join the dialogue on how to improve
public health and safety in our communities! |
| 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. |
