Latin American illicit drug business

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Watch the pharmacists

The idea that fentanyl addiction is unlikely to take root in South America may be over-optimistic. A special investigation by the Los Angeles Times published in February this year had disturbing implications. It found that pharmacies in a group of north-western Mexican cities near the US border were selling counterfeit prescription pills laced with stronger drugs such as fentanyl and passing them off as legitimate medicines. The newspaper found that pills sold as oxycodone and Adderall in Tijuana and Cabo San Lucas contained fentanyl and methamphetamines. In total the newspaper found that 71% of a total of 17 pills tested came up positive for more powerful drugs. That meant that both US tourists and Mexican residents may be unknowingly purchasing what they think are legitimate low-potency over-the-counter pain killers, which are in fact laced with fentanyl and therefore expose them to risks of addiction and even death by overdose.

The true extent of the “fentanyl-sold-via-pharmacies” problem is difficult to measure, not least because Mexico’s mortality data is believed to under-report all types of overdose deaths. While the US is reporting over 100,000 overdose deaths a year, limited Mexican data puts fatalities from all drugs, including alcohol, at under 2,000. Recorded fentanyl overdose deaths are no more than a few dozen. Chelsea Shover, a UCLA researcher conducting a study cited by the newspaper, said: “We don’t know exactly when this started, and we don’t know how widespread it is. We don’t know who is buying these pills. We don’t know who’s taking them, and we don’t know what’s happening to the people that are taking them. The most important unknown is probably how many people have died or had serious health consequences from it, and we don’t have any idea.”

The manner in which fentanyl is consumed is important. It first appeared on the streets in powder form consumed either by shooting up (injecting intravenously) or by snorting. That meant that consumers had to become involved in, or risk becoming victims of, criminal activity on the streets to get their fix. By comparison, acquiring the drug in the form of over-the-counter, legitimate-looking, pharmacy pills appears to be a much safer experience. In effect, it allows the cartels to target a wider, more middle-class market for its products. That could also mean selling more drugs inside Mexico or other Latin American countries. A UCLA assistant professor told the newspaper: “Selling fentanyl in the form of pills is really marketing to a group of the population that may not be willing to try ‘hard drugs’.”

Los Angeles Times reporters found a very high number of pharmacies selling fake painkillers. Tablets were on sale for between US$15-$35 each, depending on potency. A separate study conducted by UCLA focused on 40 pharmacies and found that a majority of them were selling high-powered prescription drugs over the counter. Given the prices, it is thought the pharmacies were mainly targeting US tourists, but they could also be selling to local residents.

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