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Mounties bust Montreal counterfeit pharmaceuticals network

In case you weren't convinced that counterfeit drugs are a big problem in Canada, maybe this will change your mind.

The photo above depicts some of the more than 15,000 counterfeit pills RCMP officers seized on Thursday from seven Montreal locations after a major, 18-month-long investigation, which also resulted in nine arrests.

Drug counterfeiting is an area of concern not only for the police but also for Health Canada officials and physicians, and a large portion of the concern arises from the growing popularity of the internet. In response to the RCMP's announcement of its sting operation, Health Canada issued a reminder to Canadians about the risks of purchasing drugs online. "If you order from these sites, you may get counterfeit drugs that may contain the incorrect dose, the wrong ingredients, dangerous additives, or no active ingredients at all, which could result in potentially serious health risks." Irregular dosages and unadvertised ingredients and additives were all present in the counterfeit erectile-dysfunction pills seized in Montreal. "Even if these drugs do not harm you directly or immediately, your condition may get worse without effective treatment," Health Canada also warned.

Much of the problem stems from the fact that, in recent years, patients have become increasingly reliant on the internet to diagnose themselves and even to obtain drugs. While none of last week's raids targeted counterfeiters who were distributing via the internet, RCMP spokesperson Sgt Luc Bissette told Canadian Medicine, "There are ongoing investigations into online distribution" but he couldn't discuss details because they are still underway. "This time we hit the stores," he said. "Maybe next time we'll hit online."

The seriousness of the dangers posed by the growing online market for counterfeit drugs was made manifest in December 2006 when British Columbia resident Marcia Bergeron became the first person definitively shown to have been killed by fake drugs bought online. After Vancouver Island regional coroner Rose Stanton filed her report the following summer, she permitted to take a look at the document, including the toxicology figures. I wrote in the National Review of Medicine: "The Burnaby, BC, lab found diphenhydramine (an OTC sedative), acetaminophen, mirtzapine (a prescription antidepressant), dextromethorphan (an OTC cough medicine) and methocarbamol (an OTC muscle relaxant). But most shocking were the dangerously high levels of metals, including aluminum (15 µg/g), phosphorus, titanium, tin, strontium, arsenic and other metals in Ms Bergeron's liver. The level of aluminum alone was 15 times higher than what's considered normal."

If that's not evidence enough to convince doctors that their patients could well be be at risk of serious injury as a result of fake drugs distributed online -- well, I'm not sure what else to say.

When I wrote that article in 2007, Dr James Wright, a University of British Columbia professor of internal medicine and pharmacology provided some excellent advice. With the government struggling to keep up with the counterfeiters, he said, physicians must take more responsibility for protecting their patients from this threat. "We are not very good at asking patients what medications they are taking other than what we are prescribing," said Dr Wright.

That advice remains as true today as it was then. Last week's RCMP raids in Montreal should not only remind patients of the risks of fake drugs bought online but should also tell doctors that the problem is likely with us to stay.

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27 comments:

  1. sharonAugust 10, 2009 at 9:22 AM

    PASTE
    Influenced by his wife's premature death from malaria, Lilly founded a pharmaceutical company at 15 W. Pearl St., Indianapolis, May 10, 1876. He had only 3 employees (including his 14-year-old son Josiah) and $1400 in working capital. His first products were gelatin-coated pills and capsules. Following on his experience of medicines used in the Civil War, Lilly committed to producing only high quality prescription drugs, in contrast to the common patent medicines of the day.
    (Wikipedia)

    ENDOFPASTE

    In this paste you have an example of a time when "patent" medicines ( 1800's) were of low quality.

    In this age we have too many global sources supplying materials to produce the end product .

    We have similar examples as we watched former president Clinton trace the path to restoring effective malaria treatment

    Excerpt from sept.15/08 post to Canadian Medicine

    paste

    'RE: flawed intellectual property and patent laws

    Obviously the focus of this article and research hinges on the question " what is the greater good?"

    The greater good for whom?

    1.The patent holder?

    e.g.medicines

    ...who faces a highly collaborative,, integrated system where the impact of the "?old"segment and differentiate practices still leaves power in the:

    +raw materials (look how Clinton had to step in on malaria drugs),

    +manufacturing, and (oddly)

    + treatment regimes that use several medications from different sources '

    endofpaste

    Note :

    1.Eli Lilly lived in an age where the integrity of an individual led him to make a commitment to society.
    This was an age that produced "champions".

    2. We live in an age where it took a top political influence, in a moment of time, to attract the spotlight to the dark places of performance.
    This is an age that produces "heros."

    Do you know the difference between the results you get from a champion and a hero?

    One lasts a lifetime... the other fixes the moment.

    What is the actual cure to the prescription drug problem?

    The entire present focus is on the "drug"....when it should be on the " prescription " process itself and how it is managed and product distributed.

    (remember "reverse subsidies" ...you cannot impose bondage on the freedom of the individual.... but you can fine them for not adhering to an "enforceable contract")

    [Perhaps we need to revisit the days where the medication was provided to the patient by mail ( e.g. malaria meds in Canada)... where the relationship with the drug ( identified as a harmful substance ) is between the physician and supplier?]

    This, of course, puts the onus on the physician to ensure quality supply and performance... and it shrinks the arena where monitoring/legal bodies have to measure quality and performance
    .......... and enforcement ............

    Delete
  2. IrvingAugust 10, 2009 at 10:22 AM

    This article is terribly misleading. The Mounties busted an operation that was NOT selling drugs over the Internet, and yet the bulk of your article was about the dangers of buying medication on-line.

    There is a very real problem of counterfeit drugs being sold at retail in Canada (and elsewhere). Rather parroting the Canadian Pharmacists Association's self-serving talking points about on-line dangers, let's press them to clean up their own house (or clean it up for them).

    Delete
  3. Sam SolomonAugust 11, 2009 at 9:51 AM

    Irving: Concern about one source of danger doesn't preclude concern about another. Counterfeiting is a health threat that doctors should be aware of, regardless of where the pills are sold. But the message here for individual doctors is: the way they can make the biggest difference is to warn their patients about buying drugs from uncertified sellers, of which there are lots and lots operating online. That doesn't mean there are no good, safe online distributors; nor does it mean retail pharmacies should be let off the hook.

    Delete
  4. sciencebasedpharmacyAugust 11, 2009 at 10:12 AM

    With a single exception (a Hamilton pharmacy that supplied counterfeit Norvasc) there is no evidence that the Canadian supply chain through legitimate pharmacies (either storefront or online) distributes counterfeit drugs.

    This article serves as a warning that if you want your Viagra, or any other prescription drug, and you're not getting it from a licensed pharmacy, there is no assurance the drug is legitimate.

    Delete
  5. sharonAugust 11, 2009 at 8:24 PM

    I'm confused?????

    RE: sciencebased pahermacy post

    a. if the seized counterfeit drugs were not sold on the internet...then..... does someone think they went door -to-door?

    RE: plugging all the holes in the boat

    What good enforcement /investigative body would fail to "alert" about all related avenues of harm ?

    RE: Blogging

    The multitude of teasers placed in your life by your googling and texting and in the margins of your social networks are based on a roaming "bot"...... assuming/presuming what you care about...
    ...to the point where we become "intellectual eunuchs" ... with no appetite for " the rest of the story" ( which is the purview of "reporters".)

    "Kudos", Sam on your ever insightful , multi-faceted presentations......... designed to make the "medicos" think ahead...not just on the margin :)

    Delete
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