I think it’s safe to say that most of us assume the medications we get at the pharmacy or hospital are actually the drugs they are supposed to be. Most people would not even think of checking authenticity. But what if you took a medication, at home or in the hospital, that didn’t contain the active ingredient(s) you need? What if it contained dangerous chemicals? The dangers of black market medications are significant, and it’s more common than you think.
What are black market medications?
Black market medications are those sold illegally, outside of the government’s watch. These dangerous medications are either stolen, expired, contaminated or fake. Often referred to as counterfeit, you can find black market medications in pharmacies, hospitals, nursing homes and doctor’s offices. Fortunately, the US government regulates our medication supply chain, which is among the safest in the world. However, black market medications are on the rise. So beware.
Experts state that “counterfeit drugs are a global problem with significant and well‐documented consequences for global health and patient safety, including drug resistance and patient deaths”.
What kinds of medications are counterfeit?
Unfortunately, all types of medications can be counterfeit, including drugs for cancer, AIDS, high cholesterol and mental health conditions. Therefore, you should not consider any medication immune from this issue.
How big of a problem is this?
The dangers of black market medications are widespread. Since 2010, there have been about 1,400 adverse events tied to counterfeit medications reported to the FDA, but that is likely just the tip of the iceberg. It’s hard to know how prevalent this is; most patients don’t realize they have taken a fake or tampered medication. When patients don’t recover as expected, or develop side effects, doctors and patients generally don’t think that counterfeit medications are the problem. Therefore, doctors and patients often don’t report counterfeit medications to the FDA.
Unfortunately, it is estimated that the black market drug trade may account for 10% of the world’s drug supply.
How are these fake medications getting into the drug supply chain?
Criminals sell fake and/or stolen medications to pharmaceutical distribution companies, which then sell the medications to pharmacies, doctors and hospitals, often at a discounted rate.
Additionally, patients can fall directly into the hands of criminals when they buy from on-line pharmacies. The Government Accountability Office estimated that in 2014 there were 36,000 “rogue” internet pharmacies, many selling medications that contained too little, too much or none of the active ingredients. And some of these medications contained dangerous substances like heavy metal and rat poison.
Scared yet? You should be.
What is the US Government doing about this?
In 2013 President Obama signed a law aimed at tightening the drug supply chain. In 2017, the government started to require a serial number on all prescription drug packaging; thereby making make it easier to track the path of medications from manufacturer to pharmacy, hospital or doctor’s office. Additionally, the law established a database of authorized wholesalers. As a result, it is easier for pharmacists, doctors and hospitals to know they are buying from licensed sources. However, criminals can outsmart this system by creating packaging with serial numbers that are copies of authentic codes.
An FDA warning to a Canadian pharmacy.
On February 26, 2019, The FDA issued a warning letter to CanaRx regarding the sale of unapproved, misbranded and unsafe drugs. CanaRx acts as a broker between 150+ employer-sponsored health insurance plans and foreign pharmacies. Here’s how it works: CanaRx receives a US prescription, then a foreign doctor rewrites the prescription and CanaRx sends the medications from an unknown source. Supposedly come from the UK, Canada or Australia, but it is impossible to know the origin or quality of each pill. FDA Commissioner Dr. Gottlieb stated that at least some of the medications received through CanaRX are “expired, mislabeled, subject to recalls or potentially counterfeit”.
What can you do to make sure you get real medications?
Because the dangers of black market medications are pervasive, you must be careful about where you get your medications. However, it’s hard to tell if a medication you receive at the hospital or your local pharmacy is a fake medication because these fake medications can look exactly like the real deal. However, there are a few things you can do to reduce your risk of taking fake medications:
- Only buy from a pharmacy located in the United States.
- If a medication looks or smells different, don’t take any of it and contact your pharmacist and doctor right away.
- Look online to see photos of medications to visually check for discrepancies. Helpful sites include WebMd and RxList.
Additionally, the FDA advises patients to beware of pharmacies that:
- Do not require a written prescription from your doctor.
- Offer steep discounts that seem too good to be true.
- Send you spam emails offering cheap medications.
If you prefer to purchase your medications on-line – beware!
The FDA’s BeSafeRx Website helps consumers understand the risks of buying medications from a fake pharmacy, and provides tips for identifying safe online pharmacies. You can look up an online pharmacy through the state board of pharmacy (there is a link on the site for each state). If your pharmacy isn’t listed, don’t use it. The FDA also advises that once you have identified a state-licensed online pharmacy, you should still make sure they require a prescription from your doctor, have a US street address and phone, and have a pharmacist on staff to answer questions. Additionally, visit the FDA’s website: The Possible Dangers of Buying Medicines over the Internet.
A few more tips for online purchases:
- Do your homework before you buy anything – check the list of Verified Internet Pharmacy Practice Sites to find a pharmacy that has been accredited by the National Association of Boards of Pharmacy.
- Don’t be fooled by the sites that advertise “Canadian Pharmacy” – 85% of the time they are located in other countries, but advertise as Canadian to lure US buyers.
- Never buy from a pharmacy that doesn’t require a prescription, a sure sign that something is not right.
- And as the saying goes – “you get what you pay for”. If the price is too good to be true, it’s probably a counterfeit.
- If you find a website that you think is selling illegal drugs, contact the FDA.
Since all medications, even those purchased at a pharmacy or received at a hospital, can harm patients, beware. Read these blog posts to learn how to reduce your risk of harm from medications:
- Can Your Medication Make You Sicker?
- How to Avoid Medication Errors in the Hospital and at Home.
- Are Antibiotics Helpful or Harmful? What You Need to Know.
- Doctors Prescribe Too Many Medications.
- Are Medications Safe?
- Is Off-Label Medication Safe?
*Note: I updated this post on 4-2-2020.