Major shipments of Mexican prescription drugs are being smuggled into Southern California from Tijuana, fueling ever greater sales through pharmacies and illegal back-room clinics, state and federal officials say.
The pervasive black-market sales, mainly by Latino merchants, have emboldened shop owners not only to sell pharmaceuticals to immigrant customers, but also to take the more dangerous next step: Some merchants are giving injections and practicing medicine.
Tustin police are investigating whether the illegal practice contributed to the death of 18-month-old Selene Segura Rios, who died two hours after receiving what her parents were told was a penicillin injection in the back room of a toy store Monday.
She was the second Latino child in the last 10 months to die after receiving injections from unlicensed practitioners in Orange County. Christopher Martinez, 13 months old, died after getting five injections from a would-be doctor at a storefront clinic in Santa Ana.
"Stores selling illegal prescription drugs of all kinds are a pervasive problem in the Hispanic community," said Howard Ratzky, the supervising drug investigator in Southern California for the state Department of Health Services' food and drug division. "It's very hard to stop, and nobody knows how many stores out there are engaging in this."
On average, state drug agents investigate about one unlicensed store each month in Southern California, Ratzky said.
But the issue has gone beyond "the trend of an unlicensed store selling prescription drugs," he said. More recently, he said, "some [merchants] have begun offering medical treatment by people identifying themselves as physicians."
A U.S. Customs agent in San Diego also noted a growing number of cases in which people who sell the drugs also inject them into patients.
"Unfortunately, immigrants know where these places are. They'll go to the back of the store and someone will say, 'You look OK,' and an untrained person will give a kid an injection," the agent said.
The problem with Mexican drugs is that many are counterfeit medicines and the quality control is lax, said Customs Agent Lisa Fairchild. "A scarier danger is that sometimes the packets don't contain the medication that the label says is inside," she added.
In almost every case, the prescription drugs are manufactured in Mexico or other Latin American countries and sold clandestinely to immigrant customers from back shops of businesses located in strip malls that cater to Latino shoppers.
Lately, more and more of those drugs are being shipped into the country illegally, customs officials say.
Drugs in Cleanser, Vitamin Containers
On Wednesday, the same day that Tustin police announced baby Selene's death, state agents and local police raided the Trolley Minimart on Valley Boulevard in El Monte. Investigators seized syringes and numerous pharmaceuticals manufactured in Mexico and hidden in false bottoms of cleanser containers and disguised in vitamin bottles, Ratzky said.
Los Angeles and Orange counties "are a big market for pharmaceuticals smuggled from Tijuana," said a U.S. Customs agent who specializes in cases involving illegal prescription drugs. "The problem has grown dramatically in the last three or four years, but nobody has a handle on how much is being brought across."
Figures released by customs officials Friday show 107 seizures of pharmaceuticals at ports along the California-Mexico border in the past four months. Six people have been arrested on smuggling charges while in possession of a variety of restricted prescription drugs, including antibiotics, opiates, barbiturates and Viagra.
But federal officials have not maintained statistics on the problem. A customs spokesman in San Diego said the emphasis is still on tracking the number and quantities of narcotics seizures.
Buyers of illegal prescription drugs typically are low-income and uninsured, mostly immigrants from Mexico and Central America. But they also can be unwitting customers of pharmacies that bring in medicine from Mexico.
The customs agent, who asked to remain anonymous, said pharmaceutical smugglers range from the nondescript to people like Park City, Utah, pharmacist Cliff Holt. Holt was arrested after customs inspectors seized 19,000 prescription pharmaceuticals at the San Ysidro port of entry Jan. 17, 1998.
The drugs were being transported for Holt by his sister and brother-in-law. Later, Holt admitted that since 1989 he had smuggled 25 loads of drugs, ranging from Prozac to pediatric antibiotics, from Tijuana for sale in his Park City pharmacy.
Federal prosecutors said Holt purchased the drugs cheaply in Tijuana and sold them as U.S.-made pharmaceuticals, making an exorbitant profit. Holt was sentenced to 13 months in federal prison.
"Increased trafficking in Mexican pharmaceuticals is a growing problem in this country, and we intend to address it," U.S. Atty. Charles G. La Bella in San Diego said when Holt was sentenced last month.
Emergency State Law Is Sought
State and federal law enforcement officials applauded efforts last year by Los Angeles County authorities to block the sale of illegally imported pharmaceuticals. Los Angeles is a "major market" for illegal prescription drugs, the customs agent said. "It's a vast underground," he said.
Stunned by the level of black-market commerce in illegally imported drugs in Los Angeles County's Latino community, Supervisor Gloria Molina pushed for an emergency state law to enable counties to crack down on vendors and stiffen penalties.
Since the law went into effect in September, health and law enforcement officials in the county have been investigating and raiding vendors on a regular basis, as well as trying to educate the community about the dangers of such drugs.
One sting operation last year at El Mercado, a popular Latino marketplace in Boyle Heights, netted drugs with a street value of nearly $1 million. In another sting last weekend at swap meets in La Mirada, Pico Rivera and El Monte, police arrested 14 people.
Last month, the county formed a full-time task force, with members from the health services, sheriff's and city police departments, to handle all the investigations and raids.
"We are definitely the county that has the most extensive sting operations going on," Molina said. "Just when we think we are covering it, then we get word of other operations going on. It's rampant."
Even with the new law, she said, "people are taking the risk because there's quite a market out there for these drugs."
Though the drugs are often being sold through mom-and-pop stores and by individual vendors at swap meets, some officials suspect there is a well-organized distribution network fed by one or two major suppliers.
"There [may be] this vast network that then trickles down to mom and pop: the beauty salons, meat markets and liquor stores," said Assemblyman Martin Gallegos (D-Baldwin Park), who introduced the emergency bill. "It's a very intricate distribution system that imports in large quantities."
The Los Angeles County task force has not nabbed any major suppliers so far, though it has received tips about them, officials said. Authorities are trying to trace the route back from arrested vendors.
No similar task force has been formed in Orange County.
Customs inspectors and agents said seizing illegal pharmaceuticals at the border is a difficult task. Conventional drug detection methods, which work well on cocaine, marijuana and heroin smugglers, are almost ineffective against prescription drug smugglers, authorities say.
"You almost have to be lucky--inspect the right vehicle or look in just the right backpack to stop it," said the customs agent interviewed by The Times.
"We have rat-packers who make multiple trips, bringing in small amounts at a time," he said. "They store them in San Diego and, when they have a bunch, move them to Orange or Los Angeles counties."
Light Penalties Don't Seem to Deter
Lenient penalties also encourage people to smuggle pharmaceuticals, even after they have been arrested multiple times. Illegal possession of prescription drugs is usually prosecuted as a misdemeanor in state court. When prosecutions occur, sentences are usually 12 months or less. However, practicing medicine without a license is prosecuted as a felony.
The back room of Los Hermanos Gift Shop, the Tustin store where baby Selene received the penicillin injection Monday night, was stocked with hundreds of illegal pharmaceuticals and syringes, police said.
But Lt. Michael Shanahan said that unless investigators can prove the injection contributed to the child's death, the store owner and the person who administered the shot can only be charged with misdemeanors.
The owner of Los Hermanos, Carlos Eduardo King, was convicted in 1992 of selling prescription drugs at an Orange County swap meet. He has said he turned the store over to his sister, Laura Escalante, a year ago, though state and local records show that he still owns it.
In the Santa Ana case, toddler Christopher Martinez died last April after being treated for flu-like symptoms at a store-front clinic by Gamaliel Moreno, who the boy's parents believed was a physician. The bogus doctor gave the baby five injections of an unknown substance and, after the death, fled to Mexico. A murder warrant was issued.
But his wife, Eulalia Parra Moreno, 34, was arrested and pleaded guilty to a misdemeanor. She was fined $1,000 and required to perform 100 hours of community service for being an accessory for removing incriminating files.
Stiffer sentences are handed down only in cases where, for example, the drugs cause a death or the defendant is a doctor, a pharmacist or a smuggler who has made a fortune from the illicit sales.
"There is money to be made and sometimes [at] very little risk," said the customs agent, who works in San Diego.
In one case, for instance, authorities had caught an El Monte woman five times at a San Diego port of entry bringing in pharmaceutical drugs, but she was never prosecuted, the agent said.
"Finally, after the sixth time, we gave her a notice to appear. She ignored the summons and was caught a seventh time and got six months in jail," the agent said.
The penalty for selling and smuggling illegal pharmaceuticals has to be stiffened at the state and federal levels, authorities said.
"Narcotics violators are a priority, and our prisons are crowded with drug smugglers. But prescription drug smuggling can be just as deadly," the customs agent said. One case he investigated involved packages purportedly containing diabetes medicine manufactured in Mexico but which actually contained medication for a heart condition.
"It's sad and dangerous, especially when parents buy medicines for their children," state investigator Ratzky said. "We have received complaints from school officials, who have reported children coming to school with prescription medication purchased by their parents at a store, not a pharmacy."
Times staff writer Julie Marquis contributed to this report.