Out-of-Control Pharmaceuticals

A Times series this week illuminated how Mexico’s lax pharmaceutical standards and a porous border with the United States have allowed smuggling of prescription drugs to flourish. Previously we prodded police to keep the pressure on illegal back-room clinics in Southern California and urged that health professionals do better in showing immigrants the dangers of these drugs. That still needs doing. What the series made clear is how extensive the problem is and how many fronts are in need of attention and reform.

The smuggling of medications and their illegal sale at swap meets and storefront clinics can be traced to eager pharmaceutical companies. Granted, authorities in Mexico need to do a better job of cracking down on pharmacy clerks who illegally prescribe and dispense medications. But pharmaceutical company excuses for sale in Mexico of drugs that are banned or restricted in the United States because of dangerous side effects are not convincing. One ridiculous rationale has it that the U.S. Food and Drug Administration is overly restrictive, so sales in Mexico are reasonable. Another rationale posits that few Mexicans die from these pharmaceuticals, so there’s not much of a problem; this conveniently overlooks the fact that causes of deaths are poorly tracked in Mexico.

Pharmaceutical companies need to examine their sales practices. They continue to market a drug like dipyrone in Mexico when they know or should know that it is used unsafely there and smuggled to the U.S. as well. Dipyrone has been banned or withdrawn in at least 22 countries, including the United States, and severely restricted in nine others because it can destroy the body’s ability to fight even minor infections. The companies also know that aspirin, Tylenol and ibuprofen are safer, cheap alternatives. And speaking of the border, let’s give customs officials the clearer guidelines they need to help stem the flood of illegal drugs.

Two deaths last year at unauthorized clinics in Orange County showed the need to also inform immigrants of the availability of free or low-cost medical care. That means more outreach by health care workers speaking Spanish and other languages and more licensed clinics close to home and work. It also means understanding cultural preferences, including the tradition in Mexico of treating ailments with an injection rather than a pill.

Many immigrants who use illegal clinics are unaware that they qualify for Medi-Cal or the Healthy Families program for the working poor. They need to be told, perhaps with the help of churches, schools and agencies assisting immigrants. The drug companies could certainly lend their marketing savvy to a campaign of warnings against dangerous drugs and back-room clinics. But the companies also need to better weigh their business practices against the harm done by dangerous pharmaceuticals on both sides of the border.