Lowering prices “must not happen at the expense of public safety,” Utah sheriff says

This editorial by Rosie Rivera was published in The Salt Lake Tribune on December 3, 2019. Rivera is the sheriff of Salt Lake County.

Concern over cost should not lead us to importing unsafe drugs

Prescription drug prices are an ongoing issue for American consumers. Advances in drug development have resulted in “Wonder Medications” in many areas of medicine. With the advances, however, the cost of medicine generally has risen severely, putting strain on seniors, families and individuals dealing with chronic conditions.

Both Congress and the current administration are currently considering a wide variety of fixes to address medication costs. One possibility being examined and considered at both the state and federal level is the importation of medications from abroad, especially Canada. As law enforcement officers, we don’t involve ourselves in political issues, except when they cross over into the area of public safety. Importing medicines from other nations is such an issue.

We are all terribly aware these days of the human costs of the opioid epidemic. Last year alone, more Americans died from overdose than perished from automobile accident, firearms, suicide or homicide. In 2016, 174 Americans per day died from some form of drug poisoning.

Certainly, counterfeit and contaminated drugs are a significant part of this scourge. Right here in Utah we have experienced the destruction caused by fentanyl, as a stand-alone narcotic and as a deadly additive to other drugs.

Recent information coming from the U.S. Drug Enforcement Administration and the Food and Drug Administration is alarming. Already our supply chain has been contaminated by foreign illicit drugs masquerading as conventional pharmaceuticals. Law enforcement’s fear is that importation will end up increasing the availability of contaminated and counterfeit drugs.

Adderall is a perfectly legitimate drug when used as medically directed, but is also subject to abuse. Recent seizures by federal authorities have revealed Adderall look-alikes on their way to market, laced with methamphetamine.

“Counterfeit pills provide an elevated danger to those who abused licit pharmaceuticals, as they often contain toxic or illicit ingredients, increasing the likelihood of an overdose”, warns D. Christopher Evans, Special Agent in Charge of the DEA’s Louisville Field Division.

According to the FDA, counterfeit medicines produce two problems: Some contain unidentified ingredients like opioids or meth, while others contain no active ingredients at all, thus endangering patients seeking treatment for cancer or diabetes sufferers.

A glance at the DEA’s annual Drug Threat Assessment reveals that the problem of illegally obtained pseudo-medications and other illicit drugs is epidemic in the U.S. Cartels and gangs purveying poison are active in every corner of the world. The human toll is staggering, and the fact is that we simply do not have a handle on the situation. Right here in Utah we live with that reality daily.

Drug importation, even from our friendly neighbor to the north, is fraught with danger. The FDA has tended to look away from the relative handful of Americans who cross the Canadian border to fill legitimate prescriptions. So far, it has proven safe enough.

But scaling up drug imports to accommodate mass market levels will unavoidably multiply the dangers. Canada has made clear that it is not positioned to guarantee quality and purity of medicines passing into the United States. They have also said their own supplies will never allow that level of export. When legitimate supplies and distribution channels are eventually exhausted, what is left?

So, while high prices require immediate attention, remediation must not happen at the expense of public safety.