State pushes back wave after wave of designer drugs
Red Wing pharmacist Cody Wiberg sometimes feels like he’s playing a life-and-death game of whack-a-mole.
As director of the state’s pharmacy board, he is the little-known point man who determines which of the latest designer drugs being sold online and on the streets should be illegal in Minnesota.
“You can ban something,” Wiberg said. “But people who have enough chemistry knowledge know if you tinker around with the molecules a little bit, three months later you can be selling something else that’s now legal but is almost chemically indistinguishable with side effects that are the same or worse. And you can’t prosecute them.”
Within hours of 19-year-old Trevor Robinson’s death from an apparent overdose of the drug 2C-E at a party this month in Blaine, Wiberg was busy in his University Avenue office drafting legislation to specifically add the hallucinogenic stimulant and its chemical cousins to the state’s illegal drug roster. Robinson’s death hit home for Wiberg, 51, who graduated from Blaine High School a generation ago.
“Beyond the Blaine connection, what really hit me is how devastating this must be for any parent to go through,” said Wiberg, whose four children range from 19 to 29.
He is among many state health and law enforcement officials scrambling to stay ahead of the rapidly evolving synthetic drug curve.
Their latest worry? An Ecstasy-like stimulant being sold as “bath salts” under such names as Ivory Wave and Vanilla Sky. In the first three weeks of this year, U.S. poison control centers reported getting half as many calls about these products as they received in all of 2010.
“People are snorting, eating, injecting and smoking it,” said Jay Jaffee, a drug abuse prevention coordinator with the state health department. “You can get anything you want on the Internet if you look hard enough and if you’ve got a credit card.”
What actually gets delivered is an unknown, experts warn. A bromide atom replacing an iodine atom in a chemical string might give whatever shows up in the mail the power to damage the brain for good.
“There’s no reason to think that what’s online is somehow legitimate,” said Carol Falkowski, a drug abuse strategist for the state Human Services Department. She likens trying to regulate Internet drug sales to keeping stolen items off eBay or sexual predators from using computers to stalk victims.
“There’s the larger issue of blocking websites in a free society,” she said. “And if the [Drug Enforcement Administration] shuts something down, then another one pops up the next day.”
Many of the drugs come from Asia and elsewhere outside the country. And it’s tricky to determine how widespread their use is because there can be a years-long lag before they become so prevalent that they show up in national drug abuse survey results.
Hooked on synthetics
Dr. Joseph Lee, medical director at Hazelden’s Center for Youth and Families, said he’s personally seen more than 100 kids who have used 2C-E-related substances. They tell him “the visual hallucinations and sensory experiences are what’s rewarding and what gets them hooked.”
Their use is still rare, Lee said. “But synthetic chemicals have been causing more problems and visits to emergency rooms,” he added.
Prescription drugs are still far and away the most common reason for a drug-related visit to an emergency room — 1.3 million visits in 2009. However, the number of synthetic cannabinoid cases reported to U.S. poison centers jumped from 14 in 2009 to 2,893 in 2010.
About 10 percent of kids at the state’s oldest high school catering to students recovering from abuse problems, the PEASE Academy in Dinkytown, mention 2C drugs in their histories, but not necessarily as their drug of choice, according to director Michael Durchslag.
Adam Pederson, prevention manager for the Know the Truth program, said that at least one student in 30 attending the 110 Minnesota schools that his program visited last year noted synthetic drugs on usage surveys.
“And it wasn’t concentrated in one area but all through the metro area,” he said.
The next crackdown
In Minnesota, Wiberg is perhaps both the most obscure and important soldier on the front line of this battle.
State law on illegal drugs mirrors federal DEA regulations. But the DEA needs oversight from the Food and Drug Administration when it bans substances. At the state level, the pharmacy board Wiberg directed for five years has broad powers to add and remove drugs from the state lists of banned substances.
“In some ways, the Board of Pharmacy has more power on the state level than the DEA on the federal level,” Wiberg said. “But those people run around with badges and guns, and I don’t do that.”
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Good prospects for Polish pharmaceutical industry
Despite a visible economic slowdown Poland’s pharmaceutical branch is in good shape, say Marcin Rudnicki, head of the pharmaceutical team at KPMG and Karol Kołt, chief executive at PMR, basing on a report prepared by both companies.
In 2008 the value of the Polish pharmaceutical market reached PLN 24.1 billion, an 11.5% rise on 2007. Today it is among the most promising segments of the national economy. In 2009-2011 the compound annual growth rate (CAGR) for the pharmaceutical branch will come to 7.4% by our forecasts and about 6% according to surveyed firms. The Polish pharmaceutical market is the sixth-largest in the EU and in 2007-2008 its sales growth (in EUR) was the second-fastest in the community. Almost one-third of the surveyed companies named new medications as the driving-force of their and the branch’s growth. Other mentioned growth factors included the general rise in buying power in Poland and refund medications. Asked about medications expected to appear in Poland in the next two years, almost 50% named cancer treatment drugs. 40% of the surveyed firms said they planned to introduce 3-10 new medications by the end of 2009, only less than one in three planned no new products. The economic slump did not hamper investment in the pharma branch. On the contrary, over 60% of the pollees planned to raise staff development funding over the next 12 months, a similar percentage intended to raise production infrastructure spending. Slightly more firms declared no change in R&D outlays than raised research spending, but at over 40% the percentage of those who planned more investment in R&D was still high. Main hindrances in the pharmaceutical branch The current economic slump in Poland and the world 36% Medication advertising ordinance of November, 2008 31% Intransparent medication policy in Poland 25% Intransparent and chaotic legislation, red tape 20% Excessive competition 15% Lengthy and complicated medication registration procedures 13% Other legislative changes 8% Adverse harmonization effects 7% Mismanagement at the Incompetence at the Office for Registration of Medicinal Products (URPL) and Main Pharmaceutical Inspectorate (GIF) 7% N=75. Pollees could provide no more than three answers. Source: KPMG, PMR Research, 2009 Medication categories (ATC) whose sales growth in the next two years will exceed the growth of the pharmaceutical market (according to pharma companies) Antineoplastic, immunomodulatory 63% Cardiac-vascular 52% Digestive, metabolic 37% Neurological 27% Respiratory 16% Antiinfective 14% Dermatological 11% Blood, blood forming organs 8% Genitourinary 7% Endocrynological (without sex hormones) 5% Sensory organs 4% Musculoskeletal system 1% N=75. Pollees could provide more than one answer. Source: KPMG, PMR Research, 2009 Over the next 12 months online and direct trade will be among the fastest-growing medication sales channels outside traditional pharmacies. According to the pollees the fastest-growing channel will be online pharmacies, as many as 80% of them claiming online pharmacies will grow faster than the entire market (over 50% said the same about other online channels). This means companies expect a further rise in illegal pharma sales in Poland in the near future (under Polish law non-pharmacy online medication sales are illegal, most products sold through such channels are falsifications). The pollees also expected a rise in direct sales, almost 60% of them convinced that their growth will exceed that of the entire market. Slowest to grow will be sales through herbal shops and so-called exclusive sales (through one producer-selected outlet). In each case 27% of pollees maintained these channels will grow slower than the market. According to AESGP the Polish pharmaceutical market is the sixth-biggest in the EU saleswise and second in sales growth after Spain (in EUR). In 2008 the value of the Polish pharmaceutical market (in EUR) rose 17.7% against the previous year at an EU average of only 3.7%. The growth of the Polish pharmaceutical market will also be driven by the fact that per-capita medication sales in Poland are still lower than in the western countries. Coupled with the gradual disappearance of income differences, this will translate into higher medication spending. Another growth factor is the gradual ageing of the polish population – a growing elderly population, often suffering from several ailments simultaneously, will boost the demand for pharma products. This material is a fragment of a Polish Pharmaceutical Market report compiled by KPMG and PMR.