[Pharmwaste] A lethal shift in abused drugs: Article in today's Phila. Inquirer

[Thompson.Virginia at epamail.epa.gov]

This article is from today's Philadelphia Inquirer, in the top right
column of the first page.  Since it is an AP article, it is likely also
in other newspapers today.  The article is available at
http://www.philly.com/mld/inquirer/16806089.htm

A lethal shift in abused drugs
Prescription medicines are fast becoming the world's high of choice,
opening the door to deadly counterfeits.
By William J. Kole
Associated Press


VIENNA, Austria - Abuse of prescription drugs is about to exceed the use
of illicit street drugs worldwide, and the shift has spawned a lethal
new trade in counterfeit painkillers, sedatives, and other medicines
potent enough to kill, a global watchdog warned yesterday.


Prescription drug abuse already has outstripped traditional illegal
drugs such as heroin, cocaine and ecstasy in parts of Europe, Africa and
South Asia, the U.N.-affiliated International Narcotics Control Board
said.


In the United States, the abuse of painkillers, stimulants,
tranquilizers, and other prescription medications has gone beyond
"practically all illicit drugs with the exception of cannabis," with
users increasingly turning to them first, the Vienna-based group said in
its annual report.


Unregulated markets in many countries make it easy for traffickers to
peddle a wide variety of counterfeit drugs using courier services, the
mail and the Internet.


"Gains over the past years in international drug control may be
seriously undermined by this ominous development if it remains
unchecked," Narcotics Control Board president Philip O. Emafo said.


Discount medications that seem to be authentic often turn out to be
powerful knockoffs concocted from recipes posted on the Web.


"Instead of healing, they can take lives," Emafo said, characterizing
the danger as "real and sizable."


Up to 50 percent of all drugs taken in developing countries are believed
to be counterfeit, the board said, citing World Health Organization
estimates.


Buprenorphine, a painkiller, is now the main injection drug in most of
India, and it also is trafficked and abused in tablet form in France,
where the Narcotics Control Board estimates at least 20 percent of the
drug sold commercially as Subutex is diverted to the black market.


The number of Americans abusing prescription drugs nearly doubled from
7.8 million in 1992 to 15.1 million in 2003, the Narcotics Control Board
said.


Among their prescription drugs of choice: the painkillers oxycodone,
sold under the trade name OxyContin, and hydrocodone, sold as Vicodin
and used by 7.4 percent of college students in 2005.


Although the number of U.S. high school and college students abusing
illicit drugs declined in 2006 for a fourth consecutive year, "the high
and increasing level of abuse of prescription drugs by both adolescents
and adults is a serious cause for concern," the report said.


Counterfeiters are exploiting intense demand for prescription drugs that
can give a high comparable to cocaine, heroin or methamphetamine, the
watchdog group said.


It singled out Scandinavia, where demand for flunitrazepam - a sedative
sold as Rohypnol and widely known as a "date-rape drug" - increasingly
is being met by unauthorized production, and North America, where
widespread abuse of prescription drugs, including the narcotic fentanyl
- 80 times as potent as heroin - has been blamed for a spike in deaths.


"The very high potency of some of the synthetic narcotic drugs available
as prescription drugs presents, in fact, a higher overdose risk than the
abuse of illicit drugs," Emafo said.


Exact figures were unavailable, he said, because few countries "are
aware to what extent drugs are being diverted and abused" and are not
tracking the trend. Nations should pay closer attention and share data
on counterfeit drug seizures, the group urged.


Other findings in the report:


Cultivation of opium poppy in Afghanistan hit a record high last year,
an assessment also made by other agencies.


Iran is now the world's No. 1 abuser of opiates, and 2.8 percent of the
population uses illicit cocaine and heroin, most of it from Afghanistan.


Bolivia plans to introduce a drug-control policy that would broaden the
marketing and use of coca leaves - a step the Narcotics Control Board
warned could violate international drug conventions.


Read from the global drug report, including a breakdown by region, via
http://go.philly.com/drugtrade

Virginia Thompson
Sustainable Healthcare Sector Coordinator
Office of Environmental Innovation (3EA40)
US Environmental Protection Agency Region 3
1650 Arch Street, Philadelphia, PA  19103
Voice:  (215) 814-5755; Fax (215) 814-2783
thompson.virginia at epa.gov