[Pharmwaste] FW: [e-drug] INCB: Abuse of prescription drugs surpasses narcotic drugabuse

[gressitt]

Note particularly 30, 31, and 36. Addressing the unused medicine disposal
issue would appear to fall in those sections. The full report is available
now on the INCB website. Stevan Gressitt 

-----Original Message-----
From: Wilbert Bannenberg 
Sent: Thursday, March 01, 2007 2:53 PM
To: 
Subject: FW: [e-drug] INCB: Abuse of prescription drugs surpasses narcotic
drugabuse



Dear colleagues

Just to inform you that INCB has today published the report on "unregulated
markets" of which I drafted an early version and to which you contributed.
As expected, the text has been seriously edited by the UN, and many issues
have disappeared. However, I already saw interviews on the BBC news, so I
think the main messages have been kept intact.

Anyway, a good opportunity to say "thank you" for your contribution.

Best regards

Wilbert Bannenberg

------
Dr Wilbert Bannenberg, Public Health Consultant

**in Tanzania 19 February -5 March 2007** Mobile NEW +255 75 2454761 Holiday
Inn, room 430, Garden Avenue, Dar es Salaam Tel Hotel :+255 22 2137575 Fax
Hotel :+255 22 2139070 Mobile fax +31-84-7135814
SMS: +31-6-20873123 (no mobile calls)
Email: wjb at wxs.nl
Skype: wilbertb1
Work website: www.hera.eu

---------
Dr Wilbert Bannenberg, Public Health Consultant Mobile +31-6-20873123 Tel
work +31-497-550713 If unavailable, call HERA at +32-3-8445930 Fax
+31-497-550712
Email: wjb at wxs.nl
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Work website: www.hera.eu
 



E-DRUG: INCB: Abuse of prescription drugs surpasses narcotic drug abuse
----------------------------------------------------------------------
The International Narcotics Control Board (INCB, see www.incb.org) has today
issued its annual report on 2006. It's first chapter is traditionally on a
specific topic. This year it discusses "unregulated markets". Misuse of
prescription drugs is overtaking the use of narcotic drugs. Counterfeiters
are increasingly filling the demand, often through illegal pharmacies easily
found on the Internet. A worrying world we live in. The "traditional" in-
and export controls of narcotics are quickly being eroded. The world needs
to tackle this organised crime on Internet with more priority, resources and
cyberdruginspectors! 

Below 2 press releases of INCB on the report. The chapter on unregulated
markets can be downloaded at:
http://www.incb.org/pdf/e/ar/2006/annual-report-2006-en-1.pdf
The full report is available at
http://www.incb.org/incb/en/annual_report_2006.html
WB]

ABUSE OF PRESCRIPTION DRUGS TO SURPASS ILLICIT DRUG ABUSE, SAYS INCB

Board warns that deaths related to overdose of prescription drugs on the
rise

The abuse and trafficking of prescription drugs is set to exceed illicit
drug abuse, warned the International Narcotics Control Board (INCB) in its
Annual Report released today (1 March 2007). The Board added that medication
containing narcotic drugs and/or psychotropic substances is even a drug of
first choice in many cases, and not abused as a substitute. Such
prescription drugs have effects similar to illicit drugs when taken in
inappropriate quantities and without medical supervision. The "high"' they
provide is comparable to practically every illicitlymanufactured drug.

The abuse of prescription drugs has already surpassed abuse of traditional
illicit drugs such as heroin and cocaine in some parts of the world says the
Board. For example, in the United States, the abuse of prescription drugs,
including pain killers, stimulants, sedatives and tranquillizers has gone
beyond the abuse levels of practically all illicit drugs, with the exception
of cannabis. The abuse rate is higher than that of drugs such as MDMA
("ecstasy"), cocaine, methamphetamine and heroin. The number of Americans
who abuse controlled prescription drugs nearly doubled from 7.8 million to
15.1 million from 1992 to 2003. Abuse of a painkiller, Oxycodone
(OxyContinR), increased by almost 40 per cent, to an annual prevalence of
5.5 per cent among students in their final year of secondary school from
2002 to 2005. Hydrocodone (VicodinR) is also widely abused, with a
prevalence of 7.4 per cent among college students in 2005.

Parts of Africa, South Asia and Europe are also facing this problem. In
Nigeria, for instance, pentazocine, an analgesic, is the second most common
drug injected. Buprenorphine, an analgesic and a drug prescribed for
substitution treatment of drug dependency, is the main drug of injection in
most areas of India and trafficked and abused in tablet form in France and
Scandinavian countries. In France, between 20 and 25 per cent of
buprenorphine (SubutexR) might be diverted to the illicit market.

The demand for these drugs is so high, that it has given rise to a new
problem - that of counterfeit products. Strong demand on the illicitmarkets
of Scandinavia for flunitrazepam (RohypnolR), a sedative, is increasingly
met by illicitly manufactured counterfeit preparations. The demand of the
illicit market in North America for OxyContinR has lead to distribution of
counterfeit products containing illicitlymanufactured fentanyl.

An equally serious consequence is that abuse of prescription drugs can have
lethal effects. An increasing number of deaths related to abuse of narcotic
drugs, including fentanyl and oxycodone have been recorded in North America
and Europe.

"Most countries do not have any mechanism to systematically collect data to
document this abuse, and are not aware to what extent drugs are being
diverted and abused," said Dr. Philip O. Emafo, President, INCB. "In
addition, what abusers do not realize is that abuse of prescription drugs
can be more risky than the abuse of illicitly manufactured drugs. 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," he added.

Aggravating this risk, is the tendency of drug abusers to create their own
recipes - for instance, they remove, with the help of instructions freely
available on Internet sites, the active substances from highdosage
formulations and separate drugs from inactive ingredients, making them even
more potent. Also, the widespread availability of pharmaceutical
preparations in many countries allows drug abusers to obtain such
preparations easily. The increasing use of the World Wide Web as a global
drug market has further contributed to the spread in the abuse of
prescription drugs. "The Board invites all Governments to alert their law
enforcement officers to the rising trafficking and abuse of pharmaceutical
products containing controlled substances. The Board also recommends
providing adequate information to law enforcement and health authorities as
well as to the general public on the risks and possible consequences of
their abuse so as to ensure a realistic risk perception," said Dr. Emafo.

The Board is requesting Governments to systematically collect data on seized
pharmaceutical products and to include the abuse of pharmaceutical
preparations in the surveys aiming at establishing the extent and types of
drug abuse.


INCB WARNS OF COUNTERFEIT MEDICINES FLOODING MARKETS

Action needs to be taken to curb unregulated market, Board warns in Annual
Report

The Vienna-based International Narcotics Control Board (INCB) today warned
that the flood of counterfeit medicines now available in many countries
could have fatal consequences for consumers. In its Annual Report released
today (1 March 2007), the Board also called on member States to enforce
legislation to ensure that narcotic drugs and psychotropic substances are
not illegally manufactured or diverted from licitmanufacture and
distribution channels to unregulated markets.

The danger of unregulated markets is the theme of chapter one of the Annual
Report. The Board is calling for it to be addressed on a priority basis. The
existence of unregulated markets means that substandard, and sometimes even
lethal medication is sold to the unsuspecting consumer. Unregulated markets
are often supplied with stolen and diverted drugs, illicitly manufactured
pharmaceuticals or through illegal sales on the Internet and distributed
through the mail and courier services.

Apart from consumers who purchase pharmaceuticals containing controlled
substances on the unregulated market because of limited access to health
care facilities or lower prices, persons dependent on and abusing such
medicationsmake use of unregulated markets to obtain them without
prescription. "Besides the fact that the existence of unregulated markets,
the sale of diverted and counterfeit drugs and the purchase of drugs
containing controlled substances without prescription contravenes
international treaties on drug control, it is important for consumers to
realize that what they think is a cut-price medication bought on an
unregulated market may however have potentially lethal effects whenever the
consumed drugs are not the genuine product or are taken without medical
advice. Instead of healing, they can take lives," said Dr. Philip O. Emafo,
President, INCB.

This danger is real and sizeable. The World Health Organization (WHO)
estimates that 25-50 per cent of medicines consumed in developing countries
are believed to be counterfeit. The problem is further compounded by the
fact that counterfeit drugs are easy to manufacture - they can resemble
genuine drugs in packaging, and labelling. Unknowing clients have
experienced serious health or even lethal consequences; for instance, in
Africa, the use of counterfeit vaccines in 1995 resulted in 2,500 deaths.
Narcotics, benzodiazepines, amphetamines and other internationally
controlled drugs are easily available in streetmarkets in several developing
countries. In developed countries, these drugs are sold via illegal Internet
pharmacies, without the mandatory prescriptions.

"The problem of counterfeit medication and abuse of pharmaceuticals
containing controlled substances bought without prescriptions, has been in
existence for some time. However, the rapid expansion of unregulated markets
has dramatically worsened the situation," said Dr. Emafo.

The unregulated market broadly covers two scenarios: unlicensed individuals
and/or entities conducting illegal trade of pharmaceutical products
containing controlled substances - for instance, a street vendor selling a
controlled drug, such as a narcotic drug, a stimulant or a sedative in a
village fair; and, licensed individuals and/or entities contravening laws to
sell controlled drugs, such as a pharmacist who sells controlled drugs
without asking for a prescription.

The Board has called on member States to enforce existing legislation, to
impede thismenace, and also take appropriate measures to increase the
availability of medicinal drugs through legitimate channels, particularly in
areas where there is lack of access.



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