Pharmacists Association Director Warns That Prescription Importation Undermines the Fight Against Opioids

Debra Billingsley, Oklahoma Pharmacists Association

Debra Billingsley's editorial was published in The Oklahoman on October 21, 2017. Billingsley is the executive director of the Oklahoma Pharmacists Association.

Oklahoma Pharmacists Association director: Congress not helping in overdose crisis

Every week, roughly 20 Oklahomans die from drug overdoses. Meth and opioids such as heroin, fentanyl and prescription painkillers account for the lion's share of the fatalities.

Oklahoma is fighting this abuse epidemic. The Sooner State has restricted patients from automatically refilling prescription painkillers. Attorney General Mike Hunter has banded with lawmakers to devise new policies to help.

But Congress could soon undermine Oklahoma's efforts. A group of lawmakers intends to let patients import prescription drugs from abroad and skip licensed pharmacists altogether, a practice that is currently prohibited.

The lawmakers mean well. They want to give consumers access to less-expensive foreign drugs. But foreign countries lack America's rigorous safety and quality control standards. Importing medications from pharmacies in other countries isn't anywhere near as safe as licensed pharmacists in Oklahoma.

Legalizing prescription importation would cause an unprecedented number of dangerous drugs to fall into Oklahomans' hands.

Right now, fentanyl is ravaging communities in Oklahoma. The synthetic opioid is up to 100 times stronger than morphine — just a grain-sized dose can be deadly. Dealers lace it into heroin or counterfeit painkillers. State officials recently discovered four new strands of the drug on Oklahoma's streets.

The effects have been devastating. In Oklahoma, at least 50 people died from the drug last year. Three Oklahomans with legitimate prescriptions took what they thought were regular pain pills before going to bed — and they never woke up. Autopsies revealed the pills actually contained fentanyl.

Even before the rise in fentanyl, Sooners were at risk of taking dangerous medications — many prescribed to them by unscrupulous doctors.

Since 2012, the Food and Drug Administration has warned nearly 40 doctors in Oklahoma to stop buying drugs from unlicensed sellers. In 2013, officials arrested the operators of the Oklahoma Male Clinic for filling drug prescriptions by using unlicensed pharmacies from out of state.

Now is not the time to allow foreign unlicensed pharmacies to start dispensing drugs into Oklahoma. It would just make it easier for drug traffickers or crooked providers to hurt our citizens.

Most fentanyl originates from China and is routed through Mexico, two countries where pharmaceuticals are notoriously unregulated. The proposed Senate bill wouldn't allow Americans to purchase drugs directly from these countries. Instead, they could import drugs only from "safe" nations, like Canada.

But there's no guarantee that these drugs would originate in Canada. One FDA investigation found that 85 percent of drug imports labeled as "Canadian" were produced elsewhere.

There'd be little stopping bad actors from shipping dangerous medicines or packages of fentanyl from China to Canada and then into the United States.

Importation isn't a slam dunk to cut costs, either. According to the Congressional Budget Office, the bill would lower drug costs by a measly 1 percent. That's because many of the top generic medications dispensed in the United States are cheaper than those in Canada. The diabetes medication Metformin, for instance, costs 10 times as much in Canada as it does in the United States.

Oklahomans are suffering. State officials are trying to help. Congress can help, too, by continuing to keep our drug supply chain as tight and as safe as possible.