Interview: On the Frontline of the Opioid Crisis with MedicineSafe
How one online pharmacy safety organization is partnering to combat the opioid addiction epidemic.
Where there is a demand, there will be supply, and as the cost of healthcare and prescriptions has risen, the industry of online pharmacies has exploded. There is no guarantee, though, that the supply chain will be legal, especially as the internet becomes a growing avenue for anonymity. In fact, statistics show 97 percent of online pharmacies are illicit, meaning they do not comply with U.S. laws and it’s estimated 50 percent of online medicine is counterfeit.
One organization, the Center for Safe Internet Pharmacies (CSIP), works with public and private organizations around the world to tackle the illicit online pharmacy industry and now they are stepping in specifically to target the opioid epidemic by launching MedicineSafe in conjunction with the Partnership for Drug-Free Kids (the Partnership).
We spoke with Marjorie Clifton of the CSIP who talked with us about the staggering problem of online pharmacies and how creating MedicineSafe with the Partnership for Drug-Free kids was a natural extension of their agency’s mission.
“When the opioid crisis hit they were the natural partner because.. a big piece of what they’ve done for the last 30 years has been navigating addiction with families. And so we kind of partnered with them and brought them into the fold to provide for our campaign we’ve been running tools that allow families to navigate this opioid crisis,” Clifton told us in an interview.
A big part of CSIP and MedicineSafe’s approach is to work by giving local communities tools to ensure the safe use of online pharmacies. That approach naturally led to working on addiction issues.
“The idea was, we want to try out this model of we go in and work with local community groups, and we provide a platform, and we provide them the tools, and they get the message out to people in their communities; to give them these tools we’ve created that allows you to check your pharmacy and make sure it’s safe, and they give you tools for getting discounts on prescription drugs. So there’s a lot of problem-solving on that front. Well, we were like what if we throw in tools for families dealing with addiction and the opioid crisis,” Clifton stated.
How Big of a Problem are Online Pharmacies?
Clifton told us that last year the CSIP and its partnering organizations shut down or blocked 117 million ads and social media posts by illegal online pharmacies last year. They also shut down thousands of websites, but every time they take down an ad or a website another one pops up.
“All of the major companies online have tools now to be able to identify and track and immediately take down these sites. The way the internet and these counterfeiters work, they will immediately, the minute the site is taken down, they basically repopulate it on another URL. So they buy up thousands and thousands and thousands of website names. So when they shut down, they reappear, so it’s a total whack a mole.”
Some of the websites, Clifton said, are extremely profitable and thus, have adopted numerous measures to evade law enforcement.
“These counterfeiters are insanely sophisticated, I mean just to give you an understanding of why, some of these websites make $1 million a day,” Clifton told us.
“They knock stuff off perfectly,” Clifton went on. “And even these little yellow pills they have, they tested the paint on the pills, it was the paint they used to paint the streets, it was that street paint. But it looks to the human eye like real pills. ”
Tracking the packages themselves have proven difficult as the packages will look legitimate with serial numbers and barcodes, but when they trace the packages, the numbers lead to dead ends.
Who Uses Online Pharmacies?
While some might think the proliferation of online pharmacies is in response to a demand for illegal drugs, it’s actually in response to regular law-abiding citizens going online to find cheaper prescriptions.
“We realized the consumers that were buying from these sites were very innocent and not, you know, they weren’t people trying to score drugs. They were people’s grandmothers who… their prescriptions had got so expensive that they went online and said, ‘well, gosh, I buy my groceries here so I can buy my drugs here too.’”
The counterfeiters know their clientele and that their clients aren’t looking to score drugs illegally, but rather are looking for cheaper ways of buying legitimate prescription drugs. Thus, online pharmacies will often pretend to be Canadian pharmacies, to lend a semblance of legitimacy, but again 97 percent of online pharmacies do not meet U.S. laws.
In fact, only a handful of drug rings, eight or so, are suspected to be behind the entire illicit online pharmacy industry. The rings have gotten so good at counterfeiting their medicine that most buyers have no idea what they are buying is likely a compromised version of their prescription pills.
“They can be everything from a placebo to a sugar pill, or they can be rat poison. It completely runs the gambit,” said Clifton.
CSIP and Partnership Launch Medicine Safe
Clifton explained the CSIP is now working with organizations around the world to address the illicit online pharmacy issue. That means CSIP is even involved in a global sting operation to try and track down the sources and the people behind the websites.
“Everybody focuses on what they’re good at it… The D.E.A. (Drug Enforcement Agency) is the one going in doing the drug busts, getting the real insider into where the drugs are coming from, who the smugglers and bad guys are. In fact, our companies participate in an annual sting operation with global law enforcement,” Clifton explained.
While the DEA addresses the supply side of the opioid epidemic, CSIP along with the Partnership launched MedicineSafe to address the demand side of the epidemic.
“But they’ve all said, ‘Look you guys totally understand the consumer behavior thing and you’re in a better position to work on the education piece,’” Clifton went on.
“All the alphabet soup of law enforcement, they are the ones that told us, they said, ‘Look we need demand to go down and when consumers don’t understand what’s happening demand stays high. So the best thing you can do to help us is decrease demand and help educate people about this. Because we just don’t know how to do that well,’” said Clifton.
“I joke about it, but I’ve seen some of the videos and things they produce, and they’re so bad. I’m like oh, ok. Yes, you’re right, let us do that… You do the crime fighting,” laughed Clifton.
As a result, MedicineSafe was born. It is working to bring the opioid epidemic out of the shadows and into the light so that people can get addiction treatment, people know what the signs of abuse are, and people know how to talk to their loved ones about addiction.
“To really curb the number of opioid-related deaths, it’s imperative that we give people the tools they need to understand how addiction starts, talk to their kids, recognize the signs of abuse or misuse, and safely navigate treatment, whether that means counseling, inpatient or outpatient rehab, medication-assisted treatment or MAT — or some combination of all of the above. Beyond that, we must make sure that people have the tools they need after they go through treatment to reduce the chances they will relapse,” MedicineSafe said in a statement.
What resources does MedicineSafe provide?
On the MedicineSafe website, users can access a number of tools to help them:
- Safely buy medicines online using our Verify Before You Buy tool;
- Safely store and dispose of medications;
- Talk to their children and other loved ones about opioids, including heroin and fentanyl;
- Recognize the signs of prescription and illicit drug misuse and abuse;
- Navigate the options and resources available for treatment and recovery, including Medicine Assisted Treatment
- Understand the laws requiring that insurance companies cover substance abuse treatment
- Access the Partnership’s 24/7 helpline where people can reach out to experts and other parents
While MedicineSafe only officially launched this past May, it is already highly successful. One of the most popular tools is the verify before you buy tool.
“We piloted in North Carolina; we had insane success. I mean our click-through rates on the ads that we’ve been putting up are, ya know, four times the typical click-through rate on the ad; which is kind of amazing. And then In North Carolina, in six weeks we had 80,000 households actively using all of our tools, which is just phenomenal,” Clifton exclaimed.
When asked if they could track the most popular usage of their site, Clifton explained that the majority of users were going to their verify tools, where you can type in your pharmacy to see if it is safe or not. Other popular tools were their discount tools, but pharmacy checking had received the most traffic so far.
Is there a solution?
The opioid epidemic is touching every community in every state in the country. According to the Substance Abuse and Mental Health Services Administration, approximately 2 million people in the U.S. are addicted to opiates.
When an epidemic of addiction is as widespread as the opioid addiction, the only solution is to have a coalition of organizations working together to tackle the epidemic from every angle, as the CSIP does.
The United Parcel Service (U.P.S.) even works with CSIP and completely reformed their screening procedures to combat the transport of illegal drugs through their shipping channels. Unfortunately, the U.S. Postal Service (U.S.P.S.) is still the preferred channel for drug shipping as the government has less of capability to easily inspect packages.
Also partnering with the CSIP are organizations like Google, Bing and Yahoo who are donating ads as part of their collaboration with MedicineSafe.
There’s also the convergence in recent years on big pharma, to hold them accountable for their role in the addiction crisis. Clifton explained that the explosion in the opioid epidemic is likely linked to numerous factors, one significant factor being the shift in medicine to the new focus on pain management.
“It’s a convergence of a lot of things. I will say that there’s definitely… and even in the medical community they acknowledge talk about this. That what happened was with the introduction of the new kind of medication, there became this fifth tenet to practicing medicine which was managing pain. And that being a fundamental part of how they practice and what that meant was a lot of prescribing of these opioids.
“And I think what they didn’t know in doing that was, how highly addictive and what the implications of that were gonna be. And, you know, big pharma is under a lot of scrutiny for that and there is about 49 states that are going after them, in these class action style lawsuits.
“There’s a belief that they knew how highly addictive they were, and were not clearly communicating that to the physicians that were prescribing and so therefore they should help with the remedy and pay for, you know, the help that we need to get people off of it and deal with the addiction epidemic that we are dealing with…That is a definite widespread belief,” Clifton said.
When watching opioid public service announcements or videos of the like, there is usually one central theme, the feeling of battling an addiction alone.
Perhaps that is one of the most significant contributions of CSIP, MedicineSafe and the Partnership For Drug-Free Kids. They are working to de-stigmatize addiction and bring resources for dealing with addiction out into the public.
The first step to addressing any problem is always acknowledging it.
“Navigating addiction for families is very personal… There’s no one clear path for every family. One of the unique things about the tools that we provide are that very personal and customized and, by the way, all free tools, to help families navigate it. And I think, you know, helping people understand and removing the stigma around addiction, that addiction hits any family, anywhere, regardless of economic, education and location.
“I would just encourage people to check out MedicineSafe; they have tools for every family. Whether you’re a party of one or a family of many,” said Clifton.
Full interview available in the video below: