A number of years ago I spent some time in Ulaanbaatar, the capital of Mongolia. It is an extraordinary place. Think: the industrial revolution meets the wild west, in the middle of the desert. Wonderful people, but a very poor country.
Good thing I didn't leave my medications at the airport in Anchorage by accident, as a friend of mine once did on the way to Europe. Upon arrival, she just popped into a pharmacy by the hotel and picked up replacements. She was quite confident that her medications were the genuine article, if she even gave it a thought.
On the other hand, had I made the same mistake on my way out of Anchorage, my experience replacing medications at the local pharmacy in Ulaanbaatar would have been fraught with anxiety. According to the Centers for Disease Control and Prevention (CDC) Traveler's Health website, up to 41% of drugs sold in low to medium income countries are counterfeit. You have no idea what you are actually buying. Very scary.
The CDC notes that high-income countries including the United States and Europe are among the safest places to purchase prescription drugs without worrying about counterfeits. Studies indicate that in these countries less than 1% of prescription drugs sold in the corner drug store or the big-box pharmacy, for example, are counterfeit.
Outside of these venues it starts to get a bit dicey. For example, according to http://www.goodrx.com:
"If you receive Botox injections in a non-healthcare setting, or from someone who isn't licensed or trained, you have a greater risk of receiving fake Botox. Anytime you're receiving Botox, ask the person administering it whether they're licensed and trained to give Botox injections. Additionally, ask them if they received the product from a legitimate, authorized source."
For more information, see: https://www.goodrx.com/botox/fake-botox
Online purchases
Moving further along on the spectrum of likely counterfeits, if you purchase medications through online pharmacies or the social media, there's a higher risk that those medications will be counterfeit. Medications that are in high demand due to shortages have an increased risk of being fakes. This is also the case for more expensive medications since counterfeits are often sold at steep discounts compared to the real thing. Pay particular attention to:
Viagra
oxycodone
HIV medications
cancer medications
weight-loss medications such as Ozempic
ADHD medications such as Adderall
Are you starting to get a really bad feeling about online pharmacies? Certainly, there is a lot to be cautious about. Now for the good news. The Food and Drug Administration (FDA) hosts a website called BeSafeRx (fda.gov/drugs/besaferx-your-source-online-pharmacy-information/about-besaferx). The BeSafeRx campaign aims to educate consumers about how to buy medicines online safely.
One way to determine it is safe to do business with an online pharmacy is to check a pharmacy's license through your state board of pharmacy. The BeSafeRx website has a list of state boards of pharmacy, including Alaska's, so you can check to see if the online pharmacy is legit. If it does not have a state license, don't use it. This website has loads of other information to help you navigate the caveat emptor expanse of online pharmacies, so take a look at it.
And here is another extraordinarily helpful website: The National Association of Boards of Pharmacy (NABP). Find them at safe.pharmacy/buy-safely/. Use NABP's Safe Site Search Tool to check whether a website is accredited by NABP or not recommended by searching for the web address. Another way to find an accredited website is to look for ".pharmacy" at the end of the web address. This means the website has been accredited by NABP-and the ".pharmacy" domain cannot be faked or forged.
The Canada question
Finally, Canada. For decades Americans have actually traveled to Canada to purchase drugs-the same drugs-more cheaply in Canada than in the United States, or have more recently been ordering them from Canadian online pharmacies. Note that doing so is technically illegal, but the FDA has an official policy of mostly looking the other way. Here is how KFF, a national nonprofit health information organization, describes the dance:
"There appears to be little enforcement by the FDA of the ban against importing FDA-approved drugs for personal use. Even if the personal importation of a drug is technically illegal, current law directs the FDA to exercise discretion in permitting personal importation of drugs when the product is 'clearly for personal use, and does not appear to present an unreasonable risk to the user,' which is reinforced in FDA guidelines."
Some so-called Canadian pharmacies are fakes, or sell counterfeit drugs. Once again, caveat emptor, but you do have help. The Canadians themselves have an excellent website to help guide you to legitimate online Canadian Pharmacies. Check out: http://www.canada.ca/en/health-canada/services/buying-drugs-over-internet.html.
Live long and prosper.
Lawrence D. Weiss is a UAA Professor of Public Health, Emeritus, creator of the UAA Master of Public Health program, and author of several books and numerous articles.
