I have written about medical tourism on numerous occasions. I once wrote that when patients cross borders it is usually the closest border. I went on to say that most medical tourism in the United States is people crossing into Mexico for dental care, optical care or to buy prescription drugs at prices cheaper than found locally. Years ago I crossed into Mexico from Weslaco, Texas. You could park on the U.S. side and walk across the bridge into Mexico. If you pull up Weslaco on Google Maps it lists eight different pharmacies or clinics within several blocks of the international border crossing. Google Maps does not always list every business. There are probably more than eight. As I recall there were rows of pharmacies. The storefronts were often narrow but deep. On one side of the pharmacy was cheap drugs while on the other side was cheap liquor.
The main attraction of pharmacies in Mexico is they sell drugs at prices cheaper than in the Unites States. Another attraction is for most drugs you do not need a prescription (the U.S. could learn something from Mexico in this regard). For the few drugs requiring a prescription pharmacy staff can direct you to a nearby doctor who will write you a prescription. The going price used to be $20.
A popular item in Mexican pharmacies is pain medications and this is where it gets risky. Reports in the news recently have highlighted accounts where people have died from counterfeit Mexican pain medications. The UCLA School of Medicine analyzed pain pills purchased from Mexican pharmacies that cater to American tourists. They found that nearly 40% of those tested were fentanyl rather than oxycodone. Both opioids are used for pain in the United States. However, fentanyl is 50 to 100 times more potent than morphine, while morphine is 1.5 times more potent than oxycodone. This means that a counterfeit oxycodone tablet, with sketchy quality control, manufactured by someone bad at math, can be deadly. According to the Washington Post there were 90,000 overdose deaths in the U.S. in 2020. The vast majority are tied to fentanyl. CBS News spoke with an Arizona mother whose daughter died after ingesting half of what she thought was a Percocet tablet.
Vice Media reports that three million Americans cross the border into Mexico annually to receive care and buy prescription drugs. The reporter interviewed numerous people, both customers and wholesalers to see what is behind the sale of Mexican prescription drugs. Vice had this to say:
While most people are able to find the care they desperately need, some are also buying cheap, unregulated meds without knowing they’re fake.
The ingredients can be completely unknown. And in recent years the DEA has seized counterfeit medication laced with the deadly opioid fentanyl.
Vice Media produced an 18-minute YouTube video on counterfeit medications from Mexico. The reporter crossed the border into Tijuana near San Diego. The reporter talked to one person who displayed a number of medications in their packaging. One by one, he identified them as “fake, cloned, pirated, and original but stolen.” She recruited a former opioid addict to clandestinely purchase Percocet so she could test it. She ground up a tablet and tested it using a portable spectrometer. It came back as fentanyl and methamphetamine. Most fentanyl used to come from China but now most of what comes across the border is made in Mexico by the Sinaloa and Jalisco New Generation cartels.
Vice news next ventured into a Mexico City to a local black market that sells medications, among other things. There she purchased numerous counterfeit medications with boxes that were close but often not quite exact copies of the original manufacturers. The most popular medications are pain relievers and antibiotics.
Finally, the Vice reporter returned to the United States and went to an area of Los Angeles on Alvarado Street. Street vendors there were also selling counterfeit Mexican medications. One street vendor sold the reporter a 10mg bar of Xanax for $5 and a blister pack of diazepam, a tightly regulated prescription anxiety medication. The brand name for diazepam is Valium. The Xanax bar was actual generic Xanax (alprazolam). However, the recommended dose according to Drugs.com is 0.25mg to 0.5mg, not 5mg or 10mg. In the U.S. Xanax bars are 2mg and meant to be broken in half. The reporter had been warned that she was buying Mexican Xanax that was really strong.
The takeaway from the video was cartels have gotten into counterfeit medications and to be careful buying medications in Mexico (especially pain medications). Not mentioned in the video is that the Cuban cigars you bought while on a cruise were probably not really Cuban.