'Lookalikes': new battle in drug abuse war

The sign outside the squat yellow bungalow reads, ''The Original Over the Counter Drug Company of America.'' Inside, an American flag hangs on the wall of a small salesroom, where two glass cases are filled with bottles of pills and capsules: ''For that fine light feeling,'' the store's advertising boasts.

The six-week-old store, the first of its kind in the Los Angeles area, has sparked a local debate that is part of the country's latest battle in the war on drug abuse - a battle set on high school campuses, in hospital emergency rooms, in state legislatures, and on Capitol Hill in Washington.

At issue are ''lookalike drugs,'' tablets and capsules packaged to mimic the appearance and physical effects of ''speed,'' or amphetamines - but which, in fact, contain only legal stimulants that are available on a nonprescription, ''over-the-counter'' basis.

In the past two years, says the federal Food and Drug Administration (FDA), lookalikes have been responsible for at least nine deaths nationwide. And since last spring, the lookalike phenomenon has spread with a popularity that baffles drug experts and which one spokesman for the National Institute on Drug Abuse calls ''extremely dangerous.''

Lookalike drug manufacturing - estimated to be a multimillion dollar business by the federal Drug Enforcement Administration (DEA) - got its start in the mid- 1970s in the Southeastern United States, where the pills were sold to truckdrivers who wanted a way to stay awake on long hauls.

Today, more than 120 wholesale distributors are operating across the country, the DEA says. Between 1979 and 1981, according to DEA statistics, the types of black- and yellow-capsule lookalikes rose from 11 and 3, to 32 and 17, respectively.

The primary target now for lookalikes, drug authorities say, are teen-agers and college students, who either buy the drugs on the street, thinking they are real speed, or who are attracted to the ''glamour'' of popping pills that look like illegally obtained drugs but can be purchased legally.

Unlike amphetamines, which are federally controlled substances (those that have a high potential of dangerous abuse), lookalikes generally are a blend of three common drugs that can be found individually in pep pills and diet pills available at most any drug store: caffeine, ephedrine, and phenylpropanolamine.

Drug experts are quick to point out that these three substances have a legitimate medical use. But the higher-level combination of the drugs in lookalikes, they say, can lead to potentially dangerous reactions. In addition, authorities note that an increasing number of overdoses being treated in hospital emergency rooms are due to lookalikes - but that efforts to care for patients are complicated because the lookalike nature of the drug may mistakenly lead doctors to treat a victim for an amphetamine overdose.

Equally worrisome in the eyes of many parents and drug-abuse officials is the fact that the distribution and use of lookalikes serve to legitimize the recreational use of drugs - and thereby add to the nation's drug abuse problem.

Although the problem has been a tricky one to combat (largely because it has been unclear which federal agency should take the lead in addressing the issue), state and federal forces have begun to fight back over the past several months.

In late September, for example, the FDA raided the offices of nine major manufacturers and, under a federal act which makes it illegal to counterfeit a drug, seized 15 million capsules and pills, along with $1 million worth of equipment. The US Postal Service is going after mail-order manufacturers under a law that makes it illegal to use the mails to send misrepresented products.

In addition, the DEA has just completed drafting model legislation for use by states that, if enacted, would make it illegal to sell or manufacture drugs that look like controlled substances. Already, several states - beginning with Delaware in June 1980 - have passed similar types of antifraud legislation, and many other states are considering it. On Capitol Hill, the House Subcommittee on Crime has held hearings on the problem and is now considering federal legislation to address it.

Authorities, however, note one hitch in these efforts, which are based on the counterfeit or fraudulent aspects of lookalike drugs: Virtually all of the action taken so far deals with controlling the drugs on the basis of their packaging, and not their content.

Thus, to escape the penalties of these laws, a manufacturer need only change the way his pills and capsules look - a move that already is being made by the manufacturer that supplies the Original Over the Counter Drug Company of America in Los Angeles.

According to Dennis Harshman, who runs the store (which has been picketed by angry residents and movie stars in recent weeks), his supplier - Zia Pharmacal of Albuquerque, N.M. - is closing out its lookalike line next month. Instead, says Mr. Harshman, the pills will be packaged in red, white, and blue.

Although the FDA has the authority to change the status of the three drugs involved from nonprescription to prescription drugs, such a move is considered unlikely because it would arouse intense opposition from drug manufacturers. Another option would require lookalike drug manufacturers to file for a new drug application with the FDA on the grounds that the combination of the three drugs creates a new drug requiring FDA approval. According to an FDA spokesman, however, no such action is at present under consideration.

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