An Rx for dubious drugstores

For some US citizens, the border with Mexico looks like a 2,000-mile long pharmacopeia.

From Tijuana to Matamoros, signs beckon in English - "Drug Store," "Yes, we have Viagra," drawing Americans south to buy prescription drugs at prices 40 percent below the US cost.

While border-hopping to fill legitimate prescriptions isn't illegal, the trouble is that these pharmacies have too often been an easy source of controlled medications like Valium, or questionable "miracle drugs" not approved in the US.

Kids looking for some "uppers" for a weekend dance party? No problem. High school boys hunting for steroids to muscle up fast? The "specialist" at the one-man pharmacy will be happy to assist you with an on-the-spot prescription - or even without one.

One Mexican border governor has begun cracking down on this dubious dispensing.

The year-and-a-half-old campaign is part of Chihuahua Gov. Patricio Martinez's effort to counter his state's anything-goes image. Several pharmacies have been sanctioned for violations, and six repeat offenders have been shut down.

A similiar effort is expected to begin by April in another border state, Baja California.

While no one claims that illegal access to controlled legal drugs has been completely cut off along the border, some area health specialists applaud results so far.

"Most of us are fully supportive of these tighter controls, we know better than most that a lot of people out there are using medications in ways they shouldn't," says Cruz Maria Areola Enriquez, past president of the pharmacists' group within Ciudad Juarez's chapter of the National Chamber of Commerce.

"We can feel the governor's program is a success, because things are more peaceful down here. We have fewer people asking for Valium or other drugs they don't have a prescription for," says Ms. Areola, whose pharmacy in downtown Juarez is within walking distance of central El Paso, Texas.

The date-rape pill scandal that shook the Juarez-El Paso area in the late 1990s is an example of the kind of situation Martinez wants to prevent.

Young people had such easy access in Juarez to a hypnotic medication called Rohypnol - used legally in Mexico to treat depression patients, but also used by some men to drug their dates into submission - that the pills became known as "Roches," after Hoffman-La Roche, the Swiss pharmaceutical company that manufactures them.

Martinez - also known in Chihuahua and along the border for his campaign against all-night discos and his "good-neighbor" effort to stop Juarez bars from serving alcohol to US citizens under 21 - began targeting lax pharmacies soon after taking office in October 1998.

The state fired all 150 of its pharmacy inspectors and hired new ones. New procedures were launched to track controlled drugs from manufacturer to pharmacy to patient, with stiffer prescription requirements. Courses were set up to explain to pharmacies why the new measures were necessary - and what penalties would be imposed for violations.

"These measures didn't form the easiest road Governor Martinez could have taken, this entailed removing people from posts that in some cases had become very lucrative for the wrong reasons," says Graciela Ortiz, social development secretary for Chihuahua. "We even had a few bomb threats."

Martinez's reform crusade in another area - cocaine and other other narcotics trafficking - is widely believed to have led to an assassination attempt on the governor in January.

Access to legal controlled drugs has been reduced in part because several smaller pharmacies have chosen to stop selling medicines like tranquilizers and narcotic painkillers that come under the state's new, tighter regulations. "All the problems led a lot of us to just get out of offering these drugs, this way you're not suspect," says Lorencia Herrera, who operates a small pharmacy in central Juarez.

Area health experts say they see Chihuahua's campaign as part of a general effort along the border to reduce illegal access to controlled drugs.

"We still see cases of charlatans who are found dispensing these drugs without prescriptions, but there's been improvement all along the border and especially in Chihuahua," says Eduardo de Cossio, binational coordinator for the Panamerican Health Organization in El Paso.

Chihuahua is one of six states along the US border. Ciudad Juarez is the largest Mexican city on the border, followed closely by Tijuana.

Despite Chihuahua's efforts, some pharmacy employees in Juarez say that people who want a certain drug are still going to find it, even if it may be more difficult now.

"I'd say the state really is controlling more the sales of Valium and such drugs, but 'controlling' like this," says pharmacist Magdalena Munoz, making imaginary quotation marks in the air. The state courses have made employees more conscious of the dangers of these drugs and the reasons for the tight controls, she says, adding that pharmacy visits by state inspectors have become more regular. "People here are a lot more aware," says Ms. Munoz, who works at the large ABC Pharmacy in central Juarez.

But she thinks the small one-man pharmacies that dot Juarez's side streets, where the same person acts as doctor and pharmacist, still could fall through the inspection net.

"Part of my doubts come from past cases, where pharmacists in that situation were found falling prey to bribes," she says. Her suspicions are also heightened, she says, because fewer customers are asking for controlled drugs in her store, "so I have to figure they're going somewhere."

(c) Copyright 2001. The Christian Science Publishing Society

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