Rx Mex

Say "Adios!" to sombreros, pinatas and tequila. In some circles, at least, the Mexican souvenirs of choice are rapidly becoming tranquilizers, amphetamines and narcotic painkillers.

The weird phenomenon--the seemingly legal circumvention of laws preventing the unnecessary prescription of U.S. drugs with recreational potential--emerged from an ever-enlarging loophole in U.S. Food and Drug Administration regulations.

Drawn up by that agency several years ago, guidelines were ostensibly designed to accommodate retirees on Medicare and other financially pressed Americans who stood to benefit from the wide disparity in prices between American and Mexican pharmaceuticals. Current policy now allows U.S. citizens to bring "reasonable" amounts of prescription medications back into this country, provided that the drugs are for personal use only and don't present "unreasonable" health risks.

But what constitutes a "reasonable" amount? What poses an "unreasonable" risk? And if retirees can routinely pass through customs with several months' worth of various medications, who's to determine that a much-younger American doesn't really need that 90-day supply of, say, the painkiller Vicodin that he's bringing back across the border?

Factor in a slew of other issues--inconsistent enforcement, understaffed customs-inspections stations and a Mexican medical system that's worlds apart from its U.S. counterpart--and it becomes easier to see how an avalanche of recreational drugs legally flood this country daily.

This wasn't always the case--at least, not in Nogales. "We used to be much more hard-nosed, especially about things like Valium and codeine," explains Ralph Guerra, chief customs inspector at the Nogales border. Up until a few years ago, anyone declaring drugs with a potential for addiction or abuse was required to produce an American prescription form. U.S. citizens carrying Mexican medications prescribed during vacations were only allowed to bring back enough pills until they could see an American doctor.

In the past, each port of entry determined its own policy requiring prescription-drug importation. But two years ago, U.S. Customs' attempt at standardizing policies meant Nogales had to drop its more stringent policing. Today, with the exception of certain drugs rarely prescribed outside a clinical setting (cocaine, morphine, steroids), citizens can theoretically bring back any drug for which they can produce any prescription. Provided they've got the right answers, that is.

"We'd have to look at each individual person and question them about what their medical conditions are," explains Guerra. "If it's someone who fits a certain profile, we might scrutinize them a little closer. It all comes down to a judgment call."

But the system is far from foolproof: Guerra claims his staff has discovered elderly couples (a group least likely to be questioned) being used as drug mules to smuggle steroids and other pharmaceutical contraband.

While virtually all drugs in Mexico are sold over the counter, many border-town pharmacies require gringos to produce a prescription before selling them drugs that carry recreational potential. Still, with little prompting, most pharmacists will direct you to an accommodating Mexican doctor--no appointment needed--who'll write the prescription necessary to buy uppers, downers and practically everything else in between.

The problem--if that's what it can be called--isn't likely to change soon, observers believe: Because Mexico is now in the throes of its worst depression in years, the booming farmacia business is the only thing keeping some border towns alive.

Although no one has a real fix on the exact magnitude of the situation, one pill-scene observer claims that Mexican-farmacia forays appear to be growing increasingly popular in recreational-pill circles.

"There's definitely a buzz about this right now," says Jim Hogshire, editor of Pills-A-Go-Go, a Seattle-based 'zine that tracks pill-popping trends. "I'm noticing that a lot of kids on the Internet are either talking about doing this or are asking questions about how to do it."

Hogshire suspects the trend may be fueled by recent publicity surrounding Rohypnol, the potent sedative linked to several college "date rapes." Until the U.S. Food and Drug Administration issued an import ban last month, Americans had been free to bring the tranquilizer into the country from Mexico.

Adding that "there's both a right way and a wrong way" to carry out business in a Mexican pharmacy, Hogshire reports that he'll address farmacia "dos and don'ts" in Pharmaceutical Nation, a book-length Pills-A-Go-Go compilation to be published this summer.

"Most people seem to be buying pills for their own personal supply, though," says Hogshire. "I don't get the impression they're going down and getting them for resale."

But one recently released study would seem to blow holes in that theory: After monitoring drug declarations at the Laredo border during an 84-day period last year, University of Texas researchers concluded they were looking at a pharmaceutical tidal wave.

Funded by two pharmacy associations, the report was expected to document the amount of business U.S. drugstores was losing to Mexican farmacias catering to the elderly and the uninsured. Instead, the study revealed that the vast majority of declared pharmaceuticals coming through that port-of-entry border were drugs with high potential for addiction and abuse--thousands of prescriptions that would probably never have been written in this country in the first place.

During the period covered in the study, U.S. citizens (most of them 35 or younger) declared more than 900,000 tabs of Valium, the most frequently declared drug. The second-most popular drug was the now-banned Rohypnol, a drug used to sedate psychotics that has never even been marketed in this country. Rounding out the top ten was a "fruit salad" of painkillers, sedatives and amphetamines--drugs which play no major role in any geriatric-health regime. And while a 90-day supply is theoretically the maximum amount of any one drug that a citizen can bring back into the United States, the study noted that enforcement was so inconsistent that, in some cases, individuals successfully declared up to 25 bottles of Valium containing 90 tabs apiece.

"People were coming across with drugs you would never prescribe [in tandem]," says Marvin Shepherd, head of University of Texas' College of Pharmacy in Austin. "And they all had prescriptions from the Mexican doctors who wrote it."

Surprising as his findings were--the study indicated that people over the age of 50 actually accounted for less than 10 percent of prescription-drug traffic--the doctor claims that his findings represent what is "probably only the tip of the iceberg." Concludes Shepherd, "It is remarkable what's being brought back across the border."

But none of this comes as any surprise to the Arizona Poison Control Center.
The Tucson-based center now answers at least 20 calls a week about Mexican drugs. Many of those queries come from woozy thrill seekers who discover too late the downside of Mexico's pill paradise: inappropriate drug substitutions.

A typical victim is the young Percodan freak who recently called the center. Mistaking the similarly named Neopercodan (in reality, a form of Darvon) for a "really weak" version of her drug of choice, she drastically multiplied her usual dosage.

"Instead of getting higher, she just got sicker," says poison-control director Jude McNally. "People have literally been found on the side of the road between Nogales and Tucson because they didn't realize what drug they had and just kept taking more and more."--Dewey Webb

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Dewey Webb

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