
Maker of dangerous pain pills is 'ghost' that can't be found [video] - mumbi
http://www.usatoday.com/story/news/nation/2013/09/25/who-is-riger-natural-maker-of-dietary-supplement-reumofan/2843161/
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DanBC
It feels like better linking of data would help a lot here. It's weird that
wide scale web scraping isn't used as an intelligence source for things like
this. (It can be done in a way that weakly preserves anonymity of innocent
victims; and the data should be destroyed after prosecution).

> _They are running a high risk: Dozens of Reumofan users have suffered
> serious and sometimes life-threatening health effects after taking the
> pills, including liver injury, strokes and severe episodes of bleeding,
> according to federal records obtained under the Freedom of Information Act._

On first reading it's easy to say these people are stupid, taking this
ridiculous medication when there are proper meds around.

Pain control and pain medication is weird. People sometimes overdose with
proper meds, leaving themselves open to similar very dangerous side effects.

Some of the meds are old, from a time when testing wasn't as good and
understanding of pain was poor. See coproxamol as an example - this med
contains 325 mg of paracetamol (therapeutic dose is 1000 mg per dose) and the
weak opioid dextropropoxyphene. Coproxamol was widely used in the UK by people
completing suicide. The dextropropoxyphene is very toxic, especially if
combined with alcohol. And people taking the med long term would increase the
dose because of tolerance to the opioid, thus risking liver toxicity from
paracetamol overdosing.

But, despite clear evidence that this med is dangerous, and no more effective
than a normal dose of paracetamol alone, there was a lot of campaigning around
its withdrawal, with people worried that they would not find a suitable
replacement.

We have better pain management now, but it's still tricky to get people the
right pain relief.

~~~
vidarh
My favorite pet peeve when it comes to paracetmol (note to Americans: that's
acetaminophen to you) is the mixed paracetamol/codeine pills.

Here we have a highly addictive drug (codeine) that is otherwise _reasonably_
safe in quite high doses, and that is regularly prescribed in substantially
higher doses. E.g. prescription co-codamol is usually sold with 30mg codeine
per 500mg paracetamol vs. 8 or 12.5 mg codein in over the counter, and you can
get prescriptions for "neat" codeine at higher doses as well.

And we have a drug that causes liver failure in quite small doses, to the
extent that the UK government put in place restrictions on it sale intended to
reduce its use in suicides (you can only buy 16 pills at a time outside of
pharmacies, and 32 pills at a time in a pharmacy). It's been widely reported
to have cut suicide deaths using paracetamol by hundreds (total, not per year)
since the restriction was put in place as just that slight little barrier of
having to go to multiple places is apparently enough to make some people think
twice.

So what do they do? Of course, since we all know addiction is bad (and we're
talking religious/morally/tabloid style righteous "bad" here), why, when they
decide to allow sales of tablets with codeine over the counter, they decide it
should be mixed with paracetamol or ibuprofen, with the codeine content low
enough that anyone left addicted after failing to get prescriptions renewed
etc. faces the choice of suffering it out, or risking their liver.

Cue a couple of years, and the warnings about the danger of these pills are
starting to emerge: Surprise, surprise, people with severe opiate addictions
are sufficiently often not in a place where you should expect them to make
rational decisions about whether or not taking products containing too much
paracetamol is a good idea...

I get migraines sometimes, and the codeine/paracetamol pills are a great help,
but I can't help but think that allowing the over-the-counter sale of them
without a "safe" alternative for those addicted to codeine is tantamount to
murder - the government knew all the risks, and in fact there'd be little
reason to require those mixes over allowing plain codeine if it wasn't as a
way of making the pills more dangerous to abuse. Yet they did it anyway.

~~~
mikenon
Codeine isn't OTC in the US, even when mixed with acetaminophen. Though, from
what I understand, a pharmacist technically has the ability to dispense
codeine-containing cough syrup without prescription.

Also, Hydrocodone (derived from codeine) is a Schedule 2 drug in the US. But,
when combined with another substance (most often with acetaminophen, like
Percocet) the drug is reduced to Schedule 3.
[http://en.wikipedia.org/wiki/Hydrocodone](http://en.wikipedia.org/wiki/Hydrocodone)

As far as addicts misusing OTC codeine/acetaminophen, it's apparently pretty
easy to filter most of the adulterant in a basic kitchen.

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swamp40
I haven't seen anyone mention here that the pills _actually_ contained
steroids and muscle relaxants, and all of the fatalities involved issues with
long-term steroid use and/or withdrawal.

Doctors and the FDA began to get suspicious because the pills worked so
_well_.

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Fuxy
Wait so these "all natural" pills contain a cocktail of drugs that are
actually approved by the FDA but require a doctor's close motoring sold at a
fraction of the price you would pay for them if you went through approved
channels.

You know the risk just may be worth it if you can get the same drug at a
fraction of the price. Some people can't afford the real thing.

~~~
rarw
I think the point of the article is more that it's a problem when something
that contains these drugs lables itself as a "natural supplement" when in fact
it is not. The issue is not so much const control as it is deceptive
marketing.

~~~
Fuxy
True. Though if they ever marketed it as what it actually contains they would
get considerably more heat.

Hacker instinct took over :)

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pyalot2
The scene in the vid where the guy says "I don't care..." with the framed
"Faith" sitting besides him, it really pulls that documentary together.

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s_baby
Allegedly the same is true for the "sexual enhancement" supplements sold at
gas stations. Many contain drugs like Viagra even though it's sold as a
natural supplement.

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GotAnyMegadeth
Labratory

