Foreign Mail Order Drugs

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The decision permitting mail order drugs in the U.S. has prompted safety concerns — though not that mailboxes will be jammed with bare hypodermic needles.

In a surprise move that has prompted both cheers and jeers, the Food and Drug Administration has decided that Americans may now mail-order foreign pharmaceuticals for personal use even though the drugs are not approved in the U.S. This means that AIDS patients can now get promising AIDS drugs, such as Japan’s dextran sulfate, from overseas, and that mail order drugs for nearly everything from cancer to arthritis are permitted. The only banned drugs are some 40 already proscribed by the FDA as fraudulent or dangerous. Otherwise, almost anything goes — as long as drug shipments are for personal use and are limited to a three-month supply or less. In addition (the real trick), you must specify that a licensed U.S. doctor will oversee treatment. However, these new guidelines are “on a pilot basis subject to change or cancellation.”

Right now, the FDA is downplaying the news for anyone other than AIDS patients and the desperately ill. The truth is that all Americans now have a world of pharmaceuticals from which to choose, albeit at their own risk. People with intractable illnesses might consult Orphan Drugs (The Body Press, $14.9 5) by Kenneth and Lois Anderson, a book that describes 192 generic and 1,545 brand-name drugs available in other countries, gives the foreign trademarks and addresses of distributors, and tells how to find a doctor overseas if a prescription is needed.

It should be kept in mind, however, that even when the FDA does approve a drug in the U.S., it may not be as safe as you think. In 1986 (the latest year for which data are available) there were more than 10,500 reports of new drugs having unexpected side effects, ranging from untoward drug interactions and nervous system or digestive problems to fatal reactions. A whopping 24% of reports on new and established drugs indicated a patient had died or was hospitalized as a result of the drug.