When remedy leads to tragedy

SINGAPORE - Desperate to relieve his chronic back pain, he bought herbal pills from a local peddler.

Unknown to him, he was taking capsules with high levels of dexamethasone, a potent steroid used for anti-inflammatory purposes, for a year.

Then he developed serious complications of Cushing's syndrome, a hormonal disorder.

Now, as the 80-something lies in intensive care fighting for his life, others continue to shop for that "miracle pill" to ease their pain or even to enhance their sexual prowess in the back lanes of Geylang.

One patron, who wanted to be known only as Mr Huang, 43, was spotted in Geylang last night doing just that - he was buying pills from a row of illegal vendors selling their wares on groundsheets by the road.

He told The New Paper that he "buys to improve my drive". He said he was introduced to them by his friends.

Last night was the fourth time he was buying such pills.

"They do work well and they are cheap. I know it is damaging if you keep taking (them), but once in a while, it should be fine," said Mr Huang, who revealed only that he works in construction.

The latest three cases - reported between the end of last year and the middle of this year - involved people aged 40 to 80 years.

Apart from the elderly patient, one other man, in his 40s, suffered serious side effects.

He bought the pills from a friend to relieve the pain from gout and as a consequence, his bones were affected.

The third person, in her 50s, had experienced rapid pain relief for her stiff neck after taking only a few capsules, which she had obtained from a friend. Suspicious, her family member immediately reported this to the Health Sciences Authority (HSA).

Bought from peddlers

Bought from peddlers

Investigations revealed that these pills were bought from peddlers or friends. HSA is looking into the original source of these illegal products.

The agency is also alerting the public to these illegal capsules being sold as herbal or traditional medicine to treat arthritic and joint pain, and to promote blood circulation.

The adulterant dexamethasone can cause serious adverse effects such as increased blood glucose leading to diabetes, high blood pressure, eye, muscular and bone disorders.

And it can cause serious withdrawal symptoms.

Those who have taken these illegal pills should consult their doctors as soon as possible.

Associate Professor Chan Cheng Leng, HSA's deputy group director of the Health Products Regulation Group, said every year, the agency receives reports of serious adverse drug reactions from consumers, who "unwittingly consume illegal health products masquerading masquerading as herbal or traditional medicines or health supplements for quick relief of chronic disease conditions, or for enhancing sexual performance and slimming".

There were "over 50 adverse events" associated with the consumption of illegal health products from 2010 to June this year.

Of these, four people died after having taken adulterated products such as Huo Luo Jing Dan, which was said to promote blood circulation and relieve aches and pains, including rheumatism and arthritis, and Power 1 Walnut, a sexual enhancement drug.

General practitioners The New Paper spoke to said they do see patients who self-medicate using alternative medicines.

They said these patients sometimes go to them with low blood pressure, dizziness and weakness of the limbs - side effects from taking certain prescription drugs.

"Most would say they were not taking prescription drugs, but traditional supplements. That is when a warning light comes on in my mind," one GP said.

Prof Chan said the issue of illegal health products has become a global phenomenon in recent years, endangering public health and safety.

"In Singapore, illegal health products are usually found on the black market, outside the legal supply chain.

"In addition to the black market supply, these products can be obtained through peddlers, friends and acquaintances who bought the products from overseas or over the Internet," she added.

Wrong or no active ingredient

According to the US Food and Drug Administration, counterfeit medicine is fake medicine. It may be contaminated or contain the wrong or no active ingredient.

Otherwise, they could have the right active ingredient but at the wrong dose.

A 2008 article from the World Health Organisation's International Medical Products Anti-counterfeiting Taskforce was reported that 30 per cent of medicine on sale in many countries in Africa and parts of Asia and Latin America may be counterfeit.

Pharmaceutical industry experts predicted that the counterfeit drugs business grew by 13 per cent last year, with a revenue of US$75 billion (S$95 billion) for the counterfeiters.

In Singapore, HSA conducts regular surveillance and raids with relevant law enforcement agencies in targeted areas associated with vice activities.

Over the last three years, HSA has conducted more than 100 raids and more than 20 illegal sellers were prosecuted.

"It is almost impossible for the consumer to know whether a product is illegal or not, other than some giveaways such as poorly labelled or poorly packaged products.

"Most illegal products look authentic and any irregularities can only be detected by laboratory testing.

"It is therefore important that consumers do not obtain medication from peddlers and dubious sources," Prof Chan warned.

- Additional reporting by David Sun and Linette Heng


This article was first published in The New Paper.

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