#18: Drug Madness is Global!

In Thailand the word “yaba” stands for madness drug and is used to describe Methamphetamine.  July of this year, the UNODC (United Nations Office of Drugs and Crime) reported that the Meth trade is now worth between $30 and $61 BILLION per year in East and Southeast Asia, Australia, New Zealand and Bangladesh.  Yes, that is BILLION with a B!!  Can you say epidemic!?  From the 70’s through the 90’s it was opium and heroin (sound familiar?) however once the traffickers realized it was easier and more profitable to produce synthetic drugs, the tide turned. 

The country of Myanmar is the region’s meth factory.  From the lawless Shan State, within Myanmar, the production of Meth has exploded and is invading most of Southeast Asia.  As the saying goes, “Follow the money.”  A gram of crystal meth sells for $560 in Japan and $390 in South Korea.  According to the US Drug Enforcement Agency, as of March of 2017 a pure gram of Meth sold for about $70 in the United States.     

Some interesting news, and a possible light on the horizon, is the company InterveXion who is attempting to develop a monoclonal antibody directed against methamphetamine.  If successful this antibody would act by re-partitioning Meth away from its sites of action within the central nervous system.  The antibody (IXT-m200) has been fast tracked by the FDA and is currently in a proof of concept study.  Where this will lead in regards to the prevention of Meth addiction is a discussion for another day.

The purpose of highlighting this Meth scourge is to once again remind everyone polypharmacy is alive and real in the drug abuse world.   Testing cannot be limited to just opioids, or other controlled substances the patients are prescribed, with the expectation that the provider will know all the controlled substances the patient is truly taking.  There are a few providers we conduct testing for who only test for the drug they prescribe for the patient. That is entirely their choice, and may well be appropriate depending upon the patient, however the potential risks of adverse drug reactions have to be considered when ordering testing.

 As much as it grates me to say it, in addition to the safety of the patient, in today’s litigious society, providers also have to practice with a calculated amount of self-preservation.  Insurances and governing bodies have done a great job instilling the fear of reprisals for over testing.  I do not advocate over testing; however, I am a huge proponent of letting health care providers make the health care decisions, not the peanut gallery!!!  Yes, there will be some who will continue to abuse the system for their benefit (Name one form of business or career where that doesn’t occur,) as well as some who do not have the training. (That is what continuing education is for!)   Regardless, we were the ones who paid the price, physically, emotionally and economically for our training.  It is up to us to help prevent “Yaba” or other drugs from dominating the US market.  Perhaps if he was still active today Fred Flintstone wouldn’t have said do, but instead would have said, “YABA, DABA, DON’T!!”

Thank you for your business.

Lance Benedict

President/CEO Industry Lab Diagnostic Partners  
9/06/2019