New Drug Floods Tel Aviv, and Prompts a Rush of Emergency Room Visits

Israel is a global center for Internet marketing of such counterfeits, and according to the Pharmaceutical Security Institute, Israel ranks 10th worldwide in the number of seizures of counterfeit drugs.

In recent months, a new fad has swept Tel Aviv: Under a variety of names, including Alice in Wonderland and VIP, a synthetic, smokable drug that resembles hashish has been offered for sale - and causing a rise in emergency room visits.

This drug is one of the things a new Health Ministry division is being set up to fight.

"We've seen dozens of young people in recent months who used this material," said Dr. Pini Halperin, who heads the emergency medicine department at Tel Aviv's Ichilov Hospital. "The material causes quasi-psychotic episodes, uncontrolled vomiting, muscle pain, breathing problems and chest pains, which require extensive testing to ensure there's no damage to the heart."

The battle against dangerous drugs has entailed raids by the police, the customs authority and the Health Ministry's pharmaceutical crime department, which was set up in 2007 to locate fake medications and dangerous drugs. Now, the ministry has decided to expand the department's operations: Instead of being part of the ministry's pharmaceutical division, it will be become an independent enforcement and inspection division with eight staffers, under the direct authority of the ministry's deputy director general, Dr. Boaz Lev.

The division's designated director, pharmacist Mickey Arieli, will also have responsibility for monitoring dangerous medical devices, which currently aren't closely supervised by the ministry.

Two months ago, a young woman was admitted to the emergency room at Jerusalem's Hadassah University Hospital with an accelerated heartbeat (tachycardia ). A few hours earlier, she said, she had undergone an MRI at a cosmetic treatment center in the Sharon region. The ministry later discovered that the machine in question, which resembles an MRI and is marketed as a medical device, was one it had never encountered before, despite a 1993 law requiring all medical devices to be registered with it.

In another case, a man undergoing alternative medicine treatments complained to the ministry about a diagnostic device that uses magnets. The device has never been approved for medical use, but the patient was told it showed he had worms in his stomach.

"There's a need for comprehensive monitoring of medical equipment that is used in violation of the law, in a way that could deceive customers and even cause medical harm," a senior Health Ministry official said.

Even before its expansion, the unit was instrumental in increasing awareness among Israelis that counterfeit drugs are being smuggled into the country. Israel is a global center for Internet marketing of such counterfeits, and according to the Pharmaceutical Security Institute, Israel ranks 10th worldwide in the number of seizures of counterfeit drugs - a list headed by Russia, China, South Korea, Peru, Colombia and the United States.

"Recently, to avoid legal complications involving patent rights, we've seen fewer counterfeit drugs and more nutritional supplements with active medical ingredients," the senior official said.

The ministry has also recently become aware of a thriving smuggling business in medical devices. A few months ago, for instance, it seized a load of suture thread that was smuggled in from the Palestinian Authority and earmarked for a Jerusalem emergency room. In a major case in Britain three years ago, millions of fake insulin syringes were smuggled into the country.

The new division will also set its sights on electronic cigarettes, or e-cigarettes, which have been on the market since 2004. These devices, mainly made in China, ostensibly contain a liquid that helps people quit smoking. Recently, they have enjoyed a surge in popularity here due to a sharp increase in cigarette prices. But as far back as 2009, the Health Ministry - acting on information from the U.S. Food and Drug Administration - warned that e-cigarettes often contain carcinogenic chemicals, including those used in anti-freeze.

At one time, the ministry even decided to ban their import. But the ban never took effect, and e-cigarettes continue to be marketed freely. Instead, the ministry published another warning this June, saying, "Their medical contribution to weaning people off smoking hasn't been proven, and in certain cases, they are liable to be a genuine danger to one's health."

"Electronic cigarettes continue to enter the country, and no one knows how to deal with them," the senior ministry official said. "Because they were viewed as plastic gadgets filled with liquid, no serious enforcement activity has yet been launched to prevent health damage from these products."

Finally, the new division is expected to receive authority for enforcing the laws on smoking and alcohol use, including the ban on selling alcohol at night and a recently enacted ban on smoking at bus and train stations, event halls and swimming pools. Two of its staffers will go out into the field in an effort to enforce these laws, the ministry said.

Nevertheless, its main activity will be aimed at products that are being sold here illegally - mainly nutritional supplements that contain active medical ingredients, and therefore require a license to sell. Three weeks ago, an undercover probe by the ministry and the customs authority seized 135,000 pills of a supplement billed as improving sexual function that in fact contained medication - not only drugs to facilitate an erection, but in some cases, also traces of weight-loss medication.

In February 2011, Haaretz reported on the sale of fake diet pills marketed as food supplements that contained a high dose of sibutramine, a drug that studies have connected with psychiatric problems. The report noted that a young woman had undergone psychiatric hospitalization after taking the pills, and a teenage boy was hospitalized with kidney problems after taking them.

This is an ongoing problem, the ministry said: Just a few months ago, a woman was hospitalized with tachycardia after taking diet pills she obtained in Umm al-Fahm.

The ministry added that it hopes to greatly increase the division's manpower next year.

A pharmacist sorts pills.