Pubdate: Mon, 05 Apr 1999 Source: San Diego Union Tribune (CA) Copyright: 1999 Union-Tribune Publishing Co. Contact: http://www.uniontrib.com/ Forum: http://www.uniontrib.com/cgi-bin/WebX DEATHS PUT ILLEGAL TRADE OF MEDICINE IN SPOTLIGHT Prescription Smugglers Overlooked In Drug War LOS ANGELES - Maria Cardenas-DeMoreno was a regular at the San Ysidro border crossing. Customs agents stopped the Los Angeles-area woman at the border at least six times trying to cart into the United States packages of medicine she purchased legally without a prescription in Mexico, authorities said. After she was charged and then ignored a court summons, "Wanted" posters were put up along the border. "She was like a professional smuggler," said an agent familiar with the case. The posters paid off. Cardenas-DeMoreno was arrested in 1996 and accused of trying to smuggle injectable penicillin and two other medicines, court records state. She pleaded guilty to a smuggling count, did a six-month stint in prison and then received three years of supervised release. In December, authorities allege, she was dabbling in the Mexican medicine trade again. She was arrested in a store she co-owned in El Monte -- east of downtown Los Angeles -- after allegedly selling penicillin and other medicine to an undercover California Department of Health Services agent. Last week, Cardenas-DeMoreno admitted in court that she violated the terms of her release, and federal Judge Gordon Thompson in San Diego sent her back to prison for 14 months. Cardenas-DeMoreno and other purported smugglers are considered a crucial and often elusive link in an illegal medicine trade that is receiving increased scrutiny in the wake of the recent deaths of two Orange County toddlers who died after receiving illegal injections of what is believed to be Mexican-produced medicine. The trade, which authorities say has existed in Southern California's Latino enclaves for years, relies on a shadowy group of smugglers and middlemen who often are overlooked amid the higher-profile war on narcotics. The dealers of these medicines are often self-appointed apothecaries who are hardly your white-coat-wearing, pill-counting neighborhood pharmacists. They sometimes sell the drugs at swap meets, in general stores, video outlets and party supply shops, and they don't have pharmaceutical licenses. Often the drugs are kept in a secret stash or a back room. Their customers are mostly recent immigrants. Some want to purchase the remedies they used back home and are accustomed to getting without a prescription. Other customers fear seeking legitimate medical care may expose their questionable residency status. Sometimes shop owners themselves diagnose their customers' ailments and sell them the medicine -- often at five times the typical cost. As for Cardenas-DeMoreno, her lawyer George Siddell said she wasn't malicious in selling the drugs. The case shows that for some in the Latino community buying such medicine without seeing a physician is just what they are used to doing in their homeland. "My client was not intending to harm anyone," he said. "In her mind, she thought she was helping people . . . This is a cultural clash, a cultural conflict." The prosecutor in the case, Assistant U.S. Attorney Bruce Smith, said, "People must keep in mind that there's a reason these drugs are prescription drugs. They're prescription drugs because it takes someone with medical training to assess what a person's needs are." The drugs aren't cheap Those familiar with the illegal sale of pharmaceuticals said when the medicines first started showing up in Southern California shops roughly nine years ago little more than birth-control pills and antibiotics were sold. "It now seems to have evolved into a whole practice of medicine where there is a person who is diagnosing illnesses and giving injections," said Howard Ratzky, a supervising investigator with the California Department of Health Services. The death of 18-month-old Selene Segura Rios -- who received an injection in February in a makeshift office in the back of a Tustin toy shop -- has sparked a grand jury probe in San Diego involving the Food and Drug Administration and the U.S. Customs Service, a source familiar with the case said. Since last May, a task force in Los Angeles County has arrested more than 50 people and conducted more than 150 investigations of shops in Latino neighborhoods selling codeine syrups, Valium and other medications -- sometimes at prices five times higher than most legitimate pharmacies. Last month, authorities also made a few arrests in predominantly Asian neighborhoods. "I do believe we've only scratched the surface," said Todd Sample, an administrator with the Los Angeles County Department of Health Services. "There could be hundreds more stores." Extensive problem Proving just as difficult to find, however, are cases like Cardenas-DeMoreno and what officials say is a vast network of people who are buying the medicines in Tijuana, getting them over the border and then trafficking them to shops. "We kept hearing about Juan in a white van," said Gregory Thompson, a pharmacist and head of Los Angeles County's Regional Drug Information Center who has joined police on many busts of retailers. "In East L.A. and Inglewood the name came up. We laughed: `How many Juans with white vans are there in the county?' I guess we have to find them all." In Los Angeles, police and health officials have found inventory lists of Mexican medicines in stores. Retailers check off the medicine they want on these lists, then pass them to the suppliers who fill the orders. Last year, authorities identified a "warehouse" of illegal medicines in southeast Los Angeles County. But when police came to the site, there wasn't a large amount of drugs in storage, said Sachi Hamai, an administrator with the county Department of Health Services. "There's apparently a vast network that involves the importers, who bring these medications in very large numbers across the border," said state Assemblyman Martin Gallegos, D-Baldwin Park, who has closely followed this issue and pushed legislation stiffening the penalties against the sellers. "They then go to a network of distributors, who are the ones who go to these local establishments, these retailers. "It is very difficult to trace back. But (investigators) know the system is working that way. They haven't been able to pin down the individuals involved," Gallegos said. Local authorities privately grumble that customs agents at the border are focused on finding cocaine, heroin and marijuana and rarely take note of pharmaceuticals. Between October and January, statistics show, agents made 107 seizures of pharmaceuticals at ports along the California-Mexico border. Six people have been arrested on smuggling charges while in possession of restricted prescription drugs. Between October 1997 and September 1998, there were more than 400 seizures. "Yes, we will focus hardest on cases that we know will result in a conviction," said a customs agent, who asked to remain anonymous. "Clearly we're not getting all of these. If we were, there wouldn't be the problem that you're having up there." Atypical smugglers The way the drugs come over varies widely and isn't always easy to detect. One of the most sophisticated cases recently prosecuted had nothing to do with Latino markets. On March 15, Utah pharmacist Terrence Frank, 59, pleaded guilty to smuggling prescription medicines over the border. In December 1996, Frank tried to bring more than 22,000 pills he purchased in Tijuana through San Ysidro. He planned to sell the medicine at one of eight pharmacies he owns, prosecutors said. As part of his plea agreement, he said his pharmacies sold Mexican pharmaceuticals valued somewhere between $120,000 and $200,000 from 1996 through January 1998. Two of Frank's colleagues were caught at the San Ysidro border trying to smuggle $60,000 worth of Premarin, Prozac and other drugs into the United States. One of them, Clifford Holt, a manager of one of Frank's pharmacies, also pleaded guilty in October and was sentenced to 13 months in prison. He admitted that since 1989 he had smuggled 25 loads of drugs, including Prozac, from Tijuana. Two other cases are pending in San Diego's federal court, according to Assistant U.S. Attorney Melanie Pierson. One involved a woman caught smuggling $15,000 worth of pharmaceuticals on Feb. 25. She told officials she planned to hand over the drugs to a contact she was meeting at the Wal-Mart store in Chula Vista. The other came one week later, when a husband and wife were caught crossing the border with $50,000 in pharmaceuticals in their car. The customs agent acknowledged that such prescription drug smugglers often can't be detected by the methods used to detect "drug war" narcotics. "It's sometimes just looking in the right backpack or catching a glance of a box that looks out of place," the agent said. "They'll bring small amounts across and then go back and bring another small amount across. That's what they call `rat packing.' They'll put it all in a storage locker in Chula Vista. When they get a lot of them, they'll get a van and head north." And agents also encounter the uninsured, senior citizens, the desperately ill, teen-age pill thrill seekers and others just looking to buy medicine on the cheap and without a prescription. In the case of Selene's death, police are investigating the King family, the purported owners of the Tustin shop. Members of the King family were also investigated over allegations they provided illegal drugs to a Santa Ana clinic where 13-month-old Christopher Martinez received five injections from an unlicensed physician. The boy died last April. The Kings, who police say have a history of selling illegal pharmaceuticals, were not charged. Now, both the FDA and the U.S. Customs Service are looking into the King family. At least two employees of the Tustin shop reportedly testified before a federal court in San Diego considering the case. Safer options While the investigations mount, public health officials are trying to heighten awareness about the availability of health care for immigrants, as well as the dangers of self-medication and using foreign-made pharmaceuticals that do not have to meet the same standards as FDA-approved drugs. "In Mexico, people are accustomed to going to the store and buying medicine for themselves," said Mary Watson, who founded the Santa Ana Safe Medicine Coalition after Christopher Martinez's death. "That's what they're comfortable with and they'll keep going to a place where they're comfortable. This is an emerging market and it shows there is a hole in our (health care) delivery system. We've got to close that hole." Los Angeles County's Thompson said people who self-diagnose and medicate their ailments frequently exacerbate their illness and end up seeking more treatment at hospital emergency rooms and school clinics. "People don't know about possible side effects or allergic reactions or whether it's dangerous to take that medicine when they're pregnant," he said. "The message we want to get out is: There are places to go for no-cost or low-cost medical care," Sample said. As he said this, he was standing outside Arco Iris Party Supplies, a small shop in a beat-up strip mall in the north San Fernando Valley community of Arleta. At the shop, officials say, amid pinatas, candies and other legitimate goods they found $25,000 worth of Mexican-and Central American-made antibiotics, steroids, influenza vaccines, blood products and treatments for venereal disease. Oddly enough, the same message Sample was pushing was advertised on a homemade sign that was taped to Arco Iris's door. - --- MAP posted-by: Derek Rea