The Online Pharmacy Landscape
For better or for worse, pharmaceuticals are everywhere—as a first line of defense, a last resort, an always-present treatment option, and a deeply ingrained part of U.S. culture. So, what happens when a crucial part of many Americans’ day-to-day lives is prohibitively expensive, or even completely unattainable? According to a recent survey by the Kaiser Family Foundation (KFF) in 2023, more than 1 in 4 adults taking prescription drugs suffered from “medication insecurity,” or the difficulty in affording their medication at least one time over the past year.
Like with any shortage or obstacle in acquiring a needed or accustomed-to item—when mainstream channels fail, people are forced to find alternative sources. This is happening more and more, as online pharmacies are becoming increasingly popularized, and legally ambiguous purchase options are flooding the clear web. Another survey by the KFF found that about 8 percent of adults in the U.S. reported either importing prescription drugs or purchasing them from outside the U.S. to save money. While reflecting the failures of the U.S. public health system, at first glance, purchasing affordable medication elsewhere seems relatively harmless. However, the WHO reported that up to 10 percent of medicines worldwide could be substandard or falsified, indicating a significant gray and black market presence in international pharmacies and online spaces that many Americans may not be aware of.
What the Ozempic and Wegovy Shortage Means
One of the most instantly-prolific drugs in American history—semaglutide, trade names “Ozempic” and “Wegovy”—has taken this nation by storm. Semaglutide is an antidiabetic medication intended for the treatment of type 2 diabetes and severe obesity. However, its popularity extends largely beyond its intended use cases of diabetes and obesity, into the lives of average-weight Americans looking to shed a few extra pounds. With its rising popularity in fitness, celebrity, and social media influencer circles, controversy and debate surrounds semaglutide’s long-term health implications, negative side effects, and public acceptance as a common weight management drug.
Due to its promises of seemingly simple weight loss, along with its substantial price tag of as much as $1000 per dose, many have already begun to seek semaglutide from alternative sources. A plethora of online pharmacies and overseas markets claim to have legitimate semaglutide for sale for much more accessible costs. However, along with these cheaper prices has come substandard quality, inconsistent amounts of active ingredients, and adulterated, or even completely different medications in place of the expected semaglutide. Currently, one of the largest risks is the substitution of insulin for semaglutide, such as the incident that resulted in a near-fatal diabetic coma in Chicago.
It is clear that Americans are willing to purchase from online or non-U.S. pharmacies without blinking an eye, so what can they do to better protect themselves in a landscape with so many counterfeit drugs?
The Importance of a Semaglutide Drug Test
Many think of drug test kits as a necessity for illicit drugs only, due to their typical and frequent attainment on the black or gray markets. However, pharmaceutical substances obtained from underground sources are just as likely (if not more) to be counterfeited or adulterated.
Another commonly adulterated drug is the popular ADHD medication, Adderall, due to the worldwide Adderall shortage and ever-increasing demand. Even in “clear market” spaces—such as licensed pharmacies in certain countries—the dangers of misrepresentation or adulteration are still present. In a recent investigation the Transparency / Bunk Police team conducted, we traveled to Mexico to investigate licensed pharmacies reportedly selling counterfeit drugs—and the results were truly shocking. Many of the pills purchased at these pharmacies, such as Adderall, oxycodone, and hydrocodone, were laced with dangerous adulterants like fentanyl, methamphetamine, xylazine, and more.
With these results only a drop in the bucket of the larger drug adulteration crisis, testing with at-home test kits, or sending your sample into a laboratory for analysis is more important than ever. The popularity of semaglutide is still rising, with the repercussions of counterfeit substitutes rising with it.
Wondering ‘How to Get Ozempic?’ Keep These Safety Tips in Mind
In the midst of the semaglutide craze, when at all possible, try to purchase from legitimate channels. While the public health system often makes this difficult—if not impossible—purchasing from gray or black market sources invites a high level of risk. Even if the products received initially seem to be legitimate, the quality control is often questionable, inviting dangerous variants in adulteration, composition, and dosage.
If a consumer does choose to purchase from these underground channels, it is important to always use at-home test kits, or send the sample into a laboratory for full analysis (to verify purity and composition of the medication). The Transparency Testing laboratory is in the final stages of offering semaglutide testing and is working on offering testing for popular semaglutide alternatives, such as tirzepatide. Our test kit organization, The Bunk Police, is in the process of offering at-home kits to test for these substances, along with many other popular gray-market pharmaceuticals.
When screening for “safe” medication, it is important not to rely on the aesthetic look of seemingly legitimate packaging, nor the appearance, press, or coloring of the pills or medication. These characteristics can all be replicated somewhat easily and should not be relied on. Similarly, be wary of personal recommendations or anecdotes of “trusted” sources—even if the medication was legitimate one time, the quality control is much more variable with online or non-U.S. pharmacies, and the product could be entirely different the next time around. The only way to be certain about the composition and amount of active substance in a sample is to get it lab tested, to conduct at-home testing (less accurate than lab testing, but much better than not testing at all), or to personally receive a prescription and source the medication from a U.S.-based pharmacy, or another country that holds similar safeguards and quality controls to U.S. pharmacies.
While many believe that pharmaceutical medications are in a category separate from the illicit drug market, they are not immune to the dangers of adulteration. In light of the spike in demand and subsequent shortages, drug checking and lab testing will continue to be important in caring for your health, and the health of your loved ones.
Adam Auctor is the Founder & CEO of Transparency and The Bunk Police, leading test kit innovation and educational outreach in the harm reduction industry. Auctor is a creative visionary, investigative filmmaker, and harm reduction activist in the drug use space.