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https://scmp.com/news/china/society/article/3044141/how-chinas-opioid-addicts-get-their-drugs-online-black-market People & Culture
How China’s opioid addicts get their drugs from an online black market
- Beijing has some of the world’s tightest narcotics regulations, but sellers are using legitimate e-commerce channels to meet demand
- Online vendors of drugs use partial names, slang, and photos of socks, plants and ceiling lamps to disguise their goods
Abusers of medical drugs in China are getting access to supplies from vendors who use e-commerce sites. Photo: AP
China has some of the world’s strictest opioid regulations, but OxyContin and other pain pills are sold illegally online by vendors who take advantage of the country’s major e-commerce and social media sites, including platforms run by Tencent, Baidu and Alibaba.
These black markets supply, among others, opioid users in China who became addicted in the way many Americans did, by a doctor’s prescription. Beijing said that the extent of painkiller abuse within China was poorly understood, making it hard to assess risks as pain care improved and China’s consumption of opioids increased.
According to the latest public figures, 11,132 cases of medical drug abuse were reported in China in 2016. Reporting is voluntary and figures were drawn from a small sample of institutions including law enforcement agencies, drug rehabilitation centres and some hospitals.
The government food and drugs regulator said in the 2016 report that it was trying to do better but, for the time being, “the nature of medical drug abuse in the population cannot be confirmed”.
Wu Yi, a 32-year-old singer, survived cancer only to find he could not stop taking OxyContin. He said his doctor told him OxyContin was not addictive and that he could take as much as he needed. As Wu was never identified as having a substance abuse problem, he was unlikely to have appeared in the government’s tally.
As his need increased, Wu began chewing OxyContin to intensify its effects and took vast quantities of alcohol and sleeping pills.
“I feel I am kind of like a drug addict, but I cannot do anything about it,” he said.
Despite the officially low numbers, the Chinese government was worried enough about pain pill abuse that it withdrew combination opioids from most pharmacies in September. Among the pills targeted was Tylox, made by the drug company Mallinckrodt’s subsidiary, SpecGx.
The risks of opioid abuse in China may be growing as pharmaceutical companies look abroad to make up for falling opioid prescriptions in the United States.
OxyContin has been marketed in China with the tactics that drove Purdue Pharma into bankruptcy in the US in September and allegedly helped spark the deadliest drug abuse epidemic in US history, according to interviews with current and former employees and documents published last month.
Purdue Pharma’s China affiliate, Mundipharma, denied allegations of wrongdoing and said it had “checks and balances in place including internal audits and reviews to ensure strict compliance with medical protocols, laws and regulations”.
People who have lost loved ones to OxyContin and opioid overdoses protest at Purdue Pharma’s US headquarters. Photo: AP
US social media platforms, such as Facebook and Twitter, have also struggled to stop illicit listings for opioids. As opioid overdose deaths surged past 400,000 in the US, online trafficking networks, many of which sourced chemicals in China, made it easier to buy black market drugs.
But despite China’s scrupulous monitoring of online activity, black markets for OxyContin and other pain pills could still be found on the open internet.
A survey of China’s major e-commerce and social media platforms identified 13 vendors selling opioid painkillers. They often used one platform to draw in customers and another for sales.
Eight of them used Tencent’s WeChat app. Last week, in a closed group for cancer patients on Tencent’s QQ app, one person tried to buy OxyContin and another offered to sell Tylox. Two vendors on Zhuan Zhuan, a second-hand marketplace backed by Tencent, offered OxyContin, Tylox, and/or MSContin for sale.
“We are vigilant against unscrupulous parties making unauthorised use of our platforms and services that include QQ and WeChat to pursue illegal activities,” Tencent said, adding that it encouraged users to report illegal activities.
Beijing-based 58.com, which runs Zhuan Zhuan, did not respond to requests for comment.
On Alibaba’s second-hand marketplace, Xianyu, known as Idle Fish in English, seven accounts were found which appeared to be run by six different people, offering OxyContin or Tylox.
One vendor created a fake storefront on Xianyu for transactions. After arranging an OxyContin sale on WeChat, the vendor sent a special link for a product listing on Xianyu for “flowers” that cost the agreed price: 1,200 yuan (US$172) for 10 boxes of 10mg OxyContin pills. “Tell me when you’ve paid,” the vendor wrote. “Pay before six and ships today.”
WeChat app owner Tencent and Sina, which runs Weibo, are among the social media companies taking action against opioid sales on their networks. Photo: Reuters
Idle Fish said it removed listings that violated marketplace policies after illicit opioid sales were brought to its attention. The company said it prohibited “illegal behaviour by third-party sellers on the platform”, monitored listings and welcomed user reports that led to shutdowns.
Alibaba owns the South China Morning Post.
A thread about quitting drugs on Tieba, a forum run by technology giant Baidu, also led to opioid dealers. One person on Tieba selling OxyContin was identified in December as were two others selling painkillers and sleeping pills earlier in the year. One swore that OxyContin was not addictive, said it made sex better and gave the user an unparalleled “feeling of floating”.
Baidu said it constantly monitored its platforms to keep them free of illegal activity, encouraged user reports of bad behaviour and reported infractions to the police.
In addition to the active vendors identified, Tianya, an internet forum, had dozens of postings by people selling or seeking OxyContin stretching back several years.
Wu, the cancer survivor, said he was offered pills after posting his contact details in a thread about OxyContin on Tianya in April. Tianya did not respond to requests for comment.
To evade detection, sellers used partial names or slang and posted stock photos of things such as socks, a cactus or elaborate pink ceiling lamps. Postings often disappeared.
The authenticity of the pills offered for sale could not be confirmed.
One significant regulatory loophole in China was that family members tried to resell OxyContin left after a relative had died.
Opioids are being sold online by people who acquired them legitimately but who no longer have a use for them. Photo: AP
That was what Zhou Shalu did after her mother died of lung cancer and left her with hundreds of 40mg OxyContin pills, worth more than US$1,000, sitting on a coffee table in her living room.
The pills were a boon for her mother in her last months, easing a pain so intense it stopped her from eating, speaking and even opening her eyes. But now Zhou did not know what to do with them.
She was afraid to throw them out, so she offered the pills at a 35 per cent discount in cancer support chat groups and internet forums. A pharmacist, Zhou knew OxyContin could be abused and asked all prospective buyers to send her copies of their medical records.
“No sales to drug dealers,” she wrote in an August post offering 20 boxes of 40mg OxyContin on the microblogging site Weibo, which has since been deleted.
A month after her mother’s death, she said she still had not found buyers she considered legitimate.
Sina, which runs Weibo, said that after finding violations, it ran a campaign in March to clean-up illicit content about medicines and medical equipment and would continue to improve key word screening and image recognition.
In August, the Ningjiang District People’s Court in Songyuan, northeastern Jilin province, convicted three people of trafficking thousands of pills of OxyContin and MSContin – both slow-release opioids sold by Mundipharma, Purdue’s China affiliate.
According to a copy of the judgment, they acquired pills from families who, like Zhou, had extra pain medicine. With online names like “Invincible Benevolent”, “Soul Ferryman”, and “Little Treasure”, the network used WeChat, Xianyu and Zhuan Zhuan to find customers and make sales, and delivered pills using SF Express, a major courier service.
Among the witnesses was a customer who became addicted to opioids after taking them for toothache and leg pain.
“Mundipharma China has no knowledge of the diversion of its products on e-commerce and social media platforms,” the company said.
Mallinckrodt’s speciality generics subsidiary SpecGx sells its pain pills to a Chinese importer. In a statement, the company said it “has no manufacturing, distribution, sales force or in-country presence in China”.
China’s National Narcotics Control Commission and the watchdog National Medical Products Administration did not respond to requests for comment.
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