Dangerous Doses: A True Story of Cops, Counterfeiters, and the Contamination of America’s Drug Supply

by Katherine Eban

In the tradition of the great investigative classics, Dangerous Doses exposes the dark side of America's pharmaceutical trade. Stolen, compromised, and counterfeit medicine increasingly makes its way into a poorly regulated distribution system—where it may reach unsuspecting patients who stake their lives on its effectiveness.

Katherine Eban's hard-hitting exploration of America's secret ring of drug counterfeiters takes us to Florida, where tireless investigators follow the trail of medicine stolen in a seemingly minor break-in as it funnels into a sprawling national network of drug polluters. Their pursuit stretches from a strip joint in South Miami to the halls of Congress as they battle entrenched political interests and uncover an increasing threat to America's health.

With the conscience of a crusading reporter, Eban has crafted a riveting narrative that shows how, when we most need protection, we may be most at risk.
 

Genres: Nonfiction, Science, Health Care, Medicine

512 pages, Paperback

First published May 9, 2005

About the author

Katherine Eban, a New York Times bestselling author and investigative journalist, is a Fortune magazine contributor and Andrew Carnegie fellow. Her narrative, deeply reported articles on pharmaceutical counterfeiting, gun trafficking, and coercive interrogations by the CIA, have won international attention and numerous awards. She lectures frequently on the topic of pharmaceutical integrity. Press and speaking event contacts can be found here: https://www.katherineeban.com/contact

Reviews

[Lisa McKenzie · Rating 5 out of 5]

Do you know where your medication has been? Spoiler alert: In all too many cases, neither does your pharmacist.

Dangerous Doses
A True Story of Cops, Counterfeiters, and the Contamination of America’s Drug Supply

By Katherine Eban

1. True or False: “Pharmaceutical middlemen…buy, sell, sort, repackage and distribute 98% of the nation’s medicine.”

2. Which of the following characters have been granted a license to trade as a secondary pharmaceutical wholesaler:
A. “A convicted heroin seller who had spent years in the Florida prison system”
B. A woman who “pleaded guilty in 2000 to selling stolen medicine through her husband’s wholesale company (and) was still on probation.”
C. “A fellow on federal probation after serving time for marijuana smuggling.”
D. “The eighth grade dropout and heroin addict”
E. Small (big dollar) businessmen that feel threatened with extinction
F. All of the above

3. What methods have been recorded as having been used by secondary wholesalers to buy low and sell high:
A. Parking lot resale. Cancer and AIDS drugs purchased directly from professional patients who sold, rather than took, their medicine.
B. Theft from competitor’s warehouses
C. Theft from hospitals
D. Drug dilution and repackaging
E. The “Puerto Rican” turn, a.k.a. the U-boat diversion, in which wholesalers take advantage of large discounts to overseas buyers, including those in Puerto Rico, by establishing companies in Puerto Rico to buy drugs at a discount. Cargo planes turn around mid-flight and resell drugs to states for a far higher price.
F. All of the above

4. True or False: Kevin Fagan, the father of a teenager poisoned by a counterfeit medication, touched the heart of Laura Bush with this personal letter:
“Today, society is suffering from a moral breakdown where huge companies look only to the bottom line and not to what is the right thing to do…I ask that you, a parent as I, do whatever you can to bring forward legislation to require drug companies to document the shipping locations of prescription drugs from the point of origin to the end user…the general public.”

5. True or False: When Governor Jeb Bush was apprised of the situation, he signed the 1993 Prescription Drug Act. He told investigators (and heroes of this book), “You guys scared the hell out of me.”

6. To research this book, Katherine Eban
a. Conducted over 160 significant interviews with people involved in the problem of contaminated medicine in America.
b. Submitted sixteen Freedom of Information Requests to the Food and Drug Administration, the Florida health department, the Florida Department of Law Enforcement, and other state pharmacy boards
c. Obtained over 13,000 pages of documents
d. All of the above

7. Dangerous Doses
a. Is a fast paced account of the slow pace of the law
b. Is more rigorously documented than the trail of a prescription drug
c. Is the scariest book I’ve ever read
d. All of the above

Check out the answers on my blog, Ms. Lab Rat. Or better yet, read the book. http://www.mslabrat.com/?p=637

[Daniella · Rating 4 out of 5]

I never used to think about how the medicine you pick up at the pharmacy actually got there. The chain of custody from when the medicine leaves the manufacturer to the time it reaches patients is extensive. Ownership of medicine changes hands so many times before it gets there that it's become a serious target of counterfeiting. Especially in a country where we pay the most money for our medicine, you'd hope it would be because we know we're getting the real thing. Unfortunately, you can't be sure that it is. This book will shock you, anger you, and make you seriously question where your medicine came from and how it got there.

[Deborah · Rating 5 out of 5]

This was a freaking Rollercoaster ride from start to finish.

[Ange · Rating 4 out of 5]

Consider the fact that approximately 1% of all prescription drugs sold are counterfeit. Some doses are weakened amounts of the prescription drug; others are completely something different. For years the counterfeit drug market was out of control, and the patchwork state pedigree laws made it fairly easy for counterfeiters to operate and make a killing (in some cases, quite literally).

A lot of the counterfeit activity happened with drugs that patients needed to stay alive. Many of them were given to patients with cancer, or AIDs, diabetes or heart disease. These patients trusted their pharmacists and thought they were treating their symptoms/diseases. What they did not realize was the web of complexity that begins with the drug manufacturers, pharmaceutical companies, repackagers, primary wholesalers, secondary wholesalers, clinics/hospitals and pharmacies along the way. There was essentially no way to track it. Investigators of these crimes had to piece everything together by inspecting various points of the supply chain network, and figuring out where the counterfeiting actually occurred was the tricky part.

Dangerous Doses dives into a few patient stories, but mostly reveals the extremely complex supply chain marketplace of prescription drugs. In reading this book, it became very clear and eye-opening to me that this problem had been swept under the rug for many years, and the need for a federal solution was off the charts. Knowing the Drug Supply Chain Security Act that is well underway and the FDA plans to enforce it, I feel a little bit better about the future integrity of the Unites States Rx products. While there are a lot of changes ahead of the industry between now and 2023, we'll eventually get to the point where we protect the integrity of the products, the lives of patients and turn toward implementing a globally effective solution.

[Sara · Rating 2 out of 5]

Consumers and medical professionals alike presume medications are handled well and lawfully. Author Katherine Eban takes the reader through a journalistic journey to find "the truth". As it would seem, the situation is not nearly as clean as one would hope or expect.

Though there is a serious problem in our country, this book did not grip me. By page 56 I felt I already received the message and began to doubt the integrity of the book. Written as more of a thriller and entertainment than informative, this book can be an interesting read. I would have preferred an article with sources rather than a drawn out theatrical version of news.

[Elizabeth Stolar · Rating 4 out of 5]

I wanted to read this after having read the author's recent release, Bottle of Lies. This was an excellent narrative about the issue of drug counterfeiting and I'm surprised it didn't make a bigger splash than it did. This book was released in 2005, and still seems pretty timely. I'm curious about what has occurred in the meantime and whether our drug supply is any safer (I tend to believe it is not much, if any safer). I encourage everyone to read this book, because many of the same structural issues that led to this counterfeiting problem do still exist. I'd love to read a follow-up!

[Arlen Strickland · Rating 5 out of 5]

The author chose a very compelling way to convey the content of her investigations - it's a crime novel format, and the resulting book is a page-turner. There may be some dramatic license taken here and there with minor details, but the essential facts and evidence are there, copiously footnoted. The facts could have been "clinically" reported in a few pages. However, the expanded book form did not sensationalize the events, rather, it served to recognize the many tireless contributions of dedicated heroes, it exposed the ineffectual bureaucrats responsible for continuous misdirection and inaction, and it put a face on and defined what were heretofore nebulous, nameless criminals.

[Heather · Rating 4 out of 5]

Stephanie Aleong (née Feldman) was one of my favorite professors in law school. Her bulldog determination combined with her strong senses of compassion and commitment to help others are captured in the book, along with an at-times-shocking exposure of nefarious dealings within the pharmaceutical trade. I appreciated this book and admire Professor Aleong all the more after reading it.

As a worker in the pharmaceuticals industry, this book helped me put reference events to what were before just concepts and loose understandings.

[Cindy Reilly · Rating 2 out of 5]

Given the work I've done lately on supply chain issues--drug shortages, supply chain integrity--I decided to finally read this mainstream account of product counterfeiting. Interesting to read a "soft account" of the events I was already familiar with, including learning about the quirky personalities of the investigators and slimy individuals involved in the illegal secondary market. Still, the book could have ussed some editing to tighten it up a bit.

[Sonya Noble · Rating 3 out of 5]

Not a book that anyone would enjoy. I found it very interesting since I work in the industry and know some of the companies involved and even 'know of' some of the people.
Very scary to think about how unsafe some of our medicine could be.

[Shawngela · Rating 4 out of 5]

It amazes me with just how recently this took place and just how much people are able to get away with. I am grateful we have laws now to better handle these situations but I am sure this is still a problem and there are still dishonest people out there.

[Kristine · Rating 5 out of 5]

Pretty Scary account of the movement and selling of fake, stolen, or altered pharmaceutical drugs that could end up right in your local CVS. These are not fakes coming from other countries, but right here in the United States.

[Karen · Rating 4 out of 5]

Wow - scary true-life story of counterfeit medicine and the criminals who make, steal, divert the drugs and ruin people's lives.

[Alyssa · Rating 5 out of 5]

This is a very scary account of how the prescription drugs we take get to the drugstore. It is hard to put this book down!

[Lisa · Rating 4 out of 5]

I read this on rotation and it is a must read for anyone who makes, dispenses, or uses medication. It's a true story written like crime fiction.

[Teresita Madani]

So far interesting!!!

[Martha · Rating 4 out of 5]

Great look at what goes on behind the scenes in the controlled substance drug world.

[Jhawn]

prescription drug fraud and contamination. If your drugs don't work, they probably are fake. Canada and overseas are not the problem. They supply lines in the US are the major source of altered drugs.