Psychotropic Substances Diversion

PRESS RELEASE BY THE DIRECTOR GENERAL OF HEALTH

1.Medical practitioners and Pharmacists in the private sector are reminded to abide by the provisions of the Poisons Act 1952 and the Poisons (Psychotropic Substances) Regulations 1989. The provisions in the Act and conditions stipulated in their licenses for the purposes of purchase, possession, supply and disposal of psychotropic substances used for medical treatment must be adhered.

2.The use of psychotropic substances and controlled medicines containing pseudoephedrine (a precursor chemical) in the healthcare industry is currently closely monitored. Data obtained from the International Narcotics Control Board (INCB) showed increasing trend of such usage by this country when compared to other countries such as Thailand, Indonesia, United Kingdom, Japan, China and India.

3.The Ministry of Health Malaysia had detected the involvements of a number of clinics and pharmacies buying psychotropic substances and products containing pseudoephedrine in suspiciously large quantities. Results of investigation revealed the role of these premises in activities relating to the supply of these medicines not for legitimate use. It is possible that the sale could be directly made to addicts or diversion to illegal outlets through middle man. These medicines are believed to be for street use and for products containing pseudoephedrine;most probably will end up in clandestine laboratories for processing illegal drugs.

4.The types of psychotropic substances traded in these illegal and diversion activities include the benzodiazepines group (namely midazolam, zolpidem, alprazolam and others), narcotic derivatives such as dihydrocodeine, dextromethorphan, tramadol and also pseudoephedrine. These products contain substances used mainly as tranquillizers, to reduce pain and also for symptomatic treatment of coughs and colds. Pseudoephedrine is a known precursor chemical used in the illegal manufacture of amphetamine type stimulants (ATS) such as syabu and ecstasy. Information has shown that due to the difficulty in obtaining supply of raw material of ephedrine and pseudoephedrine, clandestine laboratories have created methodology to extract these substances from pharmaceutical preparations.

5.Inspections carried out by the Pharmacy Enforcement, Ministry of Health Malaysia on 16 clinics in the Klang Valley revealed large purchases for Midazolam Tablet 15 mg for purpose of diversions by these clinics. Diversions of pseudoephedrine in huge quantities involving 2 pharmacies and a medical clinic have also been identified. The suspects involved are currently being investigated and legal actions will be taken against them. They will also be presented to the Committee of Inquiry of their relevant professional bodies for disciplinary actions including suspension of license and registration.

6.Manufacturers, importers and main distributors are strongly urged to be responsible for the control of supply and sale of these preparations. Purchases in large quantities by clinics and community pharmacies which are doubtful should not be entertained. Such orders should be referred to the Pharmacy Enforcement, Ministry of Health Malaysia for verification.

7.As a step towards strengthening and making control more effective, the requirement of “written attestation” as provided in Regulation 12(2)(b) of the Poisons (Psychotropic Substances) Regulations 1989 for all psychotropic substances have been enforced to curb misuse and diversion. Another step is to limit the number of licensed wholesalers allowed to purchase such items as wholesale.

8.Medical practitioners and Pharmacists who are directly involved or in cohort with these illegal syndicates are warned that they will not be spared from legal actions. In 2009, the Pharmacy Enforcement had prosecuted 29 cases involving medical clinics and 97 more being investigated. For pharmacies, a total of 30 cases had been prosecuted and 48 more under investigations.

9.All healthcare professionals handling pharmaceutical products containing psychotropic substances and controlled medicines are urged to be responsible and to take necessary measures to ensure the supply network and usage are always in accordance with existing legislations.

10.The Ministry of Health upholds strong commitment towards reducing street crimes nationwide by preventing diversions of medicines meant for legitimate medical treatment. Hence, close cooperation and collaboration amongst enforcement agencies namely the Police, Customs, National Anti-Dadah Agency, Enforcement of the Ministry of Domestic Trade, Consumerism and Cooperative and Pharmacy Enforcement of the Ministry of Health are important in our efforts to eliminate diversions and misuse of psychotropic substances and controlled medicines.

TAN SRI DATO’ SERI DR. HJ. MOHD ISMAIL MERICAN

Director General of Health Malaysia

Ministry of Health Malaysia.

23 April 2010