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investigation motivation

some time ago, a 14-year-old junior high school student in anda, heilongjiang, fell into a coma after taking the prescription drug carbamazepine in class and was rushed to the icu for emergency treatment. after the incident, the junior high school student said, "this drug can cause hallucinations and relax the mood." he had taken dextromethorphan tablets several times before, with similar effects, all purchased at a local pharmacy. recently, the local market supervision and management department issued a warning, fined and revoked the license of the pharmacy involved.

why can minors easily buy prescription drugs and even narcotic drugs? what are the dangers of drug abuse among teenagers? how to effectively control it? with these questions, the reporter conducted an investigation and interview.

"i'm sharing my delicious and healthy recipes for the week: king kong ×× on monday, × king kong on tuesday, ben hai × on wednesday, dextromethorphan ×× on thursday, selexi ×× on friday, phenylethylamine ××× on saturday, and sinuo × on sunday. come and try it!"

on the social media platform, xiao you, who shows her age as "post-00s", recently posted such a shocking "recipe". the drugs she mentioned are all prescription drugs and even narcotic drugs.

she doesn't take drugs to cure illnesses - in the content she shares, there are many comments such as "od (overdose)" and "hallucination". in the comments, one netizen left a message saying "isn't it to quit od?" xiaoyou replied "i'll quit after i finish taking it."

a recent investigation by a reporter from legal daily found that on social platforms, many young people, like xiaoyou, are addicted to taking drugs and use code words to share their feelings after taking excessive amounts of drugs.

in this regard, the experts interviewed called for relevant departments to further strengthen the supervision of relevant drugs, urge pharmacies, especially online pharmacies to implement the "prescription first, then medicine" sales process, and for online platforms to increase the intensity of reviewing illegal information. at the same time, families, schools and communities should jointly pay attention to the physical and mental health of young people, strengthen legal publicity and popular science publicity on the dangers of drug abuse, and effectively prevent young people from abusing drugs.

cartoon: li xiaojun

the code word "share" on social platforms

drug abuse has serious consequences

combing through heilongjiang xiaoqing's social media, we can clearly see the process of her drug abuse: more than a year ago, at the instigation of her friends, she took dextromethorphan and pregabalin for fun and became deeply addicted. after she broke up in july this year, she became even more unscrupulous and even shouted to her ex on the social media platform: "after leaving you, i realized that 70t (t refers to tablets/pills) is not a lethal dose."

xiaoqing said that she also tried to quit smoking, but every time she tried, she felt inexplicably empty in her heart and had no energy for anything.

public information shows that dextromethorphan is a commonly used antitussive drug in clinical practice. pregabalin is mainly used to treat epilepsy, neuropathic pain, anxiety and other diseases. currently, both are listed in the national second-category psychotropic drug catalog.

according to regulations, all narcotic drugs that are included in the control can only be dispensed, purchased and used with a prescription issued by a practicing physician. retail enterprises of the second category of psychotropic drugs should sell them according to the prescribed dosage based on the prescription issued by a practicing physician; they are prohibited from selling in excess of dosage or without a prescription; and they are not allowed to sell to minors.

however, the reporter found that it is not uncommon for teenagers to "share" the abuse of prescription drugs and narcotic drugs on social platforms, and a set of code words have been formed, such as "pr80" for pregabalin, "good night" for amantadine, and "beautiful" for dextromethorphan. some people wantonly "share" their own od experiences, and exchange experiences such as "this has fewer side effects" and "this is just a prescription, not listed, easy to buy".

according to yao huaifang, chief physician of the first affiliated hospital of anhui university of chinese medicine, drug abuse refers to the repeated and excessive use of drugs (or substances) with addictive properties for non-medical purposes, which causes users to develop mental and physical dependence on such drugs, leading to psychological and behavioral abnormalities, and compulsively and endlessly pursuing the special mental effects of drugs, thereby causing serious personal health, public health and social problems.

"many drugs are medicines when used to treat diseases, but they can easily cause drug addiction when abused. common addictive drugs include analgesics, sedatives, hypnotics, psychostimulants, and antitussives." yao huaifang said that the illegal abuse of narcotic drugs is tantamount to drug abuse.

yao huaifang said that drug abuse has a great destructive effect on the mental health of teenagers. long-term drug abuse can lead to psychological problems such as emotional disorder, anxiety, depression, etc. at the same time, the brains of minors are not fully developed. drug abuse may permanently change the structure and function of the brain, leading to decreased cognitive ability, learning difficulties and abnormal behavior.

"i'm binge eating when i'm not od, and i'm anorexic when i'm od. it's so painful! i've been binge eating these past few days when i'm not od. i've gained a lot of weight and i want to cry." xiao you has realized the side effects of drug addiction. "i took too much and finally got a good night's sleep. actually, i don't know if i slept well or fainted."

xiao you and others also have to face side effects such as memory loss. "is od's memory damage reversible? i am looking for things every day now. my memory is extremely bad and i feel so stupid." "i feel like i can't be awake. once i wake up, i start to have all kinds of random thoughts and my brain can't stop at all."

buy prescription drugs without a prescription

online drug purchases have loopholes

experts interviewed said that prescription drugs are drugs approved by the national drug supervision and administration department to ensure drug safety, and can only be dispensed, purchased and used with a prescription from a practicing physician or practicing assistant physician. the sales management of narcotic drugs is even stricter.

yao huaifang said that prescription drugs need to be diagnosed by a doctor before use. if the doctor does not make a clear diagnosis, the random use of prescription drugs may not only cause adverse reactions, but also increase the occurrence of drug-induced diseases. during the treatment of diseases, doctors and pharmacists sometimes need to adjust the dosage of drugs, or even adjust the choice of drugs.

so, where do the prescription drugs and even narcotic drugs in the hands of xiaoyou, xiaoqing and other teenagers come from?

on xiaoyou's social platform, there are not only photos of him buying medicines from abroad, but also posts recently about selling related drugs: "shequ×, fluoroxicam, fumaric acid×××, youmei××, purui××, yumei××, laura××. can be used to take photos, pretend to be mentally ill or depressed, sold at a low price." in the comment area, many people responded to the purchase request.

the reporter noticed that some drug salesmen have started business directly on social platforms. they call themselves "waistbands" and "yaodai" (both refer to drug representatives), provide contact information, and "private chat with those who are willing", claiming that they can provide unlimited quantities of various prescription drugs and even controlled drugs without prescriptions. on some social platforms, there are many posts seeking to buy or sell dextromethorphan tablets, and many sellers promote and sell alternative drugs to dextromethorphan.

in addition, some online drug sales platforms also have certain loopholes, which allow some teenagers to easily purchase prescription drugs without a prescription.

for example, the prescription drug semaglutide has become a "magic weight loss drug" sought after by some people for its "10 catties weight loss per month" legend. recently, a reporter searched for semaglutide injection on an online drug sales platform and randomly selected a pharmacy. after selecting a single box, click on the prescription to purchase, and then enter the "fill in the consultation information" page.

after filling in the user's name and other identity information and selecting a confirmed disease, the reporter selected the preset "type 2 diabetes" on the page, and was prompted with "supplemental prescriptions/medical records/examination reports (optional, up to 5)" below. the reporter did not upload any prescriptions, but simply checked the prompt "confirm that the user has had a clear offline diagnosis of the selected disease, has used the selected medicines without allergies or adverse reactions, and is currently in a stable condition. i have read and agreed to the "internet diagnosis and treatment risk notification and informed consent" and "sensitive personal information processing rules", then clicked "submit consultation information" to enter the payment order stage. the whole process took less than a minute.

the reporter also placed orders for the same medicine at several other pharmacies on the same platform. he could directly purchase semaglutide injection without uploading medical records, prescriptions, medication orders, and other information.

a medical professional told the reporter that letting consumers choose their own drugs and then having internet hospitals fill in the prescriptions is a common way for some platforms to sell prescription drugs online. "this is not in compliance with regulations." according to the "internet diagnosis and treatment supervision rules (trial)", it is strictly forbidden to provide drugs to patients before a prescription is issued. the "regulations on the supervision and administration of online drug sales" also puts prescription review in the front, emphasizing the sales process of "prescription first, then drug."

"if prescription drugs are not sold according to regulations, abuse may occur, resulting in the patient's medication safety not being guaranteed, and delaying the patient's condition. if a patient suffers a serious medication safety accident as a result, the pharmacy or platform that sells prescription drugs in violation of regulations should bear corresponding responsibility." said the above medical professional.

strengthening drug circulation supervision

the platform strengthens information review

“i don’t want to live, but i don’t particularly want to die. i want to experience what it’s like to be near death.” “i’m curious, bored, every day is boring, i want to find some excitement”... these are what some drug addicts say on social platforms.

"youth mental health issues need to be taken seriously." yao huaifang said that preventing teenagers from abusing drugs requires the joint efforts of the teenagers, their parents and the school to achieve good results. the root of the problem is still in the family. parents should maintain good communication and exchanges with their children and provide psychological counseling in a timely manner. parents should learn more about the prevention of drug abuse and guide children who really need to take drugs to use them reasonably.

in june this year, the shandong provincial higher people's court reported a case stating that the people's court promptly issued judicial recommendations to the regulatory authorities in response to the problem of minors purchasing addictive prescription drugs due to inadequate supervision discovered during the trial of the case.

according to the report, when hearing criminal cases, the people's court found that many minors involved in the case had purchased prescription drugs containing controlled psychotropic drugs from pharmacies for a long time and many times without prescriptions. the drug can cause dizziness and excitement after taking a large amount, has hallucinogenic effects, and is addictive, which seriously harms the physical and mental health of minors and has a bad social impact. the court found through investigation that some pharmacies in the area had violated regulations and laws such as failing to manage the drug in accordance with prescription drug regulations and selling the drug to minors, exposing the problem of inadequate management of addictive prescription drugs.

in this regard, xu hao, a lawyer at beijing jingshi law firm, suggested further strengthening supervision of the sales of drugs that are potentially addictive, increasing the frequency of inspections of offline sales, establishing and improving an online traceability mechanism, and using technical means such as big data to issue early warnings for behaviors such as large-scale and frequent drug purchases.

"we must further strictly control the production volume of such drugs, strengthen supervision of drug production and operation links, and strengthen inspections of delivery channels to effectively curb the abuse of these drugs and their flow into illegal channels." xu hao said that many new psychoactive substances must be severely cracked down on in accordance with the law.

experts interviewed pointed out that online platforms should also fulfill their social responsibilities and avoid fueling drug abuse. relevant platforms should consciously strengthen the identification of keywords and variant words, increase the intensity of information content review, delete illegal content immediately upon discovery, and take restrictive measures such as banning illegal accounts.