Americans flocking to Mexico for pharmaceuticals. (Medication).

As many as 40% of U.S. residents who enter Mexico this year will return home with a souvenir of their visit--a prescription drug that has not met U.S. Food and Drug Administration (FDA) safety standards. While the majority may experience no ill effects, many others risk adverse reactions and some actually may die, according to Marvin D. Shepherd, director of the Center for Pharmacoeconomic Studies at The University of Texas College of Pharmacy, Austin. The result of importing these potentially deadly, and often illegal, pharmaceuticals into the U.S. is a problem of staggering proportion, he argues. Shepherd played a key role in getting Rohypnol, a sedative/ hypnotic often known as the "date rape drug," banned from the U.S. in 1997.

The situation along the border mirrors a larger national issue. It is estimated that more than 2,000,000 packages of pharmaceuticals enter the U.S. illegally each year through the mail system. This does not include the large number of additional drugs that enter the country in the arms, pockets, shopping bags, and purses of those traveling home from foreign countries.

Shepherd explains that Americans venture into Mexico to purchase prescription drug products because of easy access, lower prices, and availability of drugs that cannot be obtained in the U.S. marketplace. The problem has escalated significantly over the past 10 years. For example, he points out, more than 80% of patients in one El Paso clinic alone go to Mexico to buy their prescription drugs.

"If you want a full perspective of the size of this importation industry, I invite you to visit any one of the Mexican border towns of Texas," Shepherd emphasizes. "Rows of `farmacias' line the streets of Nuevo Laredo, Juarez, Reynosa, and Matamoras. Farmacias are a major tourist draw for the Mexican economy, especially border town economies." The customer base for this industry primarily is U.S. residents.

Checking returning Americans for the drugs would be an overwhelming challenge, given the fact that 25-30,000 people walk across one international bridge and return the same day. In addition. more than 1,000,000 vehicles cross and return from Nuevo Laredo each month.

Shepherd was among 13 experts invited to testify on this subject before a subcommittee of the U.S. House of Representatives Committee on Energy and Commerce. He made these recommendations to Congress:

* Develop a program to educate the public concerning the risks associated with foreign medications, especially the danger of counterfeit drug products. Inform the public that the vast majority of pharmaceuticals coming from Mexico do not have FDA approval.

* Give U.S. customs and FDA officials the added manpower and technological support to develop programs to monitor the importation of foreign drug products.

* Develop a strategic plan to harmonize pharmaceutical business between U.S. and Mexico.

* Enforce existing law that bans the importing of all non-FDA-approved pharmaceuticals from foreign countries.

* Ban controlled substances from entering the U.S., especially from Mexico.