No, this is not a story about recreational drug use and the US-Mexican border. As this article in The New York Times highlights, moving pharmaceutical across the US-Canadian — and many other — border(s) is big business. The Canadian International Pharmacy Association, a 10-year-old group, said its members fill prescriptions for one million Americans each year.

Per the Centers for Disease Control, about 2%  of adults — about 5% of the uninsured —said they had bought prescription drugs from other countries. The Food and Drug Administration says on its Web site that “in most circumstances it is illegal to import drugs into the U.S. for personal use” because the agency cannot guarantee they are safe and effective. The government also prohibits “reimportation” of drugs made in the United States because it cannot guarantee the medications were not tampered with or stored improperly.

The agency said it does not track the volume of such imports. However, it “typically does not object” to people buying imported medicine for personal use “under certain circumstances,” the agency said. Often the medications are available in other countries at a fraction of the cost here in the United States, even for those with health care insurance.

Personally, I’ve purchased prescription medications — with no prescription — in Spain, France, and Hungary. (I drew the line at Niger though it would have been interesting to see what the pills actually were. In 1999 in Niamey it was not uncommon in public places to be approached by a man with a foot-tall spinning rack of colorful pills in home packaging balanced on his head that he was eager to sell. None was in any sort of original packaging or had any directions included, much less was the name of the drug stated anywhere. Given the 20% literacy rate and the fact that cheap pink toilet paper for foreigners imported from China was about the only paper available in the country, this was probably reasonable in its way. There were of course dispensairs where you could be treated by a nurse if necessary, and given the country’s 47-year life expectancy at the time finding humor in the system is hardly the point. In Hungary in 2003 I paid $20 cash for a house call and some quite effective anti-nausea pills that lasted me a couple of years; in France in 1985 it was $5 and a couple of jokes at my father’s expense for the blood pressure medication he had forgotten to packet. He was traveling around Europe before settling into Spain for an extended stay and we left the pharmacy with enough medication to last a year.) Aside from the quirky cultural interactions, the situation itself is again a reminder of the ineffectiveness of how health care availability and costs are managed in the United States. The Times article is full of examples of purchasing medications on a regular basis from overseas as the only affordable way for many, including the insured, to manage their health. The title sums it up well: “As Drug Costs Rise, Bending the Law Is One Remedy.”