Search on Telegram for the words “fentanyl”, “percoset”, or “oxycontin” (large opioid painkiller) and you’ll find many channels and groups dedicated to selling. These highly addictive prescription drugs are extremely dangerous. Nevertheless, a survey by “Shomrim” reveals that access to them goes beyond pharmacies, reaching the hands of drug dealers operating online, promoting a thriving black market. Drugs can be delivered to your door by courier.
Fentanyl, known colloquially as “penta,” is a synthetic opioid 100 times more potent than morphine because it penetrates the central nervous system and can effectively bind to pain receptors. It is usually prescribed to cancer patients or people suffering from chronic pain that other medications cannot relieve. The patch is applied to the skin for 72 hours and provides a quick and powerful effect. It is the most powerful painkiller available today.
In some respects, fentanyl and other opioids have contributed to the epidemic, which has replaced heroin as the dominant street drug in the United States, causing nearly 850,000 deaths. Using fentanyl patches is surprisingly simple. Instead of applying it to the skin, the user places it on aluminum foil, heat it and inhale it. The resulting highs are significantly stronger than those of other drugs. But fentanyl is also very fatal. According to U.S. health officials, approximately 100,000 people die from fentanyl overdose each year, a leading cause of drug-related deaths.
The extent of fentanyl use in Israel remains unknown, but browsing Telegram reveals a huge inventory of powerful prescription painkillers available through unregulated dealers. Diversity and price range suggest a highly competitive market. In addition to opioids, there is a wide range of psychoactive substances available on sale, including benzodiazepines (anti-anxiety drugs), sleeping pills, and drugs to treat attention disorders.
Telegram Group ads promote these substances with compelling offers. One post reads: “Doctor lost it. You win: a penta 100 mg patch including delivery, only 280 Nis.” Another state said: “Penta is bigger than ever! Our courier is on the field. The boss is crazy. We are all kinds of patches (100, 75, 50, 25 mg. Best price on the market. Fast delivery in Central Israel. Gifts only for new customers and order more than 3 patches.”
Images of prescription drugs include a brief description of intended use, active ingredients, and mechanisms of action. For example, under the photo of the “ATTENT” bottle, the post explains: “It is intended to treat ADHD and narcolepsy. It works by stimulating the central nervous system, increasing brain dopamine levels, increasing focus and decreasing impulsivity. Similar statements appear for drugs such as Vyvanse, Resilin, Oxycodone, Rivotril, Subutex, Zoldorm, Stilnox, Bondormin.
When Shomrim contacted the dealer to inquire about purchasing the drug, he said, “Ritalin 10mg including delivery. I have 400NIS. ID verification: Send me an ID card, Facebook profile, video of today’s date and time.” Other dealers only needed a selfie with identification documents. Ostensibly, we confirmed that the request was not part of the police stab wound. It remains unclear how these verification processes work, but what is certain is that dealers have accumulated important databases of personal information.
The flood of prescription drugs on the black market can be largely due to fraudulent or misused prescriptions. “We have lost control of the situation,” said Dr. Roni Berkowitz, executive director of the Israeli Ministry of Health, during a discussion with the Knesset Health Committee in February 2023. “quantity. ”
A closer look at the source of these prescriptions points to a specific territory, East Jerusalem. Health Fund officials have repeatedly cited East Jerusalem as a hub for excessive opioid prescriptions. “We have seen many young people aged 18-20 and have received large quantities of opioids over the years. It is clear that they have not used them personally. These amounts can kill elephants, which is clearly due to resale.” Data shows that around 4,000 claritic patients in Jerusalem have received high-dose long-term opioid prescriptions, disproportionately representing the residents of East Jerusalem.
Why doesn’t the Health Fund provide prescriptions to patients?
“It started during the second intifada when it was difficult for the health fund to reach all of the neighborhoods in East Jerusalem, and then began using subcontractors and in the process, avoiding the need to monitor what was going on.
“Some clinics are financially incentivized to freely issue prescriptions. Health funds pay NIS 70-80 per insured per month, while the government pays NIS 4,000 per insured per year. Contractors cut costs as much as possible. A license exam that has passed.”
“Fraudulent individuals will issue prescriptions. A licensed Israeli doctor will provide login credentials, and multiple unauthorized individuals will write prescriptions using the same account.”
“Yes. He’s paid. In fact, he sells his license usage.”
Does the Ministry of Health know?
“I personally reported this to the Ministry, but they don’t seem to want to deal with it for now.
So how does it work with the prescription?
“If someone comes in and asks for a prescription, I cannot refuse. I work in a dangerous environment and there is no police presence to protect me.”
Large subcontractors who live and work in East Jerusalem explain a similar reality. “I can’t call the police. I’ll be marked as a collaborator. This has to be handled internally, but addicts don’t care. The doctors get scared and give me prescriptions.
As far as you know, are there any prescriptions used to relieve pain and sell drugs?
“If a patient is given a prescription because he needs it, no one will tell him that it’s dangerous. He relies on drugs until he becomes a drug and hopes he will be willing to sell his mother, or wife, or anything he owns to get the drug.
“The other people who get the prescription are dealers who buy and sell drugs. If you step into the Shuafat district, the cost of Percoset is NIS 500. As a patient in the Health Fund, you can buy it for NIS 17, which is a good business.
The Ministry of Health has recently established a task force to address opioid addiction. Its main advantage is that in 2023, around 90,000 Israelis created a national database that revealed that opioids had been prescribed. The ministry has seen a 5% decrease in prescriptions for these drugs compared to past years.
Department officials said the decline was the result of restrictions placed on the Health Fund and more effective messaging to physicians. “If you complain to the doctor at Backpain, he cannot prescribe fentanyl. His computer issues prescriptions. The same is required for other opioids and extended prescriptions, and as a result, there is a decline in prescriptions in some areas,” Jerusalem also does.
“Studies conducted all over the world show that opioid use is more common in low-income populations. This is a global phenomenon explaining the increase in use in East Jerusalem. Clarit’s initiative is positive. Long-term prescribing in thousands of patients is currently being reviewed or stopped.
“The biggest problem is the drugs that arise from private pharmacies. Health Ministry officials said they added that there is an ongoing legislation restricting handwritten prescriptions and digital connections between private pharmacies and the Health Fund.
The intersection of poor regulation, criminal impact and thriving online markets has transformed prescription opioids into a lucrative business in Israel.
