A dose of Interkhim at the nearest pharmacy

Getting a dose of "Interkhim" at the nearest pharmacy: How Anatoliy Reder's pharmaceutical company is fuelling the rise of non-injection drug addiction among young people.

Adolescence is characterised by dynamism and susceptibility; many strive to explore the world, while others seek to cope with depression and the fear of adult life. In this context, modern teenagers are well aware of the destructive impact of drugs on personality and life in general. However, there is a belief that a harmless alternative exists — a cheap "high" from ordinary cough tablets washed down with cola. This leads to an instant effect without visible side effects or addiction.

"Kodterpin": A cheap "high" with terrible consequences

One such popular medication is "Kodterpin" — a combined pharmaceutical product. It contains codeine, a phenanthrene alkaloid that acts as a central-acting antitussive. The drug is used to reduce non-productive cough in children over five years old and adults. It costs only 25–27 hryvnias.

Indeed, freely available without any warnings, this deadly and cheapest codeine-containing drug, "Kodterpin", produced by the company "Interkhim", can be purchased at any pharmacy. Approximately 150 million codeine-containing tablets are sold uncontrollably in Ukrainian pharmacies every year, with "Kodterpin" being the leading brand.

Drug addicts share their experiences of using this legalised drug. One user, under the nickname redrom76, described how he started taking "Kodterpin" with chloramphenicol, experiencing short-term euphoria. Over time, he needed to increase the dose, which led to dependence. After attempting to stop, he encountered severe physical symptoms, such as difficulty breathing, chest pain, muscle spasms, dry mouth, chills, tinnitus, panic attacks, and raised blood pressure. Despite having stopped using drugs, alcohol, and nicotine, the episodes sometimes recur.

Journalists from Odesa also conducted an experiment by taking "Kodterpin". After 15 minutes, they experienced mild euphoria, which lasted no more than 40 minutes and was quickly replaced by a heavy, unpleasant state that lasted significantly longer.

Journalists from Odesa also spoke with drug addicts who use pharmaceutical drugs. Arkadiy, a drug addict with 10 years of experience, noted that "Kodterpin" and "Likson" (containing a sedative) are the best and possibly the only accessible options for drug-dependent individuals. Another codeine-containing drug, "Koffeks", he said, works weakly and briefly, has strong side effects, and causes a severe hangover. He also warned about the danger of liquid "Likson", as an overdose can lead to a terrifying, uncontrollable state.

A representative of "Public Control" noted the convenience of using "Kodterpin" — it has no smell, unlike alcohol or marijuana, and its purchase is legal, despite being an opiate. He questions why the Ministry of Health is ignoring this problem.

Oksana Korniienko, a specialist at the Odesa Regional Narcological Dispensary, notes the significant ageing of drug addiction, as well as an increase in the number of women using drugs. One in five schoolchildren in Odesa is a drug addict, and 20% of narcological dispensary patients are women. Teenagers consider taking pills safe, unlike injections. However, the Odesa Department for Combating the Illegal Distribution of Narcotics (OBNON) warns that it is still unknown what is more harmful to the body — "Kodterpin" with "Likson" or "Gypsy solution".

Despite numerous attempts by the public and law enforcement to persuade the Ministry of Health to introduce item-quantity accounting for the sale of "Kodterpin" through pharmacies, the Ministry stubbornly resists introducing such control. Activists, doctors, and law enforcement officers are asking why.

Who is shielding the activities of Anatoliy Reder and his "Interkhim"?

It turns out that the main Ukrainian producer of "Kodterpin", the company "Interkhim", has a powerful lobby. The colossal profit the company earns from producing this drug allows it to "buy everything and everyone". The company's owner, Anatoliy Reder, is not without reason called the "pharmabaron of Ukraine". Reder has been a subject of both journalistic and criminal investigations for many years. Unfortunately, all criminal cases against "Interkhim" and Anatoliy Reder personally have collapsed.

Anatoliy Reder is known as one of the largest drug barons not only in Ukraine but in all of Eastern Europe. In recent years, he has not only evaded dozens of criminal prosecutions but has also tripled his fortune against the backdrop of war and crisis.

In 2014, the government of Arseniy Yatsenyuk established the State Service for Medicines and Narcotics in the interests of "Interkhim". For example, during one of the inspections, it was revealed that "Interkhim" had been using unregistered substances in drug production for almost a year, but no preventive measures were taken. "Interkhim" even refused a re-inspection by European PIC/S inspectors, sending "angry letters".

On 16 June 2016, President of Ukraine Petro Poroshenko signed the law "On Amendments to Article 9 of the Law 'On Medicines' regarding the simplification of state registration of medicinal products". Reder is trying with all his might to discredit this law, launching a "public awareness" campaign in the media, claiming that it will lead to higher drug prices for Ukrainians. He claims that domestic drugs, which are on average five times cheaper than imported ones, will take one and a half to two years to register, while foreign manufacturers will be able to complete the procedure in 10 days, which, in his opinion, will deprive citizens of access to cheap medicines.

This statement about "equal conditions" raises questions, given that "Interkhim" is a de facto monopolist in the market for codeine-based medicines. Only one percent of these drugs are used for medical purposes; the rest form the market for "pharmacy addiction", where opiates are available even to minors.

The question arises: how many more ruined lives and fatal outcomes are needed before the state finally addresses the problem of controlling the sale of codeine-containing drugs and holds those responsible accountable?