Problem of illegal sale of medication larger than St. Paul market

Bee Hang waved goodbye to a friend last December as he took the cyanide that ended his young life. Relatives suspect that the poison used in the 18-year-old's suicide came from a Hmong flea market, where hundreds of pounds of misbranded and prescription drugs were confiscated last month.

Hang's suicide was one of several red flags that led investigators to conduct the search and end the backdoor practice, but authorities say the illegal distribution of medicinal drugs goes beyond just that market and the Hmong community.

"We're told that it isn't limited to any particular community or any particular facility — that it is actually pretty widespread," said Buddy Ferguson, a spokesman for the Minnesota Department of Health.

On June 11, law enforcement officers seized more than 70 bins of unmarked or misbranded pills, drugs and syringes, including suspected sodium cyanide, steroids, penicillin and opiates from more than 15 vendor stalls at the Hmongtown Marketplace on Como Avenue near N. Marion Street in St. Paul.

Residents had complained of people getting sick from taking medications from the market, where among produce stands and clothing sellers were reportedly booths with IVs illegally set up behind curtains and vendors who offered medicine for gout as well as pills intended to end pregnancies.

Undercover officers also had drugs sold to them illegally in recent months, including once in late May when an officer was told by a vendor he could be administered an IV at home "with whatever medicine [the officer] chose," according to a search warrant affidavit. Management and vendors at the market had been warned by authorities before the raid not to sell the drugs.

Last week, several vendors were charged in Ramsey County District Court with misdemeanors for allegedly illegally selling medication.

"This search warrant and this investigation … may then stop this activity from taking place elsewhere," said Randy Gustafson, spokesman for the Ramsey County Sheriff's Office. He declined to be more specific about other locations where similar drug sales could be happening.

In the wake of the raid, the Health Department has hosted meetings to increase awareness of safety issues related to unlabeled medications and to get feedback on how to promote effective communication with Hmong community members and other ethnic communities about the issue.

"A juvenile or even an adult shouldn't be able to walk into a place with an ailment and not see a medical professional and diagnose themselves," Ken Kulick, an agent with the U.S. Food and Drug Administration's Office of Criminal Investigations, said at a community meeting. "Those things are dangerous. They're medications. You just can't put a quarter in a gumball machine and pull it out."

Bee Hang frequently visited the Hmongtown Marketplace to meet his girlfriend, said his older brother Meng Hang, 32, in a translated interview at his St. Paul home. But several months before his suicide, Bee Hang told his siblings that he was depressed and that he wanted to die, his brother said.

After seeing his old girlfriend with another man at a party on Dec. 30, Hang went home, and in front of a friend, he put something in his cup and drank it. A short while later, he started convulsing.

Following his death, a relative was able to buy a cyanide tablet in a zippered plastic bag with no labels at the market, according to a search warrant affidavit. It resembled what was recovered at the scene of Hang's death. There was another cyanide suicide in St. Paul earlier this year that also could have been linked to the market.

Cyanide tablets aren't illegal to sell, but like other poisons in Minnesota, they must be labeled as such and the seller must keep a record of to whom they are sold.

Despite what happened with his brother, Meng Hang said he would still visit the market for cures for stomachaches and other common ailments because he's familiar with the medicine from Thailand, where his family emigrated from. It's also faster and easier than seeing a doctor, he said.

"I think that with immigrant cultures they have always relied on remedies they are accustomed to," said Dr. Muaj Lo, who works in family medicine at the East Side Family Clinic in St. Paul.

Lo said he believes it's mostly elderly Hmong patients going to vendors for medication. He has had patients who have been treated for high blood pressure or diabetes who then try a "cure" at a vendor only to reverse the progress they had made.

Chao Yang, a pharmacist who works in the Express Pharmacy in St. Paul, said distrust is the major deterrent for some residents.

"The reason why they keep going back is because they don't trust other settings," Yang said.

Yang said residents should believe in those who are trained instead of going to others for a quick fix. Yang recommended that medical professionals address Hmong residents at large community events to get the message across.

Outreach and education could make a difference, said Va-Megn Thoj, executive director of the St. Paul-based Asian Economic Development Association.

"Raids are not the solution," he said. "It's not because people are ignorant. It's accepted for many reasons."