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Tunxi trembled with his right hand and tilted the needle 45 degrees into the skin. She didn't feel the pain she imagined, but she was a little relaxed. Then she opened the memo in her mobile phone and wrote: "The first day: 0.25".

This is the photo of Tong Xi's first injection of smectite, and 0.25 is the dosage she used. Smegliptide is a prescription drug for the treatment of obese type 2 diabetes, but it has become a "painless slimming needle" on social media because it can lower blood sugar and suppress appetite. Since the second half of this year, major hospitals across the country have been out of stock, and the premium of e-commerce platforms is serious.

Behind the popularity, many healthy people privately prescribe drugs through the internet under the propaganda of social platforms and buy them in the "gray area" of hospitals. Some users blindly increase the injection dose. The abuse of smectite is becoming more and more serious.

Hypoglycemic drugs have become a "slimming needle" for blind abuse and are popular.

In August this year, many similar tweets appeared in Tunxi's Little Red Book: "Four sisters control my stomach", "No diet, no exercise, lying thin artifact" and "Has anyone tried to lose weight?" ... these posts are recommending an injection called smectite, describing that this drug can lose weight quickly once a week.

There are many messages under the little red book "Four Sisters" post.

Tong Xi couldn't help being moved. She overeated when she was working at home, and her weight soared to 190 kg. After that, she tried to go on a diet to lose weight, but it had little effect. In mid-August, she went to a hospital in Jiading District, Shanghai to ask about this medicine.

"I know what I mean by an injection doctor. There are too many people asking. " Tunxi said with a smile that the attending doctor who treated her also injected the medicine himself and was already "thin". "The doctor is also using it. What's the problem? "

On August 20th, Tong Xi injected the first dose of Smegrutide, and the next day he felt his appetite decreased. She smiled and said, "It's a miracle": in the first month, the amount of food per meal changed from two bowls to one bowl, and by the end of the month, the food cost was nearly 2,000 yuan less. In less than three months, her weight has dropped to 169 kg.

Tong Xi showed her the dispensing records.

Tong Xi's statement is not groundless. Smegliptide injection is produced by Novo Nordisk of Denmark. By increasing the action time of GLP- 1 in human body, insulin secretion is promoted, thus appetite is suppressed, food intake is reduced, and blood sugar is lowered.

It is precisely because of its hypoglycemic effect that the drug was approved in China in April, 20021year, and became a prescription drug for targeted treatment of obese type 2 diabetes. However, the drug has not been approved for the treatment of simple obesity in China at present, and it is not a diet drug.

Restriction can't stop the spread of drugs. There are thousands of fans on the topic of "Smeltide" in Weibo. On social media such as Little Red Books and Beeps, many dieters with normal body mass index hope to "drop below 100 kg" by taking digital photos on weighing scale and punching in real-time short videos every day. The number of related videos exceeds 10000. Some users increase the injection dose in a short time, and Tong Xi is no exception.

Although the instructions of Smegliptide indicate that "the initial dose is 0.25mg, it is not recommended to exceed 1mg per week." Three weeks later, Tong Xi increased the injection dose to 1 mg. "It's not that I'm too anxious to get fat. I increased it to 1.2 at the end of September. " Tunxi is very confident, pointing out that foreign drugs can lose up to 2.5mg. "If I don't care about money, I will play more."

Blind medication is accompanied by side effects. Several drug addicts admitted frankly in the interview: "After two injections, there was no change in weight at all. They were directly overweight to 0.75 and vomited on the spot." "I hit 0.5 when I came up, and I had a dizzy physiological reaction. I was too dizzy to walk and delayed my work. " "I want to die hard, my weight hasn't changed, but my strength is gone."

An endocrinologist felt very helpless: "Smear is not suitable for normal or thin type 2 diabetes!" He stressed that the use of smeglitazone in simple obese patients is an over-indication drug, and it is necessary to check the relevant indicators such as pancreas and thyroid, and inject it under the guidance of a doctor. It is abuse for healthy people with normal body shape to use the drug or for users to increase the dose privately. "Gastrointestinal upset and hypoglycemia are just normal side effects of drug treatment. If it is serious, it will induce acute pancreatitis or cause endocrine system disorder. "

Internet private prescription

There is a "grey zone" for hospitals to buy medicines.

The easy access to drugs intensifies the abuse of smegliptide.

When searching for "Simei" on Taobao and JD.COM, the buyer only needs to contact customer service to provide ID number and mobile phone number, and fill in the symptoms at will to automatically prescribe medicine. Merchants on some platforms directly sell this medicine as a diet pill. The product cover reads: "Self-use shaping pen! A good figure is displayed, you have the final say. " The purchase of injection needles can be found everywhere.

However, there is a "grey zone" in purchasing smectite in hospitals.

Yu Bin, a medical practitioner, said that there are three ways for hospitals to obtain this medicine at present: to prescribe medicine for patients with type 2 diabetes; Ask a medical representative to open it; Tell the doctor directly that he is obese and needs medication, and ask for it at his own expense.

"If an obese person with high blood sugar takes the initiative to find a doctor to prescribe medicine and does not need medical insurance reimbursement, many doctors will not refuse." Yu Bin revealed that in reality, who will judge whether it is over-indication? Drugs are not fatal, and it is not illegal for doctors to do so.

"In fact, I secretly drank sugar water on the day of the inspection." Tunxi said frankly that he got the prescription by virtue of "the blood sugar value just passed the line". Smeagol's little red book posts are full of various "prescription strategies": if the body mass index is not very high, test your postprandial blood sugar at home. When the blood sugar value is between 6.3 and 7, it is impaired blood sugar, not diabetes. Just write it down and take a blood test this time. "I can't say any more, I know everything."

Online pharmacies automatically issue prescriptions.

Yu Bin further pointed out that the hospital's supervision of purchasing this drug at its own expense is not strict, because it is not an anesthetic or psychotropic drug. In other words, patients can take a certain amount of medicine with a prescription and get medicine in many hospitals. Some diabetics and medical representatives saw the business opportunity and began to purchase.

"Thin doctors don't give it, they usually ask for help online." According to a purchasing description of Smegrupeptide, he will first post a drainage post on Xiaohongshu and Weibo, and the private letter purchasing requires adding WeChat, so feel free to contact if there is any goods. "We are all adults, and I am not responsible for problems." The purchasing agent said with a smile that he would only remind the other party that "there is no problem with the thyroid and pancreas". Even a nurse in Yangpu District, Shanghai started purchasing, saying, "I'll open it if I have it inside."

The reporter contacted a four-sister purchase through WeChat.

The reporter asked the online pharmacy: Do you need a prescription to buy Simei?

Qi Yuan, who works in the pharmacy of a general hospital in Shanghai, pointed out that since the beginning of June 1 1, people have come to the pharmacy every day to ask for "Pei Simei", and sometimes a person has to take three medical records and ID cards. "Ask a little more carefully, saying that it is to help bring medicine at home."

Under the frenzied snapping up of patients and purchasing agents, the online price of metformin with the original price of 478 yuan rose from 650 yuan to 900 yuan. At present, major hospitals in Shanghai have imposed restrictions on the purchase of Simao: only one prescription can be bought. Nevertheless, according to Novo Nordisk's Shanghai office, the Shanghai area is still out of stock.

Smeagol peptide on e-commerce platform is expensive.

Yuan Qi, who is also a diabetic, has been treated with smectite injection for a long time. "When the hospital has the most inventory, there are more than a dozen, which is only enough to supply a few old patients." She observed that some obese patients with type 2 diabetes had to switch to oral preparations, because they could not get smectite injection. She can't help but worry that the abnormal market beyond drug indications will continue to expand, squeezing the drug resources of real patients.

What is the boundary between "planting grass" and advertising?

Network supervision of prescription drugs needs guidance

Weight-loss enthusiasts say that "planting grass" on social platforms is the root of many drawbacks.

She saw that since the beginning of this year, users on domestic social platforms have recommended Smegrupeptide, including many well-known beauty bloggers. "Few people know the scientific nature and side effects of drugs." Linghou pointed out that the recommender was based on "the authoritative approval of endocrinologists" and "the drug has been approved by foreign governments to lose weight". In fact, Wegovy, which is approved for the treatment of obesity abroad, and Ozempic, which is popular in China, have different specifications and doses, although they are both smectite. I have also been to the endocrinology department of a well-known hospital mentioned in the post, and doctors do not advocate losing weight through drugs.

Weibo's "Four Sisters" are active.

"Isn't this false propaganda?" The monkey genus questioned that the so-called "planting grass" posts became disguised promotion, and a large number of netizens he knew took drugs under the influence of these posts, including many Z generations. ..

"The line between planting grass and advertising is blurred." Shen Tao, deputy director of the Medical and Health Business Research Committee of the Shanghai Lawyers Association, said that according to the Advertising Law, prescription drugs can only be advertised in some designated medical journals, and cannot be publicized in disguised form in the form of news reports in the mass media. "As long as the effect is mentioned, it is an advertisement in a strict sense."

"The relevant laws and regulations are perfect, but violations of laws and regulations are common." Shen Tao also observed that many drug posts on social platforms stepped on the "yellow line" in the name of "lifestyle" and "experience sharing", which made it impossible for law enforcers to define them. Unless it is reported by competitors or users, it is difficult to make penalties.

"Social platforms should have filtering and screening mechanisms for drug-related content." Zhao Heng, the founder of Medical Strategy Company, pointed out that the increasingly rich Internet communication scenarios have brought more risks of drug abuse. The platform needs clear and detailed regulatory guidelines to explain controversial and unclear places outside the current laws and regulations, such as what words are mentioned in drug experience sharing? The anchor shows whether the medication process is an advertisement through video. To help the platform better fulfill its communication responsibilities.

Purchasing indicates that meglumine macropeptide is scarce.

"After stopping the drug, the weight will rebound. However, healthy people can't always rely on drugs, and the sequelae are unpredictable. " Zhao Heng and Shen Tao believe that in order to curb the open-minded abuse, we must carry out medication education and guide more people to consider from the perspective of long-term health, instead of indulging in the immediate weight figures. If the physical anxiety of getting quick success and instant benefit is more rampant, then the abuse of ideas will only be the "beginning."

The original manuscript of Shangguan News in Jiefang Daily is strictly prohibited to be reproduced without permission.

Author: Feng Rui