WEBVTT - Caveat Injector 0:00:00.960 --> 0:00:07.160 Caveat injector there everywhere, diy peptides for losing, weight, building, 0:00:07.240 --> 0:00:12.440 muscle slowing, aging, getting tan, and general looksmaxing Inside a 0:00:12.520 --> 0:00:17.759 legally ambiguous and medically dubious global supply chain by Amanda Mole, 0:00:17.880 --> 0:00:22.000 Madison Muller, and Ashley Furlong, Read aloud by Mark Leidorf. 0:00:23.720 --> 0:00:27.000 In an industrial park a half hour outside Prague, Peter 0:00:27.160 --> 0:00:29.800 Magic finds himself at the center of a gold rush. 0:00:30.320 --> 0:00:32.879 In the fifteen years since he started his business as 0:00:32.880 --> 0:00:36.639 a teenager in his parents' garage in Slovakia, it's developed 0:00:36.640 --> 0:00:39.600 into a fast growing company with almost nine figures in 0:00:39.680 --> 0:00:44.280 annual revenue and an international clientele. He isn't training a 0:00:44.320 --> 0:00:48.280 new kind of agentic artificial intelligence that replaces your employer's 0:00:48.400 --> 0:00:53.239 legal department, or building the next online prediction market. His company, 0:00:53.360 --> 0:00:57.720 Janoshik Analytical, does purity and sterility testing for black market 0:00:57.800 --> 0:01:02.080 anabolic steroids, an obscure niche Magic found during his own 0:01:02.120 --> 0:01:06.160 foray into weightlifting. His search for other lifters online took 0:01:06.240 --> 0:01:08.800 him to four chan and read it, where many talked 0:01:08.800 --> 0:01:12.920 freely about their pharmaceutical experimentation, but fretted about what might 0:01:13.000 --> 0:01:17.119 be in their drugs. Magic figured testing steroid samples couldn't 0:01:17.120 --> 0:01:20.040 be that hard. It took a couple of years actually 0:01:20.080 --> 0:01:23.920 before we got all the processes perfected, because obviously, legally 0:01:24.000 --> 0:01:25.000 this is pretty. 0:01:24.680 --> 0:01:25.840 Thin ice, he says. 0:01:26.720 --> 0:01:31.360 Among connoisseurs, his testing has become the gold standard. Outside 0:01:31.400 --> 0:01:34.360 in his labs parking lot. He has the shimmering purple 0:01:34.400 --> 0:01:38.720 Ferrari to prove it. As it turns out, Magic's reputation 0:01:38.840 --> 0:01:43.240 for running a legitimate business evaluating illicit substances has positioned 0:01:43.319 --> 0:01:46.560 him perfectly for a new black market. The global trade 0:01:46.600 --> 0:01:51.360 in peptides. Injectable peptides are a loose cohort of amino 0:01:51.400 --> 0:01:54.360 acid based drugs that bond to receptors in the body 0:01:54.720 --> 0:01:57.920 to toggle various physiological processes. 0:01:57.320 --> 0:01:58.120 On and off. 0:01:58.600 --> 0:02:02.600 Some peptides are legal and widely used, including insulin and 0:02:02.800 --> 0:02:07.160 GLP one drugs. The pes for peptide in the early 0:02:07.240 --> 0:02:10.800 twenty twenties, as buzz about their weight loss capabilities moved 0:02:10.800 --> 0:02:15.239 beyond diabetics in doctor's offices, Ozembic and other GLP ones 0:02:15.320 --> 0:02:20.200 quickly grew popular among fringy fitness buffs, lookxmaxers, and Silicon 0:02:20.320 --> 0:02:23.520 Valley types to get weight loss drugs well outside of 0:02:23.560 --> 0:02:24.760 prescribing guidelines. 0:02:25.040 --> 0:02:26.840 Some turned to lenient. 0:02:26.560 --> 0:02:30.480 Telehealth providers and longevity clinics that were happy to welcome 0:02:30.520 --> 0:02:33.880 off label patients, the kind of clientele who are in 0:02:33.919 --> 0:02:38.000 turn happy to pay in cash. Exhilarated by the ease 0:02:38.080 --> 0:02:41.200 with which GLP ones help them get shredded, some of 0:02:41.240 --> 0:02:44.680 these users wanted to experiment further with the help of 0:02:44.760 --> 0:02:49.440 unconventional medical practitioners. These enhancement enthusiasts found more than a 0:02:49.480 --> 0:02:53.120 dozen other kinds of peptides. Most of these drugs weren't 0:02:53.120 --> 0:02:56.040 approved by the FDA and absent from the list of 0:02:56.120 --> 0:03:00.239 drug ingredients allowed to be used in compounding pharmacies, state 0:03:00.280 --> 0:03:03.840 regulated facilities that fill many gaps in the country's pharmaceutical 0:03:03.880 --> 0:03:08.480 supply by mixing customized medications. Some of these substances had 0:03:08.520 --> 0:03:11.960 been developed by traditional farmer companies but abandoned because of 0:03:12.080 --> 0:03:16.440 muddled efficacy results or lack of projected profitability. A few 0:03:16.600 --> 0:03:19.639 had hardly been tested in humans, and the potential long 0:03:19.720 --> 0:03:22.519 term side effects and safety of any of these peptides 0:03:22.880 --> 0:03:27.520 remain unknown. Their names consist of cryptic jumbles of letters 0:03:27.880 --> 0:03:33.040 BPC one F seven, CJC twelve ninety five, TB five 0:03:33.160 --> 0:03:37.320 hundred and promise all kinds of benefits. Want to sleep better, 0:03:37.560 --> 0:03:41.280 there's a peptide for that. How about helier tendinitis faster? 0:03:41.520 --> 0:03:45.280 Or lock in at work? There are peptides for that too, 0:03:45.560 --> 0:03:49.360 Need a tan sure. Then there are the stacks such 0:03:49.360 --> 0:03:54.840 as Wolverine, Klow, and Phoenix, combinations of peptides meant to 0:03:54.880 --> 0:03:59.080 max out user's results. Although most compounders stayed out of 0:03:59.080 --> 0:04:02.040 the peptide business, some were willing to fill prescriptions and 0:04:02.120 --> 0:04:05.800 risk the FDA warning letters that generally constitute the first 0:04:05.840 --> 0:04:10.520 phase of enforcement. As these peptides became mainstays of online 0:04:10.600 --> 0:04:14.040 chatter among Jim Bros and biohackers, and as their beliefs 0:04:14.040 --> 0:04:18.200 about peptides found even greater purchase among influential podcasters like 0:04:18.320 --> 0:04:22.159 Joe Rogan and Andrew Huberman, their popularity began to spread, 0:04:22.480 --> 0:04:26.960 alarming regulators. In August twenty twenty three, Jennifer Aniston told 0:04:26.960 --> 0:04:29.920 The Wall Street Journal that she swore by weekly peptide 0:04:29.920 --> 0:04:33.479 injections as part of her anti aging regimen. Weeks later, 0:04:33.720 --> 0:04:36.479 the Biden era of Food and Drug Administration changed the 0:04:36.520 --> 0:04:41.960 regulatory status of nineteen peptide drugs, effectively banning compounding pharmacies 0:04:42.000 --> 0:04:45.279 from producing them even with a valid prescription because of 0:04:45.279 --> 0:04:49.360 safety concerns. Filling these drugs was never really legal given 0:04:49.360 --> 0:04:52.159 their absence from the permitted list, but the change sent 0:04:52.200 --> 0:04:56.599 an explicit message to compounders about regulator's views. Many of 0:04:56.600 --> 0:04:59.240 the pharmacies that had been willing to test the boundaries 0:04:59.400 --> 0:05:01.320 took it as a wa warning shot and decided to 0:05:01.400 --> 0:05:06.440 drop the drugs entirely. Undeterred, peptide users simply went underground, 0:05:06.680 --> 0:05:10.120 where they found groups of fellow travelers on discord or telegram, 0:05:10.440 --> 0:05:12.520 or they formed groups of their own to track down 0:05:12.520 --> 0:05:15.720 the drugs they wanted to get them. These groups began 0:05:15.760 --> 0:05:18.839 to go straight to the source, ordering active ingredients in 0:05:18.960 --> 0:05:23.040 bulk from Chinese pharmaceutical manufacturers through wee chat, WhatsApp or 0:05:23.040 --> 0:05:27.839 other apps and paying in cryptocurrency. Suppliers then shipped the 0:05:27.880 --> 0:05:32.120 active pharmaceutical ingredients or API to buyers in little glass 0:05:32.200 --> 0:05:35.400 vials of white powder that can be reconstituted into an 0:05:35.400 --> 0:05:39.279 injectable liquid with a special type of sterile water. Labs 0:05:39.279 --> 0:05:42.719 such as Yanishik come in. When those vials arrived Stateside, 0:05:43.080 --> 0:05:45.200 buyers sent off a few to make sure they got 0:05:45.200 --> 0:05:47.760 what they paid for before divvying up the goods among 0:05:47.839 --> 0:05:51.320 group members. It wasn't long before some of these informal 0:05:51.400 --> 0:05:55.400 sourcing operations began to join a few existing peptide retailers 0:05:55.440 --> 0:05:58.440 in opening themselves to the public, which was becoming more 0:05:58.440 --> 0:06:01.680 peptide curious by the day. In spite of the FDA's 0:06:01.760 --> 0:06:06.400 safety warnings, importers expanded their orders and built ordinary looking 0:06:06.440 --> 0:06:10.760 e commerce sites, complete with advertising budgets and influencer partnerships. 0:06:11.279 --> 0:06:14.080 They believed they'd found a regulatory loophole that would allow 0:06:14.120 --> 0:06:16.320 them to sell to anyone with a credit card and 0:06:16.360 --> 0:06:21.200 sufficient risk tolerance. Like most prescription drugs, peptides aren't controlled 0:06:21.240 --> 0:06:25.760 substances that are inherently illegal to possess, but federal regulations 0:06:25.760 --> 0:06:29.159 govern what constitutes permissible trade depending. 0:06:28.720 --> 0:06:30.160 Who the buyers and sellers are. 0:06:30.800 --> 0:06:33.560 In particular, the sale of the raw materials used to 0:06:33.600 --> 0:06:36.520 make them isn't nearly as closely scrutinized as the sale 0:06:36.520 --> 0:06:39.839 of finished prescription drugs. As long as those raw materials 0:06:39.839 --> 0:06:42.640 are destined for use in a lab for research instead 0:06:42.680 --> 0:06:46.800 of in humans and animals, Sellers slapped for research use 0:06:46.880 --> 0:06:50.160 only on their websites and began filling orders for sometimes 0:06:50.279 --> 0:06:54.080 dozens of kinds of APIs, not only the controversial ones, 0:06:54.320 --> 0:06:57.240 but also those found in ozempic and zep bound, which 0:06:57.240 --> 0:06:59.640 appealed to millions of consumers. 0:06:59.000 --> 0:07:00.479 Desperate for the price use drugs. 0:07:01.120 --> 0:07:03.479 There's still really no way to know that your product 0:07:03.520 --> 0:07:06.320 is what even the testing company says it is unless 0:07:06.320 --> 0:07:09.840 you take it yourself, says a founder of Compound Sciences, 0:07:10.120 --> 0:07:12.520 a peptide site in Utah that's been around for less 0:07:12.560 --> 0:07:14.560 than a year, who asked not to be named so 0:07:14.600 --> 0:07:18.480 they could speak candidly. And you know, our families are 0:07:18.520 --> 0:07:22.040 on all of this product. He maintains that his business 0:07:22.080 --> 0:07:26.000 is careful to adhere to federal regulations around allowable marketing 0:07:26.040 --> 0:07:29.440 and packaging practices for research use API, which is where 0:07:29.480 --> 0:07:33.440 most sellers air. Interest in these substances has spread to 0:07:33.480 --> 0:07:37.400 the mainstream, and peptides are now commonly discussed online as 0:07:37.400 --> 0:07:41.600 treatment options for sagging skin and arthritis, pitched to menopausal 0:07:41.640 --> 0:07:44.560 suburban moms and offered to clients at a growing number 0:07:44.640 --> 0:07:47.720 of medspas as a casual add on to a botox 0:07:47.800 --> 0:07:52.000 touch up. Black markets, that is, sustained trade in goods 0:07:52.000 --> 0:07:54.880 that violate the law in some way are by nature 0:07:54.920 --> 0:07:58.640 difficult to measure, but there's plenty of evidence of increasing demand. 0:07:59.360 --> 0:08:02.440 There are so many many peptide sellers sending Yanoshik samples 0:08:02.440 --> 0:08:05.040 that from twenty twenty three to twenty twenty five, the 0:08:05.120 --> 0:08:08.800 volume of peptide tests the company processed increased more than 0:08:08.840 --> 0:08:12.960 twelve hundred percent, according to data it shared with Bloomberg BusinessWeek, 0:08:13.440 --> 0:08:16.160 during the first nine months of twenty twenty five, US 0:08:16.240 --> 0:08:19.240 Customs and Border Protection logged three hundred and twenty eight 0:08:19.320 --> 0:08:24.040 million dollars in active pharmaceutical ingredient imports for peptides, twice 0:08:24.080 --> 0:08:26.720 the amount imported during the same period the previous year. 0:08:27.040 --> 0:08:30.520 According to The New York Times, this included both material 0:08:30.640 --> 0:08:33.400 making its way to compound pharmacies for illegal use in 0:08:33.440 --> 0:08:38.640 medications and raw material headed to mercier destinations, but that 0:08:38.760 --> 0:08:42.079 number is likely just a fraction of the total. Importers 0:08:42.120 --> 0:08:46.920 increasingly employ more evasive maneuvers to skirt detection by customs officials, 0:08:47.480 --> 0:08:50.000 and that logged dollar amount is only the value of 0:08:50.040 --> 0:08:53.680 the imported raw material, which costs most large importers a 0:08:53.720 --> 0:08:56.640 few dollars per file, compared with the fifty dollars to 0:08:56.679 --> 0:09:00.200 three hundred dollars consumers are paying. The Compound signed Ens 0:09:00.360 --> 0:09:03.400 co founder says his company is a small business, bringing 0:09:03.400 --> 0:09:05.960 in about one hundred thousand dollars in revenue per month, 0:09:06.360 --> 0:09:09.200 with about half of that being profit that's. 0:09:09.080 --> 0:09:10.640 Purely from personal referrals. 0:09:10.679 --> 0:09:14.920 He says Compound Sciences doesn't buy ads or work with influencers, 0:09:15.440 --> 0:09:18.160 noting that he knows of larger operations that he believes 0:09:18.200 --> 0:09:20.520 bring in as much as two million dollars per month 0:09:20.559 --> 0:09:24.280 in gross sales. Investors within the industry say the black 0:09:24.320 --> 0:09:28.439 market is anywhere from one to three billion dollars. Now, 0:09:28.559 --> 0:09:32.520 this already booming economy is preparing to emerge from the shadows. 0:09:33.040 --> 0:09:36.160 Under instruction from US Secretary of Health and Human Services 0:09:36.480 --> 0:09:40.560 and self professed peptide fan Robert F. Kennedy Junior, an 0:09:40.679 --> 0:09:44.240 FDA committee is expected to recommend that seven peptides be 0:09:44.280 --> 0:09:47.440 added to the list of substances available for legal use 0:09:47.480 --> 0:09:50.960 in compounding pharmacies, with another five to be considered for 0:09:51.000 --> 0:09:54.560 inclusion by early twenty twenty seven. Such a move would 0:09:54.559 --> 0:09:57.800 help clear the way for compounding pharmacies to fill prescriptions 0:09:57.800 --> 0:10:00.800 of these medications, which, as Kennedy said in an ex 0:10:00.880 --> 0:10:04.280 post in April, would divert demand away from a dangerous 0:10:04.320 --> 0:10:08.040 black market that puts Americans at risk. It would also 0:10:08.200 --> 0:10:11.440 make a number of hyped peptides that lack rigorous scientific 0:10:11.480 --> 0:10:13.959 backing and that could have side effects. 0:10:13.559 --> 0:10:15.439 As risky as severe allergic. 0:10:15.040 --> 0:10:18.560 Reactions, liver or kidney damage, and sped up tumor growth 0:10:18.960 --> 0:10:22.720 much more palatable to the buying public. In some ways, 0:10:22.800 --> 0:10:25.560 this would be a shocking turn of events, upending the 0:10:25.559 --> 0:10:28.319 system of drug development and regulation in the US as 0:10:28.320 --> 0:10:30.920 we know it. In other ways, it's just the most 0:10:30.960 --> 0:10:34.120 recent step in the long march toward a fully consumerized 0:10:34.120 --> 0:10:38.400 healthcare system in which customers transact directly with companies marketing 0:10:38.440 --> 0:10:43.520 medications with limited interference from peski doctors and regulators, along 0:10:43.520 --> 0:10:46.600 with entrepreneurs and investors getting in position to cash in. 0:10:47.000 --> 0:10:51.199 Many existing healthcare workers stand to profit from swelling consumer demand. 0:10:51.679 --> 0:10:57.720 Telehealth companies, compounding pharmacies, medspas, testing labs, Chinese drug manufacturers. 0:10:58.520 --> 0:11:02.600 There's one industry, though, that's been caught flat footed, big pharma. 0:11:03.040 --> 0:11:06.120 It's responsible both for the peptide consumer craze and the 0:11:06.160 --> 0:11:09.240 original development of almost all of the drugs now popular 0:11:09.280 --> 0:11:13.320 on the black market. For traditional pharmaceutical companies. The growing 0:11:13.360 --> 0:11:17.239 popularity of these peptides threatens to siphon off potential customers 0:11:17.520 --> 0:11:21.040 and undermined incentives to invest in costly clinical research and 0:11:21.120 --> 0:11:25.920 drug development. Meanwhile, entrepreneurs like Nathan Gravell, the chief executive 0:11:25.960 --> 0:11:30.200 officer of longevity telehealth platform Jevity Health, are getting ready 0:11:30.240 --> 0:11:34.120 to pounce. Our pharmacy partners are already preparing for these 0:11:34.160 --> 0:11:34.760 to be legal. 0:11:35.080 --> 0:11:36.800 The twenty seven year old says. 0:11:37.000 --> 0:11:39.480 They are pre planning for a lot of volume, a 0:11:39.520 --> 0:11:43.839 lot of demand. Christy Turner is not a hobbyist, bodybuilder, 0:11:43.960 --> 0:11:47.199 or an aspiring wellness influencer or someone with a deep 0:11:47.240 --> 0:11:51.920 distrust of mainstream medicine. She's a therapist in suburban Indianapolis 0:11:51.920 --> 0:11:54.679 with a husband and two grown kids, and she's been 0:11:54.679 --> 0:11:57.079 trying to lose weight for as long as she can remember. 0:11:57.720 --> 0:12:00.440 In May twenty twenty four, Turner took her her first 0:12:00.559 --> 0:12:04.640 dose of Eli Lilly's zepbound a GLP one and felt 0:12:04.640 --> 0:12:07.839 her life change within a matter of hours. We were 0:12:07.840 --> 0:12:10.640 going with my son and his fiancee to dinner, and 0:12:10.679 --> 0:12:13.360 that was five hours later, and I realized the food 0:12:13.400 --> 0:12:17.240 noise was gone. She describes it as a magical experience. 0:12:17.280 --> 0:12:21.400 That since helped her lose almost two hundred pounds. Turner 0:12:21.440 --> 0:12:24.800 began taking zepbound after becoming a patient at Mochi Health, 0:12:25.040 --> 0:12:28.120 a San Francisco telehealth startup founded in twenty twenty two, 0:12:28.600 --> 0:12:32.160 a boom time for online medical startups thanks to the pandemic, 0:12:32.200 --> 0:12:36.000 loosened regulations, and a spike in demand for ozempic prescriptions. 0:12:36.520 --> 0:12:40.080 At Mochi, Turner met doctor Laura Rice, a functional medical 0:12:40.080 --> 0:12:45.120 practitioner and osteopath, who prescribed that first dose. Eventually, Turner 0:12:45.200 --> 0:12:48.360 canceled her Mochi subscription and continued to see Rice at 0:12:48.360 --> 0:12:49.840 her independent practice. 0:12:50.240 --> 0:12:52.040 I followed her like a little groupie. 0:12:52.080 --> 0:12:54.760 Turner says, she's the one who's opened the world of 0:12:54.800 --> 0:12:58.959 peptides to me to help with post weight loss skin sagging. 0:12:59.320 --> 0:13:03.959 Rice recommended Turner take ghkcu, a peptide the FDA has 0:13:04.000 --> 0:13:08.000 excluded from compounding in its injectable form. Turner is also 0:13:08.040 --> 0:13:12.840 on glutathione, a legal peptide for its purported immune boosting properties, 0:13:13.200 --> 0:13:15.520 which she first heard about after joining a live stream 0:13:15.559 --> 0:13:17.800 with Rice, who said it was a favorite among her 0:13:17.800 --> 0:13:21.400 other patients. My boys are twenty two and nineteen, and 0:13:21.480 --> 0:13:24.640 they make fun of me. Turner says, they're like you're 0:13:24.640 --> 0:13:28.760 turning into a gem bro. You're getting your stacks. Doctors 0:13:28.760 --> 0:13:32.120 who are willing to recommend restricted peptides to patients are 0:13:32.200 --> 0:13:37.360 usually in specialties functional and integrative medicine, longevity, anti aging 0:13:37.760 --> 0:13:40.400 that offer a broad range of therapies lacking in a 0:13:40.480 --> 0:13:44.600 rigorous scientific backing. Depending on the doctor, that can include 0:13:44.640 --> 0:13:48.959 relatively uncontroversial treatments such as acupuncture or massage, as well 0:13:49.000 --> 0:13:53.920 as more esoteric options like complex protocols of nutritional supplements. 0:13:53.520 --> 0:13:54.720 Or energy healing. 0:13:55.400 --> 0:13:58.480 I got out of mainstream medicine because I was very disillusioned. 0:13:58.679 --> 0:14:02.280 Rice says, though she still commonly prescribes statins and other 0:14:02.400 --> 0:14:06.240 FDA approved medications at her own practice, she has more 0:14:06.280 --> 0:14:09.600 latitude in how much regulatory and scientific risks she's willing 0:14:09.640 --> 0:14:13.280 to offer to patients, including through peptides that aren't supposed 0:14:13.320 --> 0:14:16.720 to be available from compounding pharmacies. She's been able to 0:14:16.760 --> 0:14:20.680 find willing compounders for the forbidden drugs anyway, including for 0:14:20.760 --> 0:14:24.080 Turner's GHKCU, which Rice is able to get from a 0:14:24.080 --> 0:14:28.000 pharmacy in Texas. The potential risk is a little bit scary, 0:14:28.160 --> 0:14:31.560 Turner admits, but she trusts her doctor to keep her safe. 0:14:31.840 --> 0:14:35.120 Doctor Rice does her research. As Rice sees it, her 0:14:35.200 --> 0:14:38.320 role is twofold to help patients in ways she doesn't 0:14:38.320 --> 0:14:41.720 think mainstream medicine can, and to blunt the safety risks 0:14:41.760 --> 0:14:44.440 that some of them are already taking after trying treatments 0:14:44.440 --> 0:14:47.760 they've heard about on Reddit or TikTok. The hard part 0:14:47.800 --> 0:14:50.680 is patients are asking for these medicines because they're seeing 0:14:50.720 --> 0:14:54.120 them online, but as physicians, we're carrying all the risk, 0:14:54.560 --> 0:14:58.040 Rice says, though she and her practice also actively promote 0:14:58.080 --> 0:15:02.840 the use of these drugs online. We're carrying sourcing sterility, potency, 0:15:03.200 --> 0:15:07.440 informed consent, state board scrutiny, malpractice. I mean, it's a 0:15:07.520 --> 0:15:11.400 huge risk, but I've also taken that risk conservatively, and 0:15:11.520 --> 0:15:14.040 probably only a small percentage of my patients are on 0:15:14.120 --> 0:15:17.920 some of the more gray area peptides. She mentions BPC 0:15:18.160 --> 0:15:22.720 one fifty seven for musculoskeletal healing, which is incredibly popular 0:15:22.760 --> 0:15:26.800 online and listed prominently on her practice's website, though it's 0:15:26.840 --> 0:15:30.520 banned from compounding pharmacies and there's almost no clinical research 0:15:30.560 --> 0:15:33.920 showing its safety or efficacy in humans. I've used that 0:15:33.960 --> 0:15:36.960 for patients, she says, is the data there to support 0:15:37.000 --> 0:15:41.960 it absolutely not. Among rice's patients taking BPC one fifty 0:15:41.960 --> 0:15:45.120 seven is Hassan Slayman, a forty five year old roofing 0:15:45.200 --> 0:15:49.400 contractor in Michigan. Slayman didn't know much about peptides, but 0:15:49.480 --> 0:15:51.960 he'd begun to worry about his health after spending much 0:15:52.000 --> 0:15:54.600 of his life ignoring it. He smoked about a pack 0:15:54.640 --> 0:15:57.320 and a half of cigarettes a day, and before construction, 0:15:57.560 --> 0:15:59.920 he'd spent years working as a bouncer and a fourty, 0:16:00.960 --> 0:16:02.960 all of which had taken a toll on his body. 0:16:03.600 --> 0:16:07.240 Nine previous surgeries and other nagging injuries kept him in pain. 0:16:07.840 --> 0:16:10.960 He found RICE through his best friend, whose transformation under 0:16:10.960 --> 0:16:14.680 the doctor he says has been incredible. Slayman's has Rice 0:16:14.720 --> 0:16:18.320 started him on terzepetide, the active ingredient in zep bound, 0:16:18.600 --> 0:16:21.440 as well as BPC one fifty seven, and he felt 0:16:21.440 --> 0:16:24.480 pretty good, even though he hadn't really changed his habits. 0:16:24.520 --> 0:16:27.920 More broadly, Now, he says he's on a stack of 0:16:28.000 --> 0:16:33.359 seven peptides, terzepetide and BPC one fifty seven, plus MOTSC 0:16:33.720 --> 0:16:39.040 for collagen production, glutethione for detoxification, and TB five hundred 0:16:39.240 --> 0:16:44.560 KPV and GHKCU for old injuries and skin quality. With 0:16:44.640 --> 0:16:48.160 the exceptions of terzepetide and gluetethione, all these drugs are 0:16:48.200 --> 0:16:53.040 currently banned from use in injectable medications by US compounding pharmacies. 0:16:53.560 --> 0:16:56.680 Slayman says he feels incredible and his health has improved 0:16:56.800 --> 0:16:59.240 enough to make his work less painful and running after 0:16:59.320 --> 0:17:02.560 his nine year old more fun. He started carrying around 0:17:02.680 --> 0:17:05.480 Rice's business cards so that when people ask what he's doing, 0:17:05.560 --> 0:17:08.080 he can send them her way. He likens it to 0:17:08.119 --> 0:17:11.080 the way he promotes his faith. Why would he gatekeep 0:17:11.160 --> 0:17:14.320 something that can help people? Most people don't even know 0:17:14.359 --> 0:17:18.760 where to start, he says. For many patients, feeling comfortable 0:17:18.800 --> 0:17:23.600 injecting a dubiously sourced medication at home didn't just materialize overnight. 0:17:24.359 --> 0:17:28.400 Often it starts with safe, legal, legitimately prescribed, and extremely 0:17:28.400 --> 0:17:33.639 effective medications. The GLP one's. They pulled the entire peptide 0:17:33.640 --> 0:17:37.200 market up there along with them, says Magic, the Janoshik founder. 0:17:37.680 --> 0:17:40.760 Some twelve percent of Americans are taking a GLP one, 0:17:41.040 --> 0:17:44.920 according to a recent survey from the health policy organization KFF. 0:17:45.359 --> 0:17:48.120 Helping convince millions of users and the many people who've 0:17:48.119 --> 0:17:51.000 watched their transformation that the key to health, beauty, and 0:17:51.080 --> 0:17:55.000 longevity might come in a syringe. The widespread use of 0:17:55.040 --> 0:17:58.919 cosmetic injectables such as botox and lip filler, now easily 0:17:59.000 --> 0:18:02.399 jabbed at a StripMap medspa near you, has bolstered the 0:18:02.400 --> 0:18:05.560 belief that injectable drugs are an easy, low risk option 0:18:05.720 --> 0:18:10.320 providing quick, visible results. Pursuit of GLP ones and the 0:18:10.359 --> 0:18:14.600 insurance denials, high cash prices, shortages, and prescribing restrictions that 0:18:14.640 --> 0:18:17.800 have commonly come with them have also pushed patients toward 0:18:17.880 --> 0:18:21.760 medical practitioners and drug sources they might have previously issued, 0:18:22.359 --> 0:18:25.280 or maybe hadn't even heard of. Patients turned to the 0:18:25.280 --> 0:18:28.199 Internet for guidance on how to find better prices, just 0:18:28.240 --> 0:18:31.120 like they do with everything else they buy. Wherever they 0:18:31.119 --> 0:18:35.919 look for advice, Reddit, Instagram, TikTok, Facebook groups, people are 0:18:35.960 --> 0:18:39.080 ready to guide them to the black market. For patients 0:18:39.080 --> 0:18:41.600 who arrive in these corners of the Internet where cheap 0:18:41.800 --> 0:18:46.040 research chemicals proliferate, it can feel like alice going through 0:18:46.040 --> 0:18:49.480 the looking glass. What if that thirteen hundred dollars medication 0:18:49.600 --> 0:18:53.440 you desperately needed was really cheap all along? Why hadn't 0:18:53.440 --> 0:18:56.639 anyone told you the truth. It's not a coincidence that 0:18:56.680 --> 0:19:00.000 some of the most vocal research peptide users, though far 0:18:59.880 --> 0:19:02.800 from all of them, are vaccine skeptics who think that 0:19:02.960 --> 0:19:07.840 common immunizations lack sufficient scientific evidence. As these users see it, 0:19:08.160 --> 0:19:10.720 vaccines and other things are foisted upon them by the 0:19:10.760 --> 0:19:15.600 government and big pharma in pursuit of control and profit. Peptides, meanwhile, 0:19:15.720 --> 0:19:18.400 are the secret key to free your personal health from 0:19:18.440 --> 0:19:25.080 institutional control. Those buying research grade chemicals effectively become impromptu pharmacists, 0:19:25.320 --> 0:19:28.479 a job most are not qualified to do. They have 0:19:28.520 --> 0:19:32.680 to turn powdered active ingredients into injectable drugs, which requires 0:19:32.760 --> 0:19:37.840 reconstituting them with bacteriostatic water, itself a sterile prescription product 0:19:37.840 --> 0:19:42.119 that customers are sourcing bootleg versions of online. Powders are 0:19:42.160 --> 0:19:46.000 sold by weight, but dosages are measured in volume. That 0:19:46.080 --> 0:19:48.840 means users who want to experiment need to understand how 0:19:48.880 --> 0:19:51.439 to combine the powdered and liquid ingredients to make a 0:19:51.480 --> 0:19:55.359 particular concentration, which some brands of syringes will then measure 0:19:55.359 --> 0:19:58.919 in milli liters, while others simply show units About a 0:19:59.000 --> 0:20:02.280 year ago new the patients of the telehealth platform ivim 0:20:02.400 --> 0:20:05.600 Health began showing up to their intake appointments mentioning that 0:20:05.640 --> 0:20:09.640 they were on reta truetide, Lily's new unapproved GLP one 0:20:09.720 --> 0:20:13.040 that in research use form is now the most popular 0:20:13.119 --> 0:20:16.880 drug among peptide buyers. When asked how much they were taking, 0:20:17.119 --> 0:20:20.760 they had no idea. When we're on those video conferences 0:20:20.800 --> 0:20:23.879 with patients, will ask them like show us the vial 0:20:24.000 --> 0:20:28.080 and show us the injection instructions, says Taylor Canter, ivem's 0:20:28.080 --> 0:20:31.520 co founder and chief medical officer. Usually they just have 0:20:31.640 --> 0:20:36.000 the vile shipping research peptides with instructions for dosage and injection. 0:20:36.119 --> 0:20:39.199 After all, would risk sellers acknowledging that they're selling to 0:20:39.240 --> 0:20:43.679 individual patients for human use. The regulatory changes the FDA 0:20:43.880 --> 0:20:46.840 is considering would be the first step in moving access 0:20:46.880 --> 0:20:50.399 to at least some of these substances into compounding pharmacies, 0:20:50.680 --> 0:20:52.840 which would reduce some of the risks that come with 0:20:52.920 --> 0:20:57.840 consumers acting as kitchen table chemists. Because retaitrutide is currently 0:20:57.880 --> 0:21:02.160 in phase three clinical trials, it wouldn't be included. Compounders 0:21:02.200 --> 0:21:06.119 operate licensed, state regulated, and sterile facilities that would ship 0:21:06.160 --> 0:21:09.600 peptides in ready to inject vials of liquid that include 0:21:09.720 --> 0:21:13.479 dosing and injection instructions. These kinds of pharmacies have been 0:21:13.520 --> 0:21:16.480 around as long as doctors have been writing prescriptions, but 0:21:16.560 --> 0:21:20.200 the COVID nineteen era boom in telehealth usage and massive 0:21:20.240 --> 0:21:23.760 shortages of name brand GLP ones suddenly put them front 0:21:23.760 --> 0:21:27.720 and center with consumers. You saw one telehealth company run 0:21:27.720 --> 0:21:31.800 a Super Bowl ad advertising compounded drugs, says Scott Brunner, 0:21:32.080 --> 0:21:35.560 a pharmacist and the CEO of the Alliance for Pharmacy Compounding, 0:21:35.840 --> 0:21:38.719 a US trade group, that would have been unheard of 0:21:38.800 --> 0:21:42.160 ten years ago. As a result, many of the country's 0:21:42.240 --> 0:21:46.159 thousands of licensed compounders have dramatically expanded their capacity to 0:21:46.200 --> 0:21:48.240 make peptides in the past few years. 0:21:49.080 --> 0:21:50.200 Although the vast. 0:21:49.920 --> 0:21:54.360 Majority of compounding pharmacies won't touch the currently unpermitted peptides, 0:21:54.600 --> 0:21:58.000 some of them, including those rice sources from for patients, 0:21:58.240 --> 0:22:01.520 have continued to fill prescriptions for the drugs anyway, even 0:22:01.600 --> 0:22:05.119 after the Biden era changes reinforced that they weren't authorized 0:22:05.160 --> 0:22:08.399 to do so. Now that there's a peptide friendly administration 0:22:08.480 --> 0:22:12.200 in the White House, some pharmacies and practitioners alike, especially 0:22:12.240 --> 0:22:15.639 those in red states, appear even more comfortable gambling that 0:22:15.760 --> 0:22:19.760 regulatory clearance is more likely than targeted enforcement for those 0:22:19.760 --> 0:22:21.560 who get into the peptide business. 0:22:21.320 --> 0:22:22.159 A little bit early. 0:22:22.720 --> 0:22:26.240 Among prescribers, the practice has become so widespread that in 0:22:26.320 --> 0:22:29.840 early June, the Alabama Board of Medical Examiners issued an 0:22:29.880 --> 0:22:34.119 official notice warning the state's practitioners that prescribing or recommending 0:22:34.240 --> 0:22:38.760 research grade medications is prohibited by law, even if patients 0:22:38.800 --> 0:22:41.919 sign a waiver advising them of the risks. That some 0:22:42.200 --> 0:22:45.720 compounders already demonstrated a willingness to play fast and loose 0:22:45.760 --> 0:22:48.360 with the rules during the heady days of the GLP 0:22:48.480 --> 0:22:52.240 one boom, worries Brunner, the Pharmacy Trade Group head, about 0:22:52.280 --> 0:22:55.680 what might be ahead. There are telehealth platforms that are 0:22:55.680 --> 0:22:58.879 members of our organization and our model citizens, but there 0:22:58.920 --> 0:23:01.800 are some that you know they didn't exist in twenty 0:23:01.840 --> 0:23:06.159 twenty three, He says, I'm concerned about that kind of opportunism, 0:23:06.480 --> 0:23:09.879 which I suspect in a universe where these peptides are authorized, 0:23:10.160 --> 0:23:14.840 will repeat itself. We'll be right back with Caveat injector. 0:23:17.680 --> 0:23:22.040 Welcome back to Caveat injector. Tucked away at the back 0:23:22.080 --> 0:23:24.680 of a cafe at a five star hotel in London's 0:23:24.760 --> 0:23:25.840 ritzy Notting Hill. 0:23:26.400 --> 0:23:28.240 Mansi Houkmani is fresh from. 0:23:28.080 --> 0:23:31.399 The gym and sipping on carrot juice. The Belize native 0:23:31.480 --> 0:23:33.880 moved to London about six months ago after a stint 0:23:33.960 --> 0:23:36.240 in New York, but it's hard to say where she'll 0:23:36.240 --> 0:23:39.159 be on any given day. She travels back to the 0:23:39.280 --> 0:23:42.600 US frequently and flits between far flung locales such as 0:23:42.680 --> 0:23:45.879 Dubai and Panama at the behest of her clients. About 0:23:45.880 --> 0:23:48.040 a year and a half ago, after leaving her career 0:23:48.119 --> 0:23:52.119 developing branding and growth strategies for tech startups, she started 0:23:52.160 --> 0:23:57.520 a wellness focused substack newsletter called Chief Longevity Officer. It 0:23:57.560 --> 0:24:00.439 didn't take long for something she'd written about pepti to 0:24:00.440 --> 0:24:03.600 make the rounds. I started getting invited a lot to 0:24:03.640 --> 0:24:07.320