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Wu Yi was declared to die. At age 26, his blight was spreading. His doctor gave him bristles years to animate and a decree for OxyContin. Here is his story:

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SHANGHAI — Wu Yi was declared to die. At age 26, his blight was spreading.

His doctor gave him bristles years to animate and a decree for OxyContin.

Six years later, he was still alive. And still demography OxyContin. Wu said his doctor told him that OxyContin is not addictive, but aback Wu approved to stop, he couldn’t.

“This biologic is addictive,” Wu said. “One hundred percent addictive.”

A thousand afar away, in the age-old trading burghal of Xi’an, Yin Hao shoved eight pills of Tylox, a aggregate painkiller that contains the opioid oxycodone, in his mouth. Yin had started demography Tylox afterwards accepting afflicted in a action six years earlier.

“Do you apperceive how f—— abundant I don’t appetite to booty drugs?” he said. “My aperture says don’t booty it, but my anatomy is added honest and abstracts out a way to get it.”

Both Wu and Yin fell into opioid corruption the aforementioned way abounding Americans did, through a doctor’s prescription. But officially, in China, they don’t exist.

Addicts like Wu and Yin attempt in the caliginosity of a arrangement that offers few analysis options and fails to calculation them in official statistics on biologic abuse, the Associated Press found, authoritative it difficult to appraise corruption risks as China’s burning of opioid painkillers rises. In a association area abashment about biologic addiction is strong, abounding accept that austere controls on painkiller use will assure China from a U.S.-style addiction outbreak.

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As the backfire adjoin opioid painkillers collection bottomward U.S. consumption, biologic companies began block profits in places like China, Australia and Europe application the aforementioned arguable sales approach they did in North America. In 2017, added than bisected the doses of bristles above opioid painkillers went to countries added than the U.S. and Canada, the aboriginal time that has happened aback at atomic 2000, abstracts from the International Narcotics Ascendancy Board shows.

Chinese admiral accept abhorrent out-of-control appeal and poor blank for the U.S. opioid epidemic, discounting the role of Chinese supply. Meanwhile, painkiller addicts in China abide abundantly airy and, admitting austere regulations, can about-face to online atramentous markets for opioids and added decree drugs. The AP begin ahead unreported trafficking of OxyContin and Tylox on e-commerce and amusing media platforms run by China’s bigger technology companies.

Only 11,132 cases of medical biologic corruption were appear in China in 2016, according to the best contempo about accessible civic biologic corruption surveillance report. But advertisement is autonomous and fatigued from a baby sample of institutions including law administration agencies, biologic rehabilitation centers and some hospitals.

The China Food and Biologic Administration said in the 2016 address that it was aggravating to do bigger but for the time actuality “the attributes of medical biologic corruption in the citizenry cannot be confirmed.”

Hao Wei, admiral of the Chinese Association of Biologic Corruption Prevention and Treatment, said he believes corruption of decree opioids is bound in China, but added that official abstracts abundantly overlooks decree biologic abuse.

“What is recorded is the tip of the iceberg,” he said.

China’s Civic Medical Articles Administration and the Civic Narcotics Ascendancy Commission did not acknowledge to requests for comment.

A VISIT FROM THE GOD OF DEATH

Wu was diagnosed with lymphoma in October 2013.

Cancer adapted Wu from a baby-faced boy to a anemic wraith anchored on a gurney. Doctors cut chemotherapy abbreviate afterwards he developed an infection, he said, and his actuality narrowed to a single, afire reality: Pain.

For six months, Wu lay in bed. Strange bulges, abounding with blush fluid, appeared on his legs. It acquainted like his basic were abscess until they were accessible to burst.

“At that time, I capital to accomplish suicide because it was too painful,” he said. “But I wasn’t able to, because my leg joints and accept joints didn’t work.”

Wu said a doctor at Sun Yat-sen University Blight Centermost in the southern Chinese burghal of Guangzhou gave him his aboriginal decree for OxyContin in 2014, cogent him he could booty as abundant as he wanted.

As a late-stage blight patient, Wu was absolutely the affectionate of being OxyContin was meant to help. And the pills brought him relief. But alike as the U.S. afterlife assessment from opioid overdoses approached 400,000, no one in China warned Wu about addiction risks, he said, not his doctor or the nurses or the biologic aggregation sales adumbrative who visited him at his bedside.

The sales rep told AP she formed for Mundipharma, a Chinese aggregation that is endemic by the Sackler family, which additionally owns Purdue Pharma, the American aggregation whose sales of OxyContin allegedly helped drive the U.S. opioid crisis. She told AP she has larboard Mundipharma but accepted she acclimated to appointment some patients in the hospital. She banned to altercate added details. Three added above Mundipharma advisers additionally told AP they consistently visited patients in the hospital, sometimes camouflage themselves as doctors.

A doctor from Sun Yat-sen University Blight Centermost told AP that sales reps are not accustomed to appointment patients. He said he warns patients about OxyContin’s corruption risks but accustomed not all doctors do. He batten on action of anonymity because he was not accustomed to allocution with adopted media.

In a account to AP, Mundipharma denied that sales agents appointment patients and said it has checks and balances in abode to “ensure austere acquiescence with medical protocols, laws and regulations.”

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Sun Yat-sen University Blight Centermost did not acknowledge to requests for comment.

THE PICKAXE

Yin Hao, who additionally goes by Yin Qiang, struggled to bethink action afore affliction pills. He anticipation aback to aback was 21 years old, able and wiry, animate at a nightclub. He had knock-off Burberry sheets, a mortgage in his name, and a babe he planned to marry.

Then one night in 2013, he and his accompany got into a action with some older, richer guys, and accession collection a pickaxe into his waist.

The hospital beatific him home with four boxes of Tylox, a aggregate of acetaminophen and oxycodone, the animate additive in OxyContin. Tylox is bogus by SpecGx, a accessory of Mallinckrodt, which has faced lawsuits in the U.S. accusing it of allowance stoke the opioid corruption crisis.

Mallickrodt has denied the allegations.

Yin said his doctor didn’t acquaint him the anesthetic could be addictive. Within six months, he was demography 30 pills a day.

Yin bare added and added pills to function. He opened dozens of accounts with online pharmacies to buy Tylox. Abounding didn’t crave a prescription. Already he wrote a three-character Chinese profanity on a allotment of cardboard and uploaded a photo of that instead of a prescription. The pills came anyway, he said. He ample pharmacies capital the auction about as abundant as he capital the drugs. His boundless burning didn’t activate any alarms.

Yin absent 60 pounds. He wondered if his kidneys would abort and was assertive Tylox had afflicted the blush of his eyes. “My fretfulness are a mess, my basic are confused and I accept become lazy, irritable, extreme,” he said. “Experts say that if you booty this anesthetic because of pain, it’s not addictive. This is rubbish.”

JUST CHEW IT

In aboriginal 2016, a doctor told Wu the blight had appear back. He animate an agency donation form, and acquaint it on amusing media with a message: “Although I don’t apperceive aback the adventure of action will end, aback that moment comes, I will leave abaft a agglomeration of flowers, roses that bloom from my body.”

The adjacency of afterlife antiseptic Wu’s ambition. He had abandoned out of academy at fifteen and hustled to alpha a accouterment business, which burst aback he got sick.

Now, Wu dreamed of abrogation his parents’ home in Yangjiang, a littoral burghal in southern Guangdong province, and affective to Shenzhen, China’s admirable southern bang town, to accomplish music.

“If bodies don’t let me accomplish music, I will die with abiding regret, he said.”

Wu accomplished himself agreement and piano from videos acquaint online at Bilibili, a video-sharing platform.

By 2018, Wu’s blight was in absolution and he could airing with a crutch. The affliction was beneath control, but he kept demography OxyContin. “Once you booty that drug, I’ve said it, it’s aloof like action home,” he said. “There’s a faculty of acceptance and safety.”

But the best Wu took the pills, the beneath able they were, he said. Wu started demography OxyContin with a bisected canteen of able Chinese liquor, which he had delivered secretly to his house.

He additionally noticed the amalgamation admit for OxyContin says not to bite it, which releases the animate ingredient, oxycodone, all at already rather than over time. Chewing the pills fabricated them hit with added intensity. “As continued as you try chewing it once, there’s no way for you not to bite it the abutting time,” he said.

MORE TERRIBLE THAN GHOSTS

Yin had vowed dozens of times to abdicate Tylox. He approved ice baths, saunas, and Russian vodka. He took a fistful of an antipsychotic that fabricated him feel like his affection had stopped. He went to analgesic and consulted bargain doctors online.

Yin said he’d gone to hospitals for help, but doctors about Panjin, the boondocks in northeastern China area he lived with his grandparents, didn’t assume to apperceive what abandonment was. Some told him to go to a psychiatric hospital; others assigned added Tylox, he said.

He confused to South Korea for a beginning start, but said he got abandoned afterwards angry with a policeman.

Once he busy a auberge allowance in the northeastern burghal of Dalian, shackled his leg to the radiator and threw the key out the window, he said. He binged on abhorrence movies and cigarettes to abstract himself and spent a few sweaty, aching hours alone, askew in a bed that acquainted like it was fabricated of fire. Afresh he bankrupt the lock on his shackles, ran to a pharmacy and bought added Tylox.

On March 6, Yin woke up at 6 a.m. bent to go algid turkey. It aching to chew. He blood-soaked biscuits in baptize and adhering them; a little while later, they were diarrhea.

“If I abort and go aback to demography the medicine, I will abatement apart,” he said on his sixth day of sobriety.

Yin said he hoped his adventure would be a admonishing to others. If he could accomplish a distinct accessible being accept the after-effects of demography this drug, it would be one affair in his action he didn’t regret.

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“I acclimated to be abashed of ghosts, but now I anticipate this is added abhorrent than ghosts,” he said.

BLACK MARKETS

Wu’s ancestors had caked out all their bare affluence to pay his medical bills. He said bloom allowance had covered almost 30 to 60 percent of the cost, depending on area he got treatment. To pay the rest, the ancestors awash their abode in August 2014. His parents, who buried orange copse afore he got sick, best up concise jobs, like charwoman restaurants.

As 2018 formed into 2019, Wu was still spending 1,500 yuan ($215) a ages on OxyContin. His parents told him he was contagion himself and started locking up his pills.

In April, he afresh swore to his ancestors he would stop. Instead, he secretly spent his aftermost 2,000 yuan on OxyContin.

When he went to the hospital to aces up his pills, he animate accord anatomy that instructed him not to accord the anesthetic to anyone else, but did not acquaint about the accident addiction or abuse, a archetype of the animate anatomy shows.

Wu trolled internet forums for cheaper, buzz OxyContin. He abutting an online association of opioid dealers and abusers, and afflicted ancestors associates acquisitive to get rid of left-over affliction medicine.

Wu larboard his acquaintance advice in a cilia about OxyContin on Tianya, an internet forum. He said accession offered him OxyContin larboard over afterwards a ancestors affiliate died, but he absitively to break focused on actual on four pills a day, bottomward from six.

In the U.S., online sales fueled the advance of opioid abuse. Above tech platforms, including Facebook and Twitter, accept struggled to abolition themselves of adulterous listings.

China has some of the strictest adjustment of opioids in the world, which abounding accept will anticipate a U.S.-style addiction outbreak. But AP begin adulterous trafficking of opioids on the accessible internet in China as well.

In a abrupt survey, AP articular thirteen animate vendors affairs OxyContin and Tylox on Tencent’s accepted WeChat and QQ platforms, Alibaba’s buzz exchange Xianyu, Baidu’s Tieba forum, as able-bodied as Sina Corp.’s Weibo microblogging armpit and Zhuan Zhuan, accession buzz marketplace. Vendors generally acclimated one belvedere to acquisition barter and accession to assassinate sales. In addition, Tianya had dozens of posts from bodies affairs or gluttonous OxyContin over the accomplished few years.

The AP did not accomplish any purchases and could not affirm the actuality of the pills.

“Mundipharma China has no ability of the aberration of its articles on e-commerce and amusing media platforms,” the aggregation said in a account to AP.

Mallinckrodt’s specialty generics accessory SpecGx sells its affliction pills to a Chinese importer. In a statement, the aggregation said it “has no manufacturing, distribution, sales force or in-country attendance in China.”

Alibaba’s Xianyu, accepted as Idle Fish in English, said it removed listings that abandoned exchange behavior afterwards AP acicular out adulterous opioid sales. The aggregation said it prohibits “illegal behavior by third-party sellers on the platform.” Sina Corp., which runs Weibo, said that afterwards award violations, it ran a attack in March to clean-up adulterous agreeable about medicines and medical equipment. Xianyu, Tencent, Baidu and Sina Corp. all said they actively adviser their platforms and animate users to proactively address adulterous activity.

Tianya and 58.com, which runs Zhuan Zhuan, didn’t acknowledge to requests for comment.

IT’S GOOD I DIDN’T DIE

On April 28, Wu ran out of money and chock-full demography OxyContin. The actuality that he was animate the year afterwards he was declared to be asleep gave him hope. “I’m still young,” Wu said. “I accept a lot of things to do.”

Four canicule later, he told a doctor at Yangchun People’s Hospital he couldn’t stop demography OxyContin and hadn’t slept in days. He larboard with a decree for benzodiazepine sleeping pills and a admonishing not to booty added than three at a time. He took 15.

The abutting day, he went aback for more, but the doctor didn’t appetite to accord him added than day’s supply. Wu lay on the hospital attic and banned to budge.

“I am adversity so much,” he alleged out. “Why do you amusement me like this?'”

Wu said he managed to get added sleeping pills that anniversary by visiting altered doctors. He’d booty 20 or added at a time. The pills abashed him, he said, but didn’t put him to sleep. At night, he’d aloof abatement down, unconscious.

“It’s acceptable I didn’t die,” he said.

Doctors at Yangchun People’s Hospital eventually cut him off and told him to go to a brainy hospital, he said.

Yangchun People’s Hospital did not acknowledge to requests for comment.

On May 29, Wu got his academician scanned at the Yangchun Minfu Psychiatric Hospital, medical annal show. Doctors there aboriginal told Wu he was adversity from schizophrenia, afresh afflicted their analysis to depression, he said.

You

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Wu didn’t accept he was mentally ill. He said he told doctors he was action through opioid withdrawal. He said he was accustomed an anti-depressant and an anti-psychotic.

A man who best up the buzz at Yangchun Minfu Psychiatric Hospital said the ability has no addiction analysis affairs and had never dealt with decree bolus abuse. He banned to accord his name and afraid up the phone.

Wu’s anatomy began to swell. Terrified his blight was back, he arrested into the oncology area of Yangchun People’s Hospital on June 15. A claret analysis came aback clean, he said. His blight was still in remission.

By the end of June, the affliction of the abandonment affection were gone.

THE WORLD WITHOUT HIM IS AN ABYSS

Despite the clearly low numbers of bolus addicts, the Chinese government was anxious abundant about painkiller corruption that in September it pulled aggregate opioid painkillers, including Tylox, from best pharmacies.

On September 18, Yin Hao acquaint an chant to Tylox on WeChat. The apple afterwards Tylox, he wrote, “is an abyss.”

He said he was demography added than 100 Tylox pills a day, which added up to over 500 mg of oxycodone and 32,500 mg of acetaminophen. The U.S. Centers for Disease Ascendancy says a dosage of aloof 33 mg of oxycodone a day doubles the accident of overdose. Demography added than 4,000 mg of acetaminophen circadian can aftereffect in astringent alarmist accident and death.

Before the new regulations took effect, it was accessible to get Tylox from pharmacies in assertive cities and online afterwards a prescription. Beforehand this year, AP articular bristles pharmacies affairs Tylox afterwards a prescription. In addition, three of six online pharmacies that said they had Tylox in banal awash it afterwards a prescription, AP found.

A ages afterwards the new rules took effect, Yin had aloof two pills left. He anticipation about committing a abomination or application harder drugs so the badge would force him into a binding detox center.

By November Yin’s bolus box was abounding again. He claimed he was able to buy Tylox illegally from some online pharmacies. He said he aria to doctors at hospitals to get added pills, admitting not anybody fell for it.

Yin said he got Tylox sales agents to advertise him aggregate pills anon and bribed a bagman not to appraise his packages. He beneath to allotment their names with AP, and it was absurd to verify his claim.

Sometimes Yin afraid badge were afterward him. He didn’t appetite to go to prison, he said. He capital to go to rehab.

If he could unspool his action and wind it up again, Yin said the additional time annular he would booty affliction instead of Tylox.

WU’S DREAM

At 9:40 a.m. on September 23, Wu took a bus to Shenzhen and begin a bargain third-floor allowance for rent.

“My dream is authoritative music,” Wu said in an account beforehand this month. “But in the two months aback I came to Shenzhen, I accept begin the absoluteness and dream are appealing different. Absoluteness is crueler.”

Wu’s face and easily seemed too big for his attenuated hips. He was aggravating to get his anatomy in bigger appearance to adapt for hip backup surgery, which he hopes to accept abutting year. He flashed a smile and said he’d acquire abundant from singing to pay for the operation, but so far he’s almost authoritative rent.

Around 1 a.m. aboriginal one Friday, Wu beggared a canteen of baptize assimilate the wheeled barrow he uses to booty his amplifier around, affective his accessory and thumped bottomward the stairs. He yanked his accessory into the aphotic December arctic and headed over to a band of restaurants to see if he could advertise any songs.

At 1:15 a.m. it started to rain. Bad luck. There was hardly anyone around. A affable restaurant administrator let him sit beneath a ablaze dejected covering until the rain stopped.

Wu best up his accessory and hauled his amplifier bottomward a block and up a block and bottomward a block again, analytical into anniversary baby restaurant for stragglers who ability pay him 30 yuan ($4) to sing.

At 2:45 a.m., bodies at a table burdened with abandoned beers took Wu’s card of songs, mostly Cantonese hits from the Eighties and Nineties, and afterwards continued deliberation, best one. Wu sat in the algid abreast a hunk of bright meat on affectation and waited for the bodies at the table to go to the bath and buy added cigarettes.

Finally, Wu began to sing, a song called, “My Acceptable Brothers.”

“Thank you,” he said aback he was done.

No one clapped.

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