Selling underground GLP-1 drugs a growing and dangerous side hustle on St. Maarten

GREAT BAY--The underground sale of GLP-1 “weight loss” injectable drugs is spreading quietly across St. Maarten, as people look for fast fixes for obesity, erectile dysfunction, and other medical conditions that should be managed by medical professionals. These drugs, commonly known by brand names such as Ozempic (semaglutide), Wegovy (semaglutide), Victoza (liraglutide) and others are being treated like beauty products instead of powerful prescription medications that alter how the body works. It should be stressed that while some of these are legal and approved, they should be administered by medical professionals. And, what is being sold as side hustles on St. Maarten, is still experimental.

The Peoples’ Tribune has received comments of concern and suggestions of leads to follow about public (civil) servants and private individuals who have turned these drugs into a side business, offering cocktails of GLP-1s and other injections without any medical training. Reports have suggested that these drugs are being administered in the Government Administration Building, among other places. Some buyers became sick after these injections, then discovered that the sellers had lied about sourcing the medication from reputable clinics and spas in the United States. When they checked, those clinics denied any link.  

And while many of these drugs should be administered and managed by medical professionals and people with medical backgrounds, what's being sold underground on St. Maarten is not, which literally puts people's lives at risk. Re-sellers are uneducated and unlicensed and using terms such as "GLP-3" as a selling point, a term that is not officially recognized in the field. Moreover the experimental drug "Retatrutide" is reportedly being used, it has not been approved for wide and safe use.  

Many users who fall ill try to ride it out at home, afraid to face a doctor because they believe they have done something illegal and have been warned by resellers to keep quiet. That silence is not just risky, it is potentially deadly, because some of the most dangerous effects of these drugs do not show up immediately.

Shortages from legit sources, high prices, and social media hype have created a secondary market for GLP-1 drugs. Regulators in Europe and the United States for example report a sharp rise in illegal and counterfeit GLP-1 products sold through websites and social media accounts. Many of these products are not authorized medicines and may contain the wrong dose, the wrong active ingredient, or contaminated substances.

When contacted for comment about the issue, the Cabinet of the Minister of VSA said that "The Ministry has not received any reports concerning unauthorized persons or entities importing or distributing GLP-1 agonists. As a Ministry, we strongly urge any individual possessing information regarding such activities to submit a report to the Inspectorate of VSA, as these actions constitute a violation of the law and present significant risks to public health and safety. Please note that the Ministry will proceed with the issuance of a general public advisory reminding the community to obtain medications solely from licensed pharmacies and to report any suspected illegal importation or sale of medicinal products to the Inspectorate."

There are real dangers

People who get GLP-1 injections through friends, salons or WhatsApp groups usually hear about nausea, vomiting, or constipation. Those problems are common, but they are not the whole story. Some of the more serious risks develop slowly, or show up only after months of use, which makes them easy to dismiss or miss completely.

One of the biggest long term concerns is what these drugs do to the gut and gallbladder. GLP-1 medicines slow the emptying of the stomach and change how the intestines move. Over time, that can tip some users into chronic problems such as severe gastroparesis (a stomach that no longer empties properly), repeated vomiting, or bowel obstruction. Rapid weight loss and changes in bile flow also raise the risk of gallstones and gallbladder inflammation, which sometimes end up needing surgery. They are conditions that can send someone to the emergency room and leave lasting damage.

The kind of weight loss seen with GLP-1s also costs more than most people realize. Studies show that a significant part of the weight that comes off is not fat, but lean tissue, which includes muscle and, indirectly, bone. Losing large amounts of muscle lowers strength and daily energy, slows metabolism, and may increase the risk of frailty and falls later in life. In a supervised program, doctors and medical professionals try to protect muscle with adequate protein and resistance training. In the underground market, where people often eat very little to “help” the drug work faster, that kind of support almost never happens.

Then there are the quiet effects of long term under-eating. When appetite disappears, people skip meals or live on snacks. Over months, that can lead to vitamin and mineral deficiencies, hair thinning, fatigue, and loss of facial volume that some users now call “Ozempic face.” On top of that, very rapid weight loss, social pressure to be thin, and existing anxiety or depression can create or worsen mental health problems. Regulators have not proven that GLP-1 drugs directly cause suicidal thoughts, but they do advise close monitoring of mood, especially in people with a history of mental health issues. In an informal, unsupervised setting, no one is doing that monitoring, and people are left to cope alone if they start to feel emotionally unstable while on the injections.

Without medical supervision

Using GLP-1 injectables without medical supervision strips away several important safety checks and greatly increases the risk of harm. People may start at doses that are too high or use these drugs even when they have conditions that should trigger caution, such as a history of pancreatitis, severe gut problems, kidney disease, thyroid cancer, or pregnancy.

That combination of wrong patient and wrong dose can lead to extreme nausea, vomiting, dehydration, and acute kidney injury that lands them in the emergency room. Because no one is reviewing their other medicines, users can also run into dangerous interactions, for example combining GLP-1 drugs with insulin or some diabetes tablets, which raises the risk of serious hypoglycemia, or using newer agents that temporarily reduce the effectiveness of oral contraceptives without being told, increasing the chance of an unplanned pregnancy. On top of that, the appetite and weight loss effects can mask underlying eating disorders, depression, or other illnesses, or even be used to drive extreme calorie restriction that no clinician would endorse.

There is also a real but less obvious risk around surgery and procedures. GLP-1 drugs deliberately slow stomach emptying, so food can remain in the stomach longer than expected even after fasting. Anesthesiologists now warn that this increases the risk of aspiration, where stomach contents enter the lungs during anesthesia, and they recommend specific pre-operative plans for patients on these medicines. Someone injecting on their own, with no doctor involved, is unlikely to disclose their use or even realize they should mention it before a procedure, which quietly adds another layer of avoidable danger.

Not knowing how to use an "epi"

Not knowing how to use an epinephrine auto-injector, or giving unclear instructions about its use, can be dangerous because it can delay or prevent life-saving treatment during a severe allergic reaction. Anaphylaxis can progress within minutes, so hesitation, confusion over when to inject, or fumbling with the device can mean the person does not receive epinephrine early enough to reverse swelling of the airway, breathing problems and a dangerous drop in blood pressure.

Incorrect technique, such as injecting through thick clothing in the wrong area, into a hand or finger instead of the outer thigh, or not holding the device in place long enough, can reduce how much medication enters the muscle or cause complications like reduced blood flow to the affected limb. Misunderstanding basic safety steps, such as not checking the expiry date, failing to carry the auto-injector at all times, or not calling emergency services after use, also increases risk. For these reasons, anyone prescribed an epinephrine auto-injector, and those around them, should receive clear, repeated training with a demo device so that in an emergency they can act quickly, calmly and correctly.

𝘌𝘥𝘪𝘵𝘰𝘳’𝘴 𝘯𝘰𝘵𝘦: 𝘚𝘦𝘷𝘦𝘳𝘢𝘭 𝘪𝘯𝘥𝘪𝘷𝘪𝘥𝘶𝘢𝘭𝘴 𝘤𝘰𝘯𝘵𝘢𝘤𝘵𝘦𝘥 𝘛𝘩𝘦 𝘗𝘦𝘰𝘱𝘭𝘦𝘴’ 𝘛𝘳𝘪𝘣𝘶𝘯𝘦 𝘸𝘪𝘵𝘩 𝘴𝘦𝘳𝘪𝘰𝘶𝘴 𝘤𝘰𝘯𝘤𝘦𝘳𝘯𝘴 𝘣𝘶𝘵 𝘴𝘢𝘪𝘥 𝘵𝘩𝘦𝘺 𝘧𝘦𝘢𝘳𝘦𝘥 𝘳𝘦𝘱𝘳𝘪𝘴𝘢𝘭𝘴 𝘪𝘧 𝘵𝘩𝘦𝘺 𝘳𝘦𝘱𝘰𝘳𝘵𝘦𝘥 𝘤𝘦𝘳𝘵𝘢𝘪𝘯 𝘱𝘦𝘳𝘴𝘰𝘯𝘴 𝘰𝘧 𝘯𝘰𝘵𝘦 𝘵𝘰 𝘵𝘩𝘦 𝘩𝘦𝘢𝘭𝘵𝘩 𝘪𝘯𝘴𝘱𝘦𝘤𝘵𝘰𝘳𝘢𝘵𝘦. 𝘛𝘩𝘦 𝘯𝘶𝘮𝘣𝘦𝘳 𝘢𝘯𝘥 𝘴𝘦𝘳𝘪𝘰𝘶𝘴𝘯𝘦𝘴𝘴 𝘰𝘧 𝘵𝘩𝘦𝘴𝘦 𝘤𝘰𝘯𝘤𝘦𝘳𝘯𝘴 𝘱𝘳𝘰𝘮𝘱𝘵𝘦𝘥 𝘵𝘩𝘪𝘴 𝘢𝘳𝘵𝘪𝘤𝘭𝘦, 𝘢𝘯𝘥 𝘸𝘦 𝘴𝘵𝘳𝘰𝘯𝘨𝘭𝘺 𝘶𝘳𝘨𝘦 𝘳𝘦𝘢𝘥𝘦𝘳𝘴 𝘵𝘰 𝘳𝘦𝘱𝘰𝘳𝘵 𝘢𝘯𝘺 𝘴𝘶𝘴𝘱𝘦𝘤𝘵𝘦𝘥 𝘪𝘭𝘭𝘦𝘨𝘢𝘭 𝘩𝘦𝘢𝘭𝘵𝘩 𝘱𝘳𝘢𝘤𝘵𝘪𝘤𝘦𝘴 𝘵𝘰 𝘵𝘩𝘦 𝘱𝘳𝘰𝘱𝘦𝘳 𝘢𝘶𝘵𝘩𝘰𝘳𝘪𝘵𝘪𝘦𝘴, 𝘢𝘴 𝘴𝘱𝘦𝘢𝘬𝘪𝘯𝘨 𝘶𝘱 𝘤𝘰𝘶𝘭𝘥 𝘱𝘳𝘦𝘷𝘦𝘯𝘵 𝘴𝘦𝘳𝘪𝘰𝘶𝘴 𝘩𝘢𝘳𝘮 𝘢𝘯𝘥 𝘮𝘢𝘺 𝘷𝘦𝘳𝘺 𝘸𝘦𝘭𝘭 𝘴𝘢𝘷𝘦 𝘢 𝘭𝘪𝘧𝘦.

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