Dangerous Drug "Karkoubi" Surges in Spain as Rivotril Sales Double

"Two years ago, I received a call from a pharmacy in Castellón. They had a client with a ’questionable’ Rivotril 2 mg prescription made with my supposed signature. They asked me if it was my patient. It wasn’t. They had copied a private prescription and ordered a stamp with my name and membership number to falsify everything," a clinical psychiatrist in Barcelona with over thirty years of experience told El Pais.

Unbeknownst to them, Spanish pharmacies and dispensaries are involved in the illegal trafficking of clonazepam, a powerful anxiolytic, the best known of which is Rivotril, used in Morocco for the manufacture of karkoubi, a drug obtained after a mixture with hashish and alcohol. This traffic generates significant profits for criminal networks, estimated at "more than 100 million euros per year" according to the police. A box of Rivotril 2 mg containing 60 tablets costs 3.12 euros in Spanish pharmacies, while a single tablet is sold for more than 10 euros (more than 600 euros per box) in Morocco.

"This is one of the biggest problems we have faced in recent years," acknowledges Raquel Martínez, secretary general of the General Council of Pharmacists’ Associations, deploring the persistence of the problem despite the palliative measures taken by the Ministry of Health, which has imposed the exclusive use of electronic prescriptions in the face of the recurring theft of prescriptions in health centers. "The Order of Physicians or Pharmacists sends the electronic prescription to the patient with a QR code that guarantees that only the latter can retrieve it and that it is for single use," explains the psychiatrist.

The illegal trafficking of Rivotril took a major turn in 2016, after the seizure in Ceuta of more than 26,000 tablets of 2 mg of this drug in a car from Algeciras. Sales of this product then began to rise in pharmacies. In the Community of Madrid, sales of Rivotril 2 mg went from 75,000 boxes in 2015 to 160,000 in 2017. Between July 2018 and June 2019, they climbed to 1.6 million boxes and reached a peak of 3.4 million the following year, an increase of 112.5%. The trend continued with 3.6 million boxes sold in June 2021, 3.9 million in 2022, 3.7 million in 2023 and 3.9 million in June 2024.

"We are convinced that the measures taken are bearing fruit and that, to a large extent, pharmacies are preventing products from leaving the legal circuit. The slight increase in recent years is probably more due to the increase in the population in Spain and the consumption of psychotropic drugs observed after the pandemic," analyzes Raquel Martínez, urging the maintenance of electronic prescriptions, "at least for drugs such as Rivotril".