Named after | Four thieves vinegar |
---|---|
Formation | 2015 |
Founder | Michael Laufer |
Legal status | Active |
Purpose | Biohacking |
Products | EpiPencil, Apothecary MicroLab |
Website | fourthievesvinegar |
The Four Thieves Vinegar Collective is an anarchist biohacking group founded in 2015 by Michael Laufer. They have published instructions for the "EpiPencil", an epinephrine autoinjector, and the "Apothecary MicroLab", a do-it-yourself (DIY) device intended to make a variety of medications, most notably pyrimethamine (Daraprim). The medical community has criticized them for causing potential harm to patients with the DIY instructions, but Laufer claims to defend people's right to attempt their medical treatment.
Four Thieves' membership is generally composed of technically trained people, but does not include medical professionals. [1]
Laufer has compared his work to that of Women on Waves, a group that provides abortion medication to women in areas where abortion is illegal. [2] His motivation in founding the group is to provide medication to people when it is too expensive for them to afford, illegal to acquire, or unavailable due to it treating an orphan disease. He believes that providing lifesaving medication to those who need it justifies violating the intellectual property rights of pharmaceutical companies, and supports cognitive liberty. [1]
Laufer, trained in mathematics, formed the group in 2008 during a graduate school trip to El Salvador. While visiting a local medical clinic he learned that despite the existence of many clandestine chemistry labs producing methamphetamine and MDMA, the clinic was out of oral contraceptives. He investigated the possibility of DIY pharmaceuticals which culminated in the founding of Four Thieves in 2015. [3] He took the name from four thieves vinegar, a legendary plague cure. [4]
Four Thieves had formerly partnered with Chematica to develop recipes for the group's medication, [2] but this ended and they lost access to information and software they had been given after pharmaceutical company Merck bought the startup. [1]
In 2016, after the price for an EpiPen was raised from $57 to $318 by its manufacturer Mylan, Four Thieves released instructions for how to build an "EpiPencil", a homemade epinephrine autoinjector that can be built for $30. [5] It is made from three off-the-shelf parts. [6] It has been criticized for potential danger, with Yvette d'Entremont criticizing the lack of sterility in the EpiPencil assembly. d'Entremont also highlighted the error of margin when drawing up the epinephrine could easily be misjudged, putting people's lives at risk. [7] Theresa Eisenman, a spokeswoman for the United States Food and Drug Administration, stated that using such a device is a "potentially dangerous practice". [8] The device is not known to have actually been used. [4]
Four Thieves has released instructions for building an "Apothecary MicroLab", a DIY controlled lab reactor claimed to be able to synthesize a variety of medications. The group released instructions for manufacturing pyrimethamine (Daraprim) from acetonitrile, ethyl bromide, and dicyandiamide with it. [3] [2] Laufer claims that it can also be used to make naloxone, cabotegravir, mifepristone, and misoprostol. [1] Jeremiah Johnson, a researcher at the Massachusetts Institute of Technology, has stated that using it would be very dangerous as it could create the wrong drug or the wrong dose. [3] Eric von Hippel, an economist at MIT who supports DIY medication, has stated that the design could create chemical byproducts as well as or instead of the intended medication. [1]
Laufer claims that they have successfully synthesized cabotegravir, an experimental new integrase inhibitor, and asked heroin dealers to cut their product with it in order to help lower the rates of HIV infection among heroin users. [1]
In 2022, Four Thieves released detailed instructions for how to make an abortion pill, [9] and subsequently distributed business cards at a hacker convention in Queens, New York, that were labeled "This Card is an Abortion" and had three doses of misoprostol embedded in them. [10]
Jose Gomez-Marquez, who is researching pharmaceuticals at MIT, has stated his belief that the group is more about publicity than medication, and is concerned about the danger of unvetted information being published. [3] Vinay Prasad, a professor of medicine at Oregon Health & Science University, believes that DIY medication is "foolhardy". [4]
Jo Zayner, another biohacker, believes that the group's work is more symbolic than anything else. [4]
Chemist Derek Lowe described the Vice magazine article on the collective as "largely bullshit". [11] He noted that they had synthesized known substances rather than producing new ones. [11] He also pointed out that their proposal to combat Hepatitis C could accidentally cause treatment-resistant strains of Hepatitis C. [11] In September 2024 Derek Lowe replied to further publicity for the group, pointing out that they don't address the fact that Sofosbuvir is given as part of a compbination therapy or how they calculated the figure of $70 for a whole course of treatment. [12] He also pointed out that the group doesn't address waste disposal, purification, solvents or availability of starting materials. [12]
Patricia Zettler, a former attorney at the FDA, believes that Four Thieves' work is legal because they are only providing information rather than drugs themselves. [4]
Mifepristone, also known by its developmental code name RU-486, is a medication typically used in combination with misoprostol to bring about a medical abortion during pregnancy and manage early miscarriage. This combination is 97% effective during the first 63 days of pregnancy. It is also effective in the second trimester of pregnancy. It is taken by mouth.
An epinephrine autoinjector is a medical device for injecting a measured dose or doses of epinephrine (adrenaline) by means of autoinjector technology. It is most often used for the treatment of anaphylaxis. The first epinephrine autoinjector was brought to market in 1983.
Misoprostol is a synthetic prostaglandin medication used to prevent and treat stomach and duodenal ulcers, induce labor, cause an abortion, and treat postpartum bleeding due to poor contraction of the uterus. It is taken by mouth when used to prevent gastric ulcers in people taking nonsteroidal anti-inflammatory drugs (NSAID). For abortions it is used by itself or in conjunction with mifepristone or methotrexate. By itself, effectiveness for abortion is between 66% and 90%. For labor induction or abortion, it is taken by mouth, dissolved in the mouth, or placed in the vagina. For postpartum bleeding it may also be used rectally.
Self-medication, sometime called do-it-yourself (DIY) medicine, is a human behavior in which an individual uses a substance or any exogenous influence to self-administer treatment for physical or psychological conditions, for example headaches or fatigue.
Sodium metabisulfite or sodium pyrosulfite (IUPAC spelling; Br. E. sodium metabisulphite or sodium pyrosulphite) is an inorganic compound of chemical formula Na2S2O5. The substance is sometimes referred to as disodium metabisulfite. It is used as a disinfectant, antioxidant, and preservative agent. When dissolved in water it forms sodium bisulfite.
A self-induced abortion is an abortion performed by the pregnant woman herself, or with the help of other, non-medical assistance. Although the term includes abortions induced outside of a clinical setting with legal, sometimes over-the-counter medication, it also refers to efforts to terminate a pregnancy through alternative, potentially more dangerous methods. Such practices may present a threat to the health of women.
King Pharmaceuticals, Inc. is a pharmaceutical company, a wholly owned subsidiary of Pfizer based in Bristol, Tennessee. Before being acquired by Pfizer, it was the world's 39th largest pharmaceutical company. On October 12, 2010, King was acquired by Pfizer for $14.25 per share. King produced a wide range of pharmaceuticals, including Altace for heart attack prevention, Levoxyl for hypothyroidism, Sonata, a sleeping aid, and Skelaxin, a muscle relaxant. King Pharmaceuticals operated manufacturing facilities in Bristol, Tennessee; Rochester, Michigan; St. Louis, Missouri; St. Petersburg, Florida; and Middleton, Wisconsin. They employed approximately 2,700 people including a sales force of over 1,000 individuals.
Mylan N.V. was a global generic and specialty pharmaceuticals company. In November 2020, Mylan merged with Upjohn, Pfizer's off-patent medicine division, to form Viatris. Previously, the company was domiciled in the Netherlands, with principal executive offices in Hatfield, Hertfordshire, UK and a "Global Center" in Canonsburg, Pennsylvania, US.
Pyrimethamine, sold under the brand name Daraprim among others, is a medication used with leucovorin to treat the parasitic diseases toxoplasmosis and cystoisosporiasis. It is also used with dapsone as a second-line option to prevent Pneumocystis jiroveci pneumonia in people with HIV/AIDS. It was previously used for malaria but is no longer recommended due to resistance. Pyrimethamine is taken by mouth.
Medication costs, also known as drug costs are a common health care cost for many people and health care systems. Prescription costs are the costs to the end consumer. Medication costs are influenced by multiple factors such as patents, stakeholder influence, and marketing expenses. A number of countries including Canada, parts of Europe, and Brazil use external reference pricing as a means to compare drug prices and to determine a base price for a particular medication. Other countries use pharmacoeconomics, which looks at the cost/benefit of a product in terms of quality of life, alternative treatments, and cost reduction or avoidance in other parts of the health care system. Structures like the UK's National Institute for Health and Clinical Excellence and to a lesser extent Canada's Common Drug Review evaluate products in this way.
Abortion in Venezuela is currently illegal except in some specific cases outlined in the Venezuelan Constitution, and the country has one of Latin America's most restrictive laws.
Drug packaging is process of packing pharmaceutical preparations for distribution, and the physical packaging in which they are stored. It involves all of the operations from production through drug distribution channels to the end consumer.
PT Kalbe Farma Tbk, or simply known as Kalbe, is an Indonesian pharmaceutical, healthcare and nutrition company established in 1966. The company has expanded by strategic acquisitions of pharmaceutical companies, becoming an integrated consumer health and nutrition enterprise. The Kalbe Group has brands in the prescription drugs, OTC drugs, energy drink and nutrition products, distribution arm that reaches over 1 million outlets. Notably, the company produces misoprostol, a drug which is used to treat stomach ulcers but is also widely used in Indonesia as an illegal abortifacient.
Martin Shkreli is an American investor and businessman. Shkreli is the co-founder of the hedge funds Elea Capital, MSMB Capital Management, and MSMB Healthcare, the co-founder and former CEO of pharmaceutical firms Retrophin and Turing Pharmaceuticals, and the former CEO of start-up software company Gödel Systems, which he founded in August 2016.
A medical abortion, also known as medication abortion or non-surgical abortion, occurs when drugs (medication) are used to bring about an abortion. Medical abortions are an alternative to surgical abortions such as vacuum aspiration or dilation and curettage. Medical abortions are more common than surgical abortions in most places around the world.
Meridian Medical Technologies, LLC is an American company which specialized primarily in developing and manufacturing antidotes for chemical weapons.
Harrow Health, Inc., formerly known as Imprimis Pharmaceuticals, is a publicly traded pharmaceutical company based in Nashville, Tennessee.
Epinephrine, also known as adrenaline, is a medication and hormone. As a medication, it is used to treat several conditions, including anaphylaxis, cardiac arrest, asthma, and superficial bleeding. Inhaled epinephrine may be used to improve the symptoms of croup. It may also be used for asthma when other treatments are not effective. It is given intravenously, by injection into a muscle, by inhalation, or by injection just under the skin.
Aid Access is a nonprofit organization that provides access to medication abortion by mail to the United States and worldwide. It describes its work as a harm reduction strategy designed to provide safe access to mifepristone and misoprostol for those able to become pregnant in the United States who may not otherwise have access to abortion or miscarriage management services. People are able to manage their own abortion with remote access to a physician and a help-desk for any questions. The website is available in English, Spanish, and Dutch.
Michael Swan Laufer is the de facto leader of the open-source anarchist biohacking network, Four Thieves Vinegar Collective. Laufer is notable for creating the EpiPencil, an open source alternative to the Epipen.