[17] The bile can be harvested using several techniques, all of which require some degree of surgery, and may leave a permanent fistula or inserted catheter.
Farmed bile bears are housed continuously in small cages which often prevent them from standing or sitting upright, or from turning around.
These highly restrictive cage systems and the low level of skilled husbandry can lead to a wide range of welfare concerns including physical injuries, pain, severe mental stress and muscle atrophy.
[5][23] The demand for bile and gallbladders exists in Asian communities throughout the world, including the European Union and the United States.
[24][28] To facilitate the bile extraction process, mature bears are usually kept in small cages measuring approximately 130 x 70 x 60 cm.
These include declawing in which the third phalanx of each front digit is amputated to prevent the bears from self-mutilating or harming the farm workers.
[26] Pathology reports have shown that bile from sick bears is often contaminated with blood, pus, faeces, urine, bacteria and cancer cells.
In combination with the impacts of small cage sizes, their spacing and lack of internal structures, there are several indicators of poor welfare.
[31] A 2000 survey revealed that bile bears suffered from sores, skin conditions, ectoparasites, hair loss, bone deformities, injuries, swollen limbs, dental and breathing problems, diarrhoea and scarring.
[32] Academic sources have reported that bile bears exhibit abnormal behaviours such as stereotypies, lethargy, anxiety, and self-mutilation.
[30][31][33] The Chinese media reported a story in which a mother bear, having escaped her cage, strangled her own cub and then killed herself by intentionally running into a wall.
"[37] However, a 2007 veterinary report published by the Animals Asia Foundation (AAF) stated that the Technical Code was not being enforced and that many bears were still spending their entire lives in small extraction cages without free access to food or water.
The report also noted that the free-dripping technique promoted in the Technical Code was unsanitary as the fistula was an open portal through which bacteria could infiltrate the abdomen.
In addition to the suffering caused by infection and pain at the incision site, 28% of fistulated bears also experience abdominal hernias and more than one-third eventually succumb to liver cancer, believed to be associated with the bile-extraction process.
[40] Government officials see farming as a reasonable answer to the loss of wild bears from poaching and are insouciant about animal welfare concerns.
[46] A review of multiple types of wildlife tourist attractions concluded that bile bear farms had negative impacts on both animal welfare and conservation.
Initially, it was considered that occasional hunters were the cause, but investigations uncovered evidence that large commercial organizations were dealing in poaching and smuggling.
Another investigation in Oregon led police to bring racketeering charges against an organisation that poached an estimated 50 to 100 bears per year for a decade.
[23][48] It was estimated in 2008 that in North America, 40,000 American black bears are illegally poached for their gallbladders and paws each year.
[49] It was estimated in 2008 that 100,000 kg of synthetic UDCA was already being used each year in China, Japan and South Korea, and that the total world consumption may be double this figure.
[5] The goal is to more closely recreate the chemistry of bear bile powder, so that the alternative is deemed appropriate by traditional Chinese medicine practitioners.
[8] One company (Fujian Guizhen Tang Pharmaceutical Co. Ltd) alone has more than 400 black bears to supply bile using the free drip method.
[62] A 2019 survey published by the Claremont Colleges of 206 older Northern Vietnamese locals found that roughly 44% of respondents knew at least one other person who had used bear products from farms in the past year, compared to 55.33% of those who did not.
[8][24] It is currently found in various forms for sale including whole gallbladders, raw bile, pills, powder, flakes, and ointment.
[24] China's National Health Commission drew criticism in 2020 after reportedly recommending 'Tan Re Qing', a traditional medicine which contains the bile, to treat severe cases of COVID-19.
[64][65] Some South Korean bear bile farmers in the same year advertised that their products could also help with the coronavirus, drawing criticism from local animal rights groups.
Ursodeoxycholic acid has been shown to exert anti-inflammatory and protective effects in human epithelial cells of the gastrointestinal tract.
[74][75] Due to controversy around the use of bear farming to obtain bile, synthetic sources for ursodeoxycholic acid are currently being worked on and investigated.
[81] A report published in 2013 stated that a poacher in North America can usually get US$100 to $150 for a gallbladder, but the organs can fetch $5,000 to $10,000 in the end-market once they are processed into a powder.
[86] The company responded with demonstrations of the extraction process where the bears seemed unconcerned by the procedure, in an attempt to counter the allegations its business was cruel.