In today’s communications landscape where Internet access is readily available and advertising for prescription medication it is no surprise that many patients are using online pharmacies.
There are many benefits to this type of drug distribution: Disabled or homebound patients can have their medications conveniently delivered to their homes. Shoppers enjoy a certain level of discretion and anonymity. The selection of products is vast. Medications can be easily researched and compared, and computers can quickly catch potentially dangerous interactions.
But there are also drawbacks to buying medications online. A study released July 9th by the National Center on Addiction and Substance Abuse at Columbia University found that most websites selling prescription opioids, stimulants, and depressants do not require a legal prescription. This rise in illegitimate drug activity also has been linked to the growing abuse of prescription drugs especially among adolescents. There are hundreds of sites devoted to selling powerful drugs such as Oxycontin, Vicodin, methadone and Xanax without a prescription.
According to a 2005 study completed by Christopher Littlejohn and his associates, online merchants can be categorized into four basic types: legitimate, subscription, lifestyle and no-prescription.
Legitimate online pharmacies operate similar to traditional brick-and-mortar pharmacies. Customers must have a prescription from a licensed medical practitioner, and in general these websites do not offer the types of controlled prescription drugs that are most commonly obtained illegally and abused.
Users of subscription pharmacies are granted access to a full range of drugs without a prescription once they sign up for a program and pay a membership fee. These subscription websites often are maintained in countries where prescription regulation is more lax than it is in the United States.
Lifestyle pharmacies ask customers to fill out a medical questionnaire instead of a prescription. They commonly provide more elective or luxury drugs that treat conditions such as alopecia, obesity, and impotence.
No-prescription pharmacies are just that sites that are willing to mail controlled drugs to online customers without a prescription.
Littlejohn’s study also contended that the people who most commonly ordered drugs illegally from these websites were literate, credit card owning individuals with Internet access. These three factors also lead to the inference that the abusers of online pharmacies are of a relatively high socioeconomic status.
Unlike conventional pharmacies, there is little to no consumer protection over the Internet. Products can be advertised with false claims and the sale of unapproved trial drugs goes unchecked. The administrators of illegal websites often remain anonymous and can quickly disable and create new sites that make it difficult for any regulatory agency to keep track of their activities. Operations are also commonly run outside of the U.S. making law enforcement officials scramble to put together international cooperation efforts.
This lack of effective online pharmacy regulation can lead to disastrous consequences. Francine Haight of La Mesa, Calif. lost her son Ryan to an overdose of the generic form of Vicodin, which he ordered without her permission online with a debit card. “The Internet made it easy for the drug dealers to sneak into your living room,” she said.
The sale of online drugs has led to drug and substance abuse, death related to drug interactions, incorrect dosage or administration, and impure drugs. Illegal prescriptions can end up in the hands of children or others who are incapable of using them responsibly. According to the Drug Enforcement Agency, 85 percent of Internet drug sales are controlled drugs while only 11 percent of those same drugs are being sold at traditional pharmacies.
These statistics display the obvious potential for drug abuse and need for greater online pharmaceutical quality control. The Food and Drug Administration has vowed to increase public outreach and awareness, expand enforcement, and develop tighter bonds of international cooperation. In April the “Ryan Haight Online Pharmacy Consumer Protection Act” was approved by the Senate and is currently being reviewed in House committee meetings. If passed, the legislation would require online pharmacies to be properly certified and for doctors to meet in person with patients before giving out a prescription for a controlled drug. Some state governments have already passed laws that regulate the online drug trade but many advocates are pushing for stricter federal regulation. Some search engine companies have begun to fight back against online sellers by employing a program called “Pharmacy Checker.” The device filters out unlawful advertisers and forces them to provide verification.
Eckholm, Erik. (2008, July 9). Abuses Found in Online Sales of Medication. New York Times, Retrieved July 10th, 2008.
Henney, Jane. (2001). Cyberpharmacies and the role of the US Food and Drug Administration. Journal of Medical Internet Research, 3(1), Retrieved July 10, 2008 from the PubMed database.
Littlejohn,C., Baldacchino, A., Schifano, F., & Deluca, P. (2005). Internet Pharmacies And Online Prescription Drug Sales: a cross-sectional study. Drugs: education prevention and policy, 12, 75-80. Retrieved July 10th 2008, from the Academic Search Premier database.