Internet is 'Pharmaceutical Candy Store'

OxyContin. Valium. Xanax. Vicodin. Ritalin. Adderall. Despite being some of the most commonly abused and misused prescription drugs in the country, each of these controlled drugs is readily available online and most websites sell them without prescriptions, according to a report released today by the National Center on Addiction and Substance Abuse at Columbia University (CASA). Despite recent crackdowns by federal and state agencies, the report entitled, "You've Got Drugs!" found that prescription drug trafficking is alive and well on the web.

"The bottom line is that any person of any age, including children, can, with a click of a mouse, order these drugs online and get them," said CASA Chairman and President Joseph A. Califano, Jr.

Out of 365 Web sites that CASA found advertising or selling controlled prescription drugs – drugs that the Federal Drug Enforcement Administration (DEA) controls because of abuse potential or risk – only two sites were certified by the National Association of Boards of Pharmacy as legitimate online pharmacies.

"The other 363 were rogue sites," said Califano, a former U.S. Secretary of Health, Education, and Welfare.

The study also found that 85 percent of Web sites selling prescription drugs do so without a physician's prescription. Of those, 42 percent stated that no prescription was required, 45 percent offered online consultations, and 13 percent did not mention prescriptions at all.

Federal law prohibits consumers from purchasing controlled prescription drugs without a valid prescription from a physician. These sites, Califano said, get around the law by having consumers complete online questionnaires or participate in virtual meetings with doctors employed by the sites.

"They're sham consultations," said Califano. "They ask you a few medical questions and then say you need this drug."

The U.S. Drug Enforcement Administration (DEA) says that prescriptions written by these "cyber doctors" are not legitimate under the law. But at a hearing before the House Judiciary Committee last month, DEA Deputy Assistant Administrator Joseph Rannazzisi said that the proliferation of rogue Internet pharmacies has created new legal challenges, including the involvement of internet web site operators, medical practitioners and pharmacists in online consultations.

"This process is designed to elicit what drug the customer wants and what the method of payment will be," Rannazzisi said, "rather than diagnosing a health problem and establishing a sound course of medical treatment."

Rannazzisi said that most illegal pharmacies are run by people with no medical or pharmaceutical training but who get doctors to approve prescriptions in exchange for $10 to $25. Some doctors, he said, authorize hundreds of prescriptions a day through Web sites.

"In short, the Internet has provided drug trafficking organizations with the perfect medium," Rannazzisi said. "It connects individuals from anywhere in the globe at any time it provides anonymity, and it can be deployed from almost anywhere with very little formal training."

CASA's study was conducted by entering various keywords and phrases into popular search engines, where unlicensed pharmacies are allowed to advertise their services, said Califano, who thinks it should be illegal for the search engines to have these pharmacies on their sites unless they've been certified.

Eight states passed laws in 2006 and 2007 to regulate the online selling of prescription drugs. The Senate passed a bill in April that prohibits the online distribution, dispensing and delivery of controlled substances without a prescription from a practitioner who has evaluated a patient in-person and which requires online pharmacies to be federally certified. It is now before the House.

"This report further emphasizes the need to take immediate action to stop rogue pharmacies on the Internet," said Senator Dianne Feinstein (D-CA) who, along with Senator Jeff Sessions (R-AL), introduced the "Ryan Haight Online Pharmacy Consumer Protection Act."

The bill is named after Ryan Haight, a 25-year-old San Diego man who died of a drug overdose in 2001. Feinstein said Haight purchased hydrocodone, a cough suppressant with effects similar to morphine, on the Internet after completing an online questionnaire. According to Feinstein, Haight said he had chronic back pain but was not examined by, nor did he meet, the doctor who eventually wrote the prescription.

Feinstein said she knows of at least 17 other people who have died due to overdoses from drugs purchased online through these types of pharmacies.

CASA has been tracking the online availability of controlled prescription drugs for five years. While this year's report, which calls the Internet a "pharmaceutical candy store," found a decline in the number of Web sites advertising or selling these drugs – down to 365 from 581 in 2007 – it found, for the first time, that some Web sites are now selling prescriptions that consumers can print off at home and take to a local pharmacy.

"And the prescriptions actually get filled," said Califano. "What's the real killer here is that any kid can get this stuff."

On its website, the U.S. Food and Drug Administration warns that some drugs sold online are fake, expired or handled incorrectly. The agency recommends that consumers make sure that online pharmacies are licensed through the National Association of Boards of Pharmacies and that any potential Web site requires a prescription and has a pharmacist available for questions.

Megan Chuchmach is a 2008 Carnegie Fellow at ABC News in New York. She recently graduated from Columbia University's Graduate School of Journalism.

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