From Our 2008 Archives

Narcotics Sold Online, No Rx Needed

Study Shows Some Web Sites Lack Controls to Keep Kids From Buying Drugs

By Kelli Miller Stacy
WebMD Health News

Reviewed By Louise Chang, MD

July 9, 2008 — Scores of web sites do not require a prescription to buy narcotics, stimulants, and other controlled substances — and none of those sites has controls to prevent children from making such purchases, a study shows.

A report released today by the National Center on Addiction and Substance Abuse at Columbia University reveals that 85% of web sites selling potent prescription drugs such as OxyContin, Valium, and Ritalin do not ask Internet users for a proper prescription from a doctor. Many explicitly state that no prescription is needed.

"Anyone of any age can obtain dangerous and addictive prescription drugs with the click of a mouse," Joseph A. Califano Jr., chairman and president of the National Center on Addiction and Substance Abuse and former U.S. secretary of Health, Education, and Welfare, says in a news release. "This problem is not going away."

The report, titled "'You've Got Drugs!' V: Prescription Drug Pushers on the Internet," details the advertising and selling of controlled substances online. It is the fifth annual report on the subject. The report tracks the availability of prescription opioids such as OxyContin and Vicodin, depressants such as Valium and Xanax, and stimulants such as Ritalin and Adderall.

The analysis showed that fewer web sites are selling and promoting controlled substances than last year (361 vs. 581); in the new report, 206 sites were found to advertise drugs and 159 offered drugs for sale. However, only two are "legitimate" pharmacy sites, meaning they have received certification by the National Association of Boards of Pharmacy as a Verified Internet Pharmacy Practice Site (VIPPS). To receive VIPPS accreditation, a pharmacy site must comply with the licensing and inspection requirements of their state and each state that they dispense prescriptions in.

Califano credits improved state and federal efforts to crack down on Internet drug trafficking for the decline.

The "most disturbing" finding, the authors write, is that "there are no controls on any of these sites blocking access by children." Most Internet users are adolescents and young adults; 78% of kids 12 to 17 have online access. Nearly all college students do, too.

Nearly one in five teenagers has abused prescription drugs in their lifetime, according to a 2005 survey. Many think prescription drugs, particularly painkillers, are easier to get than illicit drugs like cocaine or crack.

Children easily gained access to the online pharmacies by typing in a fake age. Yet in some cases, a child may still buy and receive drugs by providing true information — even when their answers should raise red flags. A previous report revealed how a supervised 13-year-old ordered and received Ritalin after entering her own age, height, and weight on a site's questionnaire.

Internet Drug Trends

This report also reveals a trend in which many sites allow Internet users to buy a controlled substance after signing up for an online "medical consultation." Visitors must complete an online questionnaire about their medical history before having their prescription filled. However, the answers may or may not be reviewed by a doctor. Such sales do not constitute a legitimate doctor-patient relationship, according to the study authors.

Other findings in the report include:

  • Half of the sites that require prescriptions allowed faxed copies, creating a "significant opportunity for fraud."
  • The drugs most frequently offered for sale were drugs such as Xanax and Valium, followed closely by opioid painkillers including hydrocodone (contained in drugs like Vicodin, Lortab), codeine, and oxycodone (contained in drugs such as OxyContin and Percocet).
  • The number of sites offering stimulants for sale increased to levels not seen since 2004.

The report showed many sites do not require prescriptions:

  • 85% of online pharmacy anchor sites did not require a prescription to buy controlled drugs.
  • Of that group, 42% specifically said that no prescription was needed.
  • 13% never mentioned a prescription.
  • 45% offered an "online consultation."

The study also shows that many sites get their drugs from overseas:

  • Slightly less than a fourth of online pharmacy anchor sites said the drugs would ship from a U.S. pharmacy.
  • 40% said they'd come from outside the U.S.
  • 36% didn't say where the drug would be shipped from.

In April, the U.S. Senate passed a bill controlling Internet trafficking of controlled prescription drugs. The bill calls for federal certification of online pharmacies and prohibits the delivery, distribution, or dispensing of controlled substances online without a prescription issued by a practitioner who has conducted at least one in-person medical evaluation. The bill awaits House approval.

SOURCES: News release, The National Center on Addiction and Substance Abuse at Columbia University. The National Center on Addiction and Substance Abuse at Columbia University: "'You've Got Drugs!' V: Prescription Drug Pushers on the Internet," July 9, 2008.

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