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Are Online Pharmacies Fueling the Prescription Drug Abuse Epidemic?

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By Allison McCabe

04/23/14

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Online pharmacies are interested in turning a profit by ensuring repeat customers. Selling fake drugs defeats that purpose unless the fake can consistently mimic the real drug well enough that the customer keeps coming back for more. The competition between rogue pharmacies is fierce; they operate like street dealers, offering specials and bulk discounts to regular customers. Their job is to keep you addicted so they can keep raking in profits. Whether the drug is counterfeit or genuine shouldn’t matter to the DEA anyway: the Haight Act prohibits the unrestricted selling of drugs that even claim to be controlled substances. Whether they are counterfeit or not is irrelevant.

Lisa placed her first online pharmacy order in 2009, the same year that the Ryan Haight Act went into effect. Like Jennifer, Lisa originally found her online pharmacy by doing a search. She placed an order then was contacted by phone the following day. “Jon” confirmed her order, told her she had VIP status which entitled her to certain benefits, and directed her to order from him going forward.

Lisa was a regular customer for two years. Her “personal account manager” was Jon for a while, then she started getting calls and emails from “Derrick” (sometimes Derrik), then “Lilly,” “David,” and “Chandra.” Each had a personal email address from Gmail or Hotmail and a U.S. phone number. Each account manager urged her to order only from him or her. In the beginning she would order in quantities of 180-200 which would last for a month or two.

“I was always paranoid to order too much because I thought they were going to think I was selling. I also didn’t want them to know I was a ‘drug addict.’ Ridiculous, right? They were thrilled to take my order.”

By 2012, two years after the DEA claimed it had successfully solved the rogue pharmacy problem, Lisa was spending about $4,000 a month on Ambien and Xanax. Lisa was never asked for a prescription, never directed to fill out a medical questionnaire, and never had to answer any questions about why she needed the medication.

Empirical data supports the anecdotal evidence provided by Jennifer and Lisa: According to a recent survey done by the National Association of Boards of Pharmacy on over 10,500 Internet pharmacy sites, 88% did not require prescriptions. An additional 9% were operating in violation of other pharmacy laws and practice standards, meaning that a remarkable 97% of online pharmacies are breaking federal law or otherwise compromising the security and safety of the consumer.

How can the DEA possibly claim that they have “pretty much eliminated the online business in the United States”?

The Ryan Haight Act is a U.S. law, and therefore can only be used by the DEA to prosecute and/or shut down online pharmacies operating in violation of the act in the U.S. Many, if not most, online pharmacies operate overseas. Both Jennifer and Lisa received their packages from Pakistan or India, or occasionally from the U.K. The DEA claims it cannot use the Haight Law to prosecute, but that is incorrect. Since these pharmacies operate as websites, no one knows where the physical supply of drugs actually is. It could be in some guy’s garage in Pakistan, or in a warehouse in England. But the selling is happening via website, and in order to reach the huge U.S. market, the websites almost always need to use domain name registrars, payment processors, and shipping services in North America. In some cases, the website hosting company is within the U.S. Since all of the selling is facilitated by U.S. channels, the businesses are operating within the DEA’s domain and should be subject to federal prosecution. If the DEA will not or cannot prosecute for some reason, they could at least alert these processing companies that they are being used for illegal purposes, something they all expressly prohibit. Presumably a letter from the DEA would carry enough weight to get these services to stop dealing with the rogue pharmacies. The pharmacies would then find themselves without a website, payment processor, or shipping service to use for their North American customers.

It can be difficult to pin down a rogue pharmacy because of the nature of the Internet – sites can be taken down and put up within minutes, and domain names can be pointed to new URLs easily. Also, many rogue pharmacies use tricks where they only advertise non-controlled substances on their homepages but have other domain names which, when clicked on, “unlock” hidden parts of their websites. So although the homepage for catchynamepharmacy.com only shows ads for Viagra and Celebrex (non-controlled substances), if you access the site via a different, heavily-advertised site name (something like getphenfennow.com, for example), you will get taken to a separate, interior page which will sell you phentermine, a federally controlled substance.

So these pharmacies are sneaky, but in the course of writing this article I was able to easily find more than one place to buy Ambien, Xanax, even morphine. If I can do it from my laptop in my living room, then surely the DEA has the ability and tools to do it. These rogue pharmacies are profiting at the expense, addiction, and sometimes lives of their customers. The DEA is the only federal agency that has the power to enforce the Ryan Haight Act and shut down these illegal businesses.

The DEA maintains a page about the Haight Act with a hotline for people to report suspicious pharmacies. I called the hotline and was given two menu items – one to report the abuse of controlled substances and one to report extortion scams. There was nothing about online pharmacies. After looking around more, I found a “Consumer Alert” with a link to a form which you can use to report a suspicious online pharmacy. The Consumer Alert also explains that buying controlled substances online without a valid prescription is a punishable offense, and that it is a felony to import drugs into the U.S. and ship to a non-DEA registrant. (All individuals and businesses that prescribe or dispense controlled substances must be registered with the DEA.)

So were Jennifer and Lisa committing federal crimes? Yes. Does it matter? No.

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