Are Online Pharmacies Fueling the Prescription Drug Abuse Epidemic?
Once Lisa received a letter informing her that a package addressed to her had been seized by U.S. customs. If Lisa did not provide customs with proof of DEA registration, she would be in violation of the law. The letter included a form for Lisa to fill out and return. Alarmed, Lisa immediately called her current sales manager. He assured her that it was normal and she should ignore it, there was nothing to worry about and he would send out a replacement immediately. A few days later she received her regular shipment of Xanax and Ambien. This only happened once over the two years she was a regular customer.
Extortionists take advantage of the DEA's non-action
In a strange ironic twist, some criminals are taking advantage of the DEA’s lax attitude in going after the purchasers of these illegal prescriptions by pretending to be federal agents themselves. These con men call people who have, at some time in the past, purchased drugs online and tell them that they have broken the law and are at risk of going to prison. In order to avoid incarceration, the purchaser must pay a fine by wiring a sum of money to the “court.”
The DEA is very aware of this extortion scam, and it has gotten considerable media attention. In fact, based on the DEA homepage, the press release about the scam, and the message I received when I called the hotline, the DEA appears to be more concerned with this matter than it is with the issue of rogue pharmacies. Naturally, any impersonation of a federal agent is alarming and requires immediate action, but if the DEA was effectively policing and managing the rogue pharmacy issue, the opportunities for extortionists to implement this scam would be almost nil. Why not go after the root of the problem instead of making a huge deal about fixing one of its symptoms?
Operation Cyber Chase
Despite abundant evidence to the contrary, the DEA prides itself on a job well done “targeting rogue online pharmacies for prosecution and shutting down these illegal websites” and has a press release detailing its big takedown, “Operation Cyber Chase.” Operation Cyber Chase took place in 2005, before the Ryan Haight Act was implemented. We know, however, that even at that time there were thousands of unregulated pharmacies operating illegally. The result of the bust? 20 arrests in eight U.S. cities and four foreign countries. The press release explains that these criminals were using more than 200 websites to “illicitly distribute pharmaceutical controlled substances.” The DEA took great pride in Operation Cyber Chase: According to DEA Administrator Karen P. Tandy, “For too long the Internet has been an open medicine cabinet with cyber drug dealers illegally doling out a vast array of narcotics, amphetamines, and steroids. In this first major international enforcement action against online rogue pharmacies and their sources of supply, we’ve logged these traffickers off the Internet.” With the Ryan Haight Act providing even stronger tools for the DEA to use in their fight against these traffickers, why aren't there more press releases detailing successful investigations and prosecutions post-2005?
Chief Postal Inspector Lee R. Heath had high hopes at the time: "Operation Cyber Chase sends an instant message to ‘cybercriminals’ that the Internet is not their safehouse. Criminals, disguised as entrepreneurs, use the Internet to invade your home and push their poison. Whether the battle is on the street or on the Web, the outcome remains the same: Postal Inspectors will continue working with our law enforcement partners to bring offenders to justice.”
The prescription drug abuse epidemic
In 2011, the CDC reported that prescription painkiller overdoses have tripled over the past decade and SAMHSA reported a 430% spike in prescription painkiller addiction. In another recent study, The Partnership at DrugFree.org found that 36 million people, or one in six Americans, have gotten prescription medicine via the Internet without a prescription. Also, according to LegitScript, a company that monitors rogue pharmacies and provides a list of legitimate ones, the operators of these illegal pharmacies typically make five figures per month in commissions alone. Some surveys estimate that 10% of prescription drug abusers obtain their drugs through the Internet. Also in 2011, a study published by Jena and Dana Goldman, PH.D., showed a correlation between states with the greatest expansion in high-speed Internet access from 2000 – 2007 and the largest increase in prescription drug abuse treatment admissions. “For every 10 percent increase in high-speed Internet use during those years,” the study authors estimate, “admissions for prescription drug abuse increased 1 percent.”
While they were in the depths of their addiction, online pharmacies were like a godsend for Jennifer and Lisa. In recovery, however, they have found it difficult to escape the reach of their incessant marketing. Lisa, with over a year drug-free, continues to get email almost daily and phone calls from different numbers weekly. When I asked if she felt that it threatened her recovery, she told me that when she was at a weak place, she had given in: “I had a relapse two weeks out of treatment and 'Derrik' had called me that week. While on a prescribed refill of Xanax, I ordered thousands of dollars of pills from him. I tried to stop it the next day but couldn't. I had someone get rid of it when it was mailed to me. I was in sober living at the time. I immediately deleted all communication from him.” Two months later Lisa had a friend answer one of the calls. The friend told Derrik that Lisa had OD’d on prescription drugs purchased from an online pharmacy and asked if he would like to help in the investigation. Derrik hung up. A few days later the calls resumed. Lisa doesn’t answer, and blocks the numbers as they come in. Fortunately, she has reached a place in her recovery where she does not feel threatened. “Now, they are no longer a threat because [taking drugs is] not an option for me.”
Jennifer, who has been sober for over six months, gets calls daily, always from different phone numbers.
“I blocked all their numbers but they keep calling me from new ones.“
Jennifer has used the DEA reporting system to report the harassment multiple times but she has not gotten any response. She says she is considering changing her phone number, even though it will mean she’ll have to change her whole life around.
Prescription drug abuse usually starts with the doctor. If we have better safeguards in place and if doctors are educated more thoroughly on addiction, then fewer people will get addicted in the first place and be forced to look elsewhere for their fix when their prescriptions run out.
But more importantly, especially for those ex-addicts who used to get their drugs online, the DEA needs to go after these rogue pharmacies. Clearly the DEA’s data is flawed: the problem was not solved as a result of the Ryan Haight Act. The Haight Act did have an impact on DEA registrant pharmacies in the U.S. (such as the one that sold Ryan Haight the Vicodin that killed him). They will no longer dispense controlled substances without a valid prescription. But the vast majority of these rogue pharmacies went overseas (or were overseas to begin with) and so the DEA has been unable or unwilling to go after them. Sites like legitscript have pointed out ways to shut down these sites, but so far the DEA has not taken their advice.
In 2007, Judiciary Committee Chairman Sen. Patrick Leahy remarked that “Internet drug trafficking has presented another challenge for law enforcement. If drug dealers came into our neighborhoods selling these kinds of drugs, Americans would be up in arms.” It’s even more insidious than your neighborhood drug dealer; all you need is an Internet connection and a credit or debit card (and some sites sell their prescriptions COD so you don’t even need that).
In June of last year, the FDA shut down 1,677 online pharmacies which were operating illegally. Also, most of these pharmacies rely heavily on search engine advertising. In 2011, Google settled with the federal government for $500 million for allowing these rogue pharmacies to buy sponsored ads in search engine results. Last year, UPS paid $40 million for shipping prescription drugs from known illegal pharmacies. Neither of these companies will do business with rogue pharmacies again. Google and Godaddy have partnered with American Express, eNom, MasterCard, Microsoft, Network Solutions, Neustar, PayPal, Visa, and Yahoo to create a nonprofit organization dedicated to taking down illegal online pharmacies. These admirable efforts are attempting to pick up the slack where the DEA has failed. Will it work?
Jennifer feels helpless. She is working hard to maintain her sobriety. In early sobriety, one of the best pieces of advice we give newcomers is to stay out of situations and places which you associate with drug use. But what if the place you associate with drug use won’t leave you alone? If your street dealer was harassing you, you could call the police. Jennifer has followed the DEA's instructions and reported the illegal activity, but no one has responded. Her pharmacy is still calling.
“All in all the whole thing really frustrates and upsets me, I feel like I’m their prey and they’re waiting for me to have a moment of weakness and say ‘what the hell, sure I’ll refill my order,’” Jennifer says. “I don’t even know if I have another sobriety in me. I would probably die.”