A large majority of 365 Internet sites that advertise or sell controlled medications by mail are offering to supply the drugs without a proper prescription, according to a new study. The online trade is stoking the rising abuse of addictive and dangerous prescription drugs, the authors and federal officials say.
Drugs offered online include generic versions of opiates like OxyContin, methadone and Vicodin, which are legitimately prescribed as painkillers; benzodiazepines like Xanax and Valium, which are prescribed for anxiety; and stimulants like Ritalin.
Federal and state efforts to crack down on Internet sales appear to have reduced the number of sites offering such drugs, from 581 last year, said Joseph A. Califano Jr., director of the National Center on Addiction and Substance Abuse at Columbia University.
“Nevertheless, anyone of any age can obtain dangerous and addictive prescription drugs with the click of a mouse,” Mr. Califano said. The center is issuing the study, the latest of five annual surveys, on Wednesday.
The Drug Enforcement Administration found that 85 percent of all Internet prescription sales involved controlled drugs, compared with just 11 percent of those filled through regular pharmacies, suggesting that online sales often are destined for misuse.
“Abuse of prescription drugs has exploded among college students, and we think that one way they get these drugs is over the Internet,” Mr. Califano said. The use of prescription opioids and anxiety drugs, especially in combination, accounts for a growing share of deadly overdoses nationwide.
“The Internet made it easy for the drug dealers to sneak into your living room,” said Francine Haight of La Mesa, Calif, whose son Ryan died in 2001 at the age of 18 from an overdose of hydrocodone, generic Vicodin, which he had secretly ordered online with a debit card. An A-student and varsity tennis player, he had claimed in an online questionnaire to be a 25-year-old with back pain, got his prescription and was mailed the drug. Ms. Haight, a registered nurse, has since fought against online sales.
Federal law bars dispensing dangerous medications without a prescription from a doctor who has a bona fide relationship with the patient. But officials have had a hard time catching up to rogue Internet pharmacies that sometimes ship the drugs from foreign countries in disguised packages.
For the last several years, the Drug Enforcement Administration and others have worked to halt the illegal trade and prosecute involved doctors and suppliers, with limited success.
“One of the main problems is that the sites can literally open up for a week, close and open up under a different name,” said Michael Sanders, a spokesman for the Drug Enforcement Administration.
In a more recent practice, the new study found, some sites sell written prescriptions that can then be used at local pharmacies.
Using popular search engines like Google, Yahoo and MSN, the Columbia researchers found 365 sites offering controlled drugs by mail. Of these, 206 were advertising sites, directing consumers to a seller. Of the 159 sites that directly sold controlled drugs, 135, or 85 percent, did not require a prescription or provided them on the basis of online questionnaires.
In an effort to make their surveys consistent, in each of the last five years the researchers have spent the same amount of time searching, 210 hours, for the same list of drugs. The number of sites rose to 581 in 2007, then fell to 365 this year. The study will be available online on Wednesday at http://www.casacolumbia.org/.
In April, the Senate passed the Ryan Haight Online Pharmacy Consumer Protection Act, which would require certification of online pharmacies and that doctors see patients before prescribing controlled drugs. The bill is now in committee in the House.
At least eight states have passed laws barring electronic prescribing or sales without a legitimate prescription. Minnesota passed a law in 2007 requiring doctor-patient consultations but found that “the Web sites went around us, doing 30-second consultations on the phone,” said Dan Pearson of St. Cloud, Minn., whose son Justin died of drug poisoning in 2006, aged 24, after obtaining large quantities of hydrocodone and Xanax from 17 online pharmacies. The law was strengthened this year to require face-to-face consultations.
“Anyone can have these drugs at their door within 48 hours,” usually using a credit or debit card to pay for an online prescription and then a money order to pay for express delivery, C.O.D., Mr. Pearson said.
Federal drug authorities have begun working with credit card companies and banks to try to prevent such transactions, while major Internet search engines have used a verification program called Pharmacy Checker to confirm that advertisers are legitimate. But the system appears to be full of holes, critics say.
Mr. Califano sent letters this week to senior officials of Google, Yahoo and MSN asserting that they were “profiting from advertisements for illegal sales of controlled prescription drugs online,” and calling for stronger action.
Diana Adair, a spokeswoman for Google, said the company took the problem seriously and in addition to using Pharmacy Checker, had consulted with federal agencies on ways to stem the trade. Kelley Benender, a spokeswoman for Yahoo, said the company was “working to identify the illegal sites and will take appropriate action.”
A spokesman from MSN said the company had no comment.
