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The Role of Internet Pharmacies in Prescription Drug Abuse

Posted Dec 20 2011 10:40am

Efforts to halt the growing abuse of prescription drugs must include addressing the availability of these drugs on the Internet and increasing physician awareness of the dangers posed by Internet pharmacies.  In a commentary in the December 20 Annals of Internal Medicine, investigators from Massachusetts General Hospital (MGH), the Schaeffer Center for Health Policy and Economics at the University of Southern California (USC), and The National Center on Addiction and Substance Abuse at Columbia University (CASA Columbia) describe the probable contribution of Internet pharmacies to the problem and outline potential strategies for addressing the problem.

“Controlled prescription drugs like Oxycontin, Xanax, and Ritalin are easily purchased over the Internet without a prescription, yet physician awareness of this problem is low,” says Anupam B. Jena, MD, PhD, of the MGH Department of Medicine, lead author of the article. “Abuse of medications purchased from websites can pose unique challenges to physicians because patients who abuse these medications may not fit clinical stereotypes of drug abusers.”

The authors note that abuse of controlled prescription drugs now exceeds abuse of all illegal drugs combined, except marijuana.  Some illegitimate online pharmacies sell drugs with no prescription or medical information at all while others ask for completion of a questionnaire before a prescription is issued by a physician who has never seen the patient.  Studies from CASA Columbia have found that 85 percent of websites offering controlled prescription drugs do not require a prescription, and many that do allow the prescription to be faxed, increasing the risk of forgery or fraud.

“The Internet serves as an open channel for distribution of controlled prescription drugs with no mechanisms to even block sales to children. This is particularly dangerous given that addiction is a disease that, in most cases, originates with substance use in adolescence,” says Susan Foster, MSW, vice president and director of Policy Research and Analysis at CASA Columbia.

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