Drug Trafficking on the Information Highway

As a tribute to Internet drug trade, I suggest we all begin stressing the "high" in information highway.

Access to Viagra, Soma, Valium, Steroids and any other cocktail addition is at your fingertips, as long as you have Internet and credit card access. The search engine Excite, alone, boasts 14,129,860 entries when you type in "online pharmacy." Google has 319,000; Lycos has 392,879; Northern Light has 281,965. Log on and load up -- could be a great sales slogan.

On most of the sites, you don't even need a prescription to get what you want -- just fill out a survey for a doctor to "evaluate." The survey includes questions about your height, weight, current medications and medical history. After you agree to an $85 (or more) fee, some guy you'll never meet will write you the prescription you requested -- once you sign a waiver protecting the site from any responsibility, of course. After a few days or weeks, your drug of choice is delivered to your doorstep.

The problem here goes beyond the mere availability of drugs. Flaws center on drug interactions, prescribing the wrong medication, allergic reactions, patient history, no doctor interaction or examination and potential side effects that accompany drugs. Once you pass your initial survey, your drug spree is doctor-free.

We're not talking your common cold medicine or heartburn reliever here, either. The most common online meds include Viagra (erectile dysfunction), Meridia (weight loss) Propecia (hair loss), Claritin (allergies), Celebrex (arthritis pain) and Zyban (smoking cessation). With a more extensive search, it's also easy to find muscle relaxants like Soma, painkillers Hydrocodone (Vicodin) and Oxycodone (Percodan), anti-anxiety medications like Diazepam (Valium) and antidepressants (Prozac).

But it's the foreign pharmacy sites that would make a cokehead sniff. On those, you can find things like childbirth painkiller Stadol, acne medication Accutane, minor tranquilizer Alprazolam, highly addictive codeine and even penicillin. And, according to the sites, consumers can legally purchase up to a three-month supply of each medication at a time.

Nevada, a pioneer?

The state of Nevada has responded to the Web drug trade increase with "one of the toughest pharmacy laws in the country," according to Louis Ling, Nevada's Board of Pharmacy general counsel. He's referring to a new law that focuses on examining Internet pharmacies and aims to crack down on the illegal ones. The law will go into effect in October. The bill was sponsored by Valerie Wiener, D-Las Vegas, who says it's the first of its type in the country.

Internet pharmacies struck home with Wiener because they impact so many, including seniors, juveniles and substance abusers. Fearful of medications -- often outdated or imitations -- falling into the wrong hands, she decided something needed to be done. "This bill's important to me as a consumer protection bill -- because that's what it is," she says.

Wiener also feared that Nevada would become some kind of Internet pharmacy headquarters. "It's a good start to make sure that Nevada doesn't become in Internet pharmaceuticals what it has become in telemarketing," she says.

The law will require all pharmacies that do business with Nevada residents to be licensed by the Pharmacy Board. It also requires that patients see a doctor within the past 6 months, and that the doctor has prescribed them the medicine they're buying.

"Most Internet pharmacists do questionnaires, but they don't validate it, don't view it, and charge up to $100," Wiener says. "The Md.'s don't even see the patients."

Once the law goes into effect, district attorneys and the attorney general will try to enforce it. "Enforcing it's going to be tough," Wiener admits. "A lot of enforcement will come from complaints."

Federally-encouraged crackdown

On the national level, the Food and Drug Administration is also trying to cut back on Internet pill pushing. Their Web site reports that the seizure of scheduled or controlled substances at international mail facilities increased 450 percent in 1999.

According to Tom McGinnis, Director of Pharmacy Affairs at the FDA, there are three types of Internet pharmacies. There are legitimate ones, like Drugstore.com and Walgreens.com, which are state licensed and require a legitimate doctor's prescription. Then there are two categories he referred to as "rogue" sites: the ones where you fill out a survey and an online "doctor" reviews it and fills a prescription; and foreign pharmacies selling just about anything, including prescription drugs not approved in this country.

In 2000, the FDA sent out several dozen "cyberletters" -- emails -- warning companies thought to be selling illegal drugs. They will continue with this practice, as email is the only way to contact an Internet pharmacy that gives no physical address or phone number.

In the future, McGinnis is counting on states to follow Nevada's lead and target these illegal pharmacies. "Most of the laws were written back in the '50s when everyone knew where the pharmacy was. Now, online it's hard to find out where these rogue pharmacies are located. So they are updating laws that will make it tougher on some of these illegal online pharmacies," he says.

As with all legislation, it's a matter of jumping through political fire hoops before we can expect any positive changes to occur. For now, if you come across an online prescription site that seems suspicious, you can log onto the FDA website and let them know. Last year, McGinnis says, the agency checked out more than 3,000 tips.

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