Commentary calls for awareness of Internet pharmacies' role in prescription drug abuse
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.
Additional investigations by U.S. agencies have verified the ease with which controlled drugs can be purchased online, but little information is available on how drugs acquired that way are used. While some surveys suggest that as many as 10 percent of prescription drug abusers obtain their drugs online, the authors stress that such surveys probably underestimate the situation and would not reach individuals most likely to abuse prescription drugs purchased over the Internet. They also note that surveys in drug treatment centers would totally miss local drug dealers, who are increasingly likely to access their supplies online.
Earlier this year Jena and Dana Goldman, PhD, director of the Schaeffer Center at USC and also a co-author of the current article, published a study finding that that states with the greatest expansion in high-speed Internet access from 2000 to 2007 also had the largest increase in admissions for treatment of prescription drug abuse. They estimated that for every 10 percent increase in high-speed Internet use during those years, admissions for prescription drug abuse increased 1 percent. "Prescription use starts with the physician," says Goldman, "and we need to more actively engage them to control illicit use. Access to universal, electronic prescription records would be of great assistance in this regard."
Both federal and private agencies have taken measures to reduce the impact of illicit Internet pharmacies, including the 2008 passage of the Ryan Height Online Pharmacy Consumer Protection Act, which specifically prohibits delivery of controlled substances prescribed by a physician who had never examined the patient. But the success of that law and related efforts, such as FDA warning letters to Internet pharmacies and their service providers, is unknown. The authors note that regulatory efforts also are "stymied by these pharmacies' ability to appear, disappear, and reappear constantly," and the reluctance of search engines to stop running ads for rogue online pharmacies. The increasing online availability of prescription drugs may entice individuals believed to be at low risk for drug abuse to overuse controlled medications.
The authors note that, while physicians and other health care providers should play a major part in addressing the challenges posed by Internet pharmacies, their awareness of the problem and ability to recognize and treat substance abuse of any kind is usually limited. "Physicians need to educate patients about the risks of purchasing any medications over the Internet and should consider brief but routine questioning about Internet-based medication use," says Jena, who is also a senior fellow at the Schaeffer Center at USC. "Given the ability of illegal online pharmacies to evade law enforcement efforts, physician awareness and involvement will be crucial to reducing this problem."
Journal reference: Annals of Internal Medicine
Provided by Massachusetts General Hospital
- Increase in Internet access parallels growth in prescription drug abuse May 12, 2011 | not rated yet | 0
- FDA again warns of Internet drug sales Jul 03, 2007 | not rated yet | 0
- Google to settle drug probe for $500 million Aug 24, 2011 | not rated yet | 0
- A prescription for excellence Mar 25, 2010 | not rated yet | 0
- Non-medical prescription drug use more common among rural teens than city dwellers Nov 01, 2010 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Why is zone 1 in liver more prone to ischemic injury?
May 23, 2013 Hi, Is it because around central vein, there is only deoxygenated blood from the vein where as in the periphery there is hepatic artery. Also why...
How can there be villous adenoma in colon, if there are no villi there
May 22, 2013 As title suggest. Thanks :smile:
How can there be a term called "intestinal metaplasia" of stomach
May 21, 2013 Hello everyone, Ok Stomach's normal epithelium is simple columnar, now in intestinal type of adenocarcinoma of stomach it undergoes "intestinal...
Pressure-volume curve: Elastic Recoil Pressure don't make sense
May 18, 2013 From pressure-volume curve of the lung and chest wall (attached photo), I don't understand why would the elastic recoil pressure of the lung is...
If you became brain-dead, would you want them to pull the plug?
May 17, 2013 I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
- More from Physics Forums - Medical Sciences
More news stories
(AP)—Merck & Co. says it is ending development of an experimental Parkinson's disease drug because the drug wasn't working.
Medications 11 hours ago | 1 / 5 (1) | 0
(AP)—Johnson & Johnson is developing what could eventually be game-changing treatments for depression and pain, and it's aiming to apply for approval of more than 10 new medicines by 2017, executives said Thursday during ...
Medications 12 hours ago | 5 / 5 (1) | 0
An independent panel of experts on Wednesday recommended US approval of a new Merck sleeping pill called suvorexant, but expressed concerns over the highest dosage and risks of drowsy daytime driving.
Medications May 22, 2013 | not rated yet | 0
GlaxoSmithKline PLC says it's starting an unusual collaboration with the U.S. government to develop several antibiotics for both bioterrorism threats and bacterial infections resistant to current medicines.
Medications May 22, 2013 | not rated yet | 0
The new 13-valent pneumococcal conjugate vaccine (PCV13) appears to be as safe as the previous version used prior to 2010, the 7-valent pneumococcal conjugate vaccine (PCV7), according to a Kaiser Permanente study published ...
Medications May 22, 2013 | not rated yet | 0
The British Menopause Society and Women's Health Concern have today released updated guidelines on Hormone Replacement Therapy (HRT) to provide clarity around the role of HRT, the benefits and the risks. The new guidelines ...
34 minutes ago | not rated yet | 0
(Medical Xpress)—Regulating the distribution of power in neurons is done by a system that makes the national electric grid look simple by comparison. Each neuron has several thousand mitochondria confined ...
11 hours ago | 4.8 / 5 (6) | 0 |
A brief visual task can predict IQ, according to a new study. This surprisingly simple exercise measures the brain's unconscious ability to filter out visual movement. The study shows that individuals whose ...
17 hours ago | 4.5 / 5 (10) | 1 |
Teams of highly respected Alzheimer's researchers failed to replicate what appeared to be breakthrough results for the treatment of this brain disease when they were published last year in the journal Science.
15 hours ago | 5 / 5 (1) | 2 |
Scientists at the National Institutes of Health report they have discovered in mouse studies that a small molecule released in the spinal cord triggers a process that is later experienced in the brain as ...
15 hours ago | 5 / 5 (2) | 0 |
Little is known about why asthma develops, how it constricts the airway or why response to treatments varies between patients. Now, a team of researchers at Weill Cornell Medical College, Columbia University Medical Center ...
15 hours ago | not rated yet | 0 |