Don’t click your life away

Buying prescription drugs online can seriously damage your health and in some instances lead to death, says Rita de Brun

PHARMACY is a safe-sounding word. It conjures up images of highly-qualified professionals knowledgeably dispensing medications from pristine premises, for the common good. Fake internet pharmacies cash in on the trusted reputation of their high-street counterparts.

Of the estimated 40,000 active online pharmacies worldwide, some are legal, above board and managed by well-known corporate brands, but most are bogus and run by criminal gangs, with not a pharmacist among them.

The ease with which an online pharmacy can be established, was demonstrated in September last year by medical researchers from the University of California, who created a fake pharmacy in 15 minutes, at a cost of less than $80 (€62).

According to the World Health Organisation’s 2011 report, Safety and Security on the Internet, nearly every major category of prescription drug is available online without a prescription.

The Irish Medicines Board urges caution. “There can be no guarantees that medicines bought online are effective, safe or of an acceptable standard or quality,” says a spokesperson.

Counterfeit drugs may contain too much, too little or none of the active ingredient. Some have been found to contain toxic substances such as rat poison or arsenic. And because you don’t know what’s in the drugs you buy online, they could adversely interact with other medications you may be taking.

In its report, The Counterfeiting Superhighway, the European Alliance for Access to Safe Medicines estimated that 62% of medications purchased online are fake or substandard, as in expired or improperly stored.

The fact that a label on drugs purchased online does not include banned substances among the contents, is no guarantee that the medication is free of them.

An 18-year-old Irish girl last year underwent an emergency colectomy, having consumed diet pills purchased over the internet. The Irish Medicines Board (IMB), found that the pills contained a high dose of Sibutramine, a drug which was banned in Ireland in 2010 and which has been associated with increased risk of heart attack and stroke.

The health risks associated with self-medicating can be fatal, and you don’t have to consume prescription drugs to put yourself at risk.

An Irish man tragically lost his life from complications arising from the seemingly unquenchable thirst he developed, having consumed salt tablets purchased over the internet.

When buying prescription drugs from sites which require the completion of an online medical questionnaire, it’s natural to assume that responses will be considered by pharmacists, but there’s no guarantee this will happen. Studies carried out in 2006 at the University of Washington found that two thirds of the sites tested, sold controlled drugs without a prescription to a researcher who listed known risk factors for use of that medication, when completing her online medical questionnaire.

Of course, it isn’t always the site managers who break the rules. To show how easy it is for canny consumers to cheat, one researcher faxed the same prescription to a number of online pharmacy sites and, counting on the fact that none of the pharmacies would contact the doctor who wrote his script, succeeded in filling his prescription five times.

Despite the fact that the supply of prescription-only medicines over the internet is illegal in Ireland, consumers continue to buy these drugs online.

Inspector John Ferris of the Garda Press Office is clear about the legal position.

“It’s a criminal offence to be in possession of prescription drugs without a prescription. Those who accept delivery of packages containing controlled drugs from online pharmacies, may expect a visit from a Garda with a search warrant,” he says.

Inspector Ferris says preservation of life is his main concern. “People are consuming what appear to be and what they believe to be legitimate pharmaceuticals bought online. But many are being fooled, as often the contents differ from what it says on the label.”

The IMB shares his concerns. “The Irish Medicines Board is particularly concerned about the potential risks for patient health associated with [the] online purchase of any prescription medicine and in relation to any attempt to self-medicate,” says a spokesperson.

In the United States, the National Association of Boards of Pharmacy (NABP) found that only 3% of the thousands of online pharmacies it reviewed, followed state and federal laws. The Food and Drug Administration (FDA) was equally damning in its condemnation, stating that the majority of active online pharmacies are fraudulent and likely to be selling drugs that are fake or counterfeit.

Despite the well-documented risks the steady online demand shows no hint of slowing. In 2009, Irish customs officials seized 1,216 packages of abortion pills which were imported into Ireland. The previous year they seized 48.

An FDA survey conducted in May 2012 found that almost 25% of internet shoppers surveyed had bought prescription drugs online, while almost 30% said they weren’t confident they could do so safely. Studies carried out last year found that only 48% of internet pharmacy websites disclose their location.

Online shopping is on the increase in Ireland. Research by Visa Europe reported a 39% rise in the amount spent online in 2010 by the Irish adult population, compared with a year earlier. Most of those who shop online for medicine do so for convenience and lower prices, others for access to controlled drugs, but some for anonymity.

Men who don’t want to see their doctors with erectile dysfunction problems may opt to buy Viagra online. The ease with which it’s available was confirmed by a British study conducted in 2010, which found that 34% of the internet pharmacy sites contacted offered to sell Viagra to consumers who had not had a medical consultation.

While Sam McCauley Chemists sell health, beauty, and other products through their website, they don’t sell drugs online. “It’s difficult to ascertain the true source of drugs offered for sale over the internet,” says Patrick McCormack, MD. “Significant amounts of fake prescription drugs are sold in that way and the amount of spam we get offering to sell us Viagra and similar products does nothing to inspire confidence in the sale of drugs online.”


- Permits you to buy prescription medicines without a prescription.

- Offers prices that seem too good to be true.

- Sends spam or unsolicited emails offering cheap drugs.

-Sends medicines without labels or instructions as to how they should be taken.

- Does not disclose its location.

- Further reading: Buying online / World Health Organisation

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