The dangers of buying drugs on the internet
ANYONE who wants to get their hands on drugs needs just three things: the internet, a credit card and a spare five minutes.
That’s how easy it is to obtain everything from Viagra and Prozac to Valium and hardcore painkillers - all without so much as a prescription from your family doctor.
It is a growing global trend that is worrying Irish doctors, putting patients’ lives at risk and making billions of euro for organised crooks worldwide.
Earlier this year, the Irish Medicines Board revealed it had shut 12 illegal online pharmacies that had been selling drugs to patients.
Nine were based abroad and three were at home.
So the Irish Examiner decided to find out how easy it was to order prescription medicines on the net.
In the space of just 10 minutes, we ordered 10 of the most popular prescription drugs - without so much as a visit to a GP or a prescription.
Our subsequent investigation into the medicines haul spanned the globe and uncovered websites with very little regard for personal safety or the quality of medicines on offer.
Here is what we got through the post without any questions or a warning despite the fact that we faced a 10-year jail term:
* The impotence drug Viagra - complete with instructions in Dutch.
* A copycat of the anti-depressant Prozac - all the way from Fiji and without any instructions at all.
* The hardcore painkiller Tramal - shipped from Vanuatu in the Pacific without safety instructions.
* Marvelon, the female contraceptive pill - even though the website was told the buyer was male.
* Hair-loss cure Propecia, from London - unlicensed and therefore illegal here.
* A copycat version of Lipitor, a cholesterol buster that is the world’s best-selling medicine - ours was made in the hippy resort of Goa.
* Ventolin asthma inhalers clearly marked for the New Zealand market.
* The antibiotic amoxicillin which arrived in pink gift wrap from Madras in India.
* Tamiflu, which could help fight bird flu, from Holland - with a patient safety leaflet in Dutch again.
* Xenical, the obesity drug, from Holland with a “prescription” issued by a doctor in Cape Town.
Not a single site asked us for so much as a prescription and indeed all of them boasted that buyers did not need a prescription.
We created a fictitious identity - that of a 48-year-old man - and made up bogus medical complaints to get our hands on whatever we wanted. And that is exactly what millions of desperate patients across the world are doing in the belief they are getting their hands on medicines they need - at the right price.
Dr Ronan Boland, who is vice-chairman of the Irish Medical Organisation’s family doctors committee, said: “The problem with internet medicine is simple: you have no quality control and no guarantee that you are getting what you pay for - and there’s no comeback.
“If I prescribe medicine for you then there’s a proper trail from my office, to the dispensing chemist, to the warehouse and the manufacturers. There’s a chain of responsibility and accountability that does not exist if you buy something off the internet. What guarantee do you really have that you are getting what you pay for or that you are not getting sub-standard medicine?”
This is the main problem for many who risk buying medicines on the internet: how can the ordinary consumer know that what they get in the post is genuine, a lethal fake or a harmless con?
The vast majority of internet sites make a great play of being discreet, avoiding any awkward requirements like a prescription from your GP or even their name and address.
The sites make the whole process simple - easy for you to buy and easy for them to collect the money. And money is what it’s all about.
Rogue internet pharmacy sites - which make up the majority of online pharmacies - are part of a €28 billion global racket selling fake medicines, adulterated drugs and out-of-date tablets to people with blind faith in the internet.
It’s a headache that occupies the best minds at the United Nations. The International Narcotics Control Board (INCB), which monitors global drugs conventions, has an entire section devoted to internet medicine in its 2005 annual report.
The report said: “Customers of illegally operating internet pharmacies need to be aware that their chances of receiving the authentic product is low. In the United States, for example, it is estimated that only 50% of customers ordering through illegal internet pharmacies receive the genuine product.”
The vast majority of medicines on the internet are counterfeit mainly because of successful efforts by the large drug companies authorities to stop rogues getting their hands on the genuine stuff.
Tablets purporting to be Viagra, which treats erectile dysfunction, are the biggest seller on the internet today. But Pfizer, which makes the genuine drug in Ireland, has carried out studies which show fake Viagra has been found to contain paint, cement and even amphetamine. Other internet medicines have been found to contain lead and arsenic.
Pfizer, which is battling to stop fakes, also claims criminal gangs are making drugs in cement mixers and are drying out substances using naked light bulbs hanging over shelves.
That explains how illicit websites get hold of fake medicine but how are they obtaining genuine medicines from other manufacturers?
The International Narcotics Control Board found many of the drugs were supplied by some established chemical and pharmaceutical companies in addition to their legitimate manufacturing activities.
“The phenomenon of a business enterprise having both legal and illegal operations, commonly called “night shifts” or “the front and back offices”, can be found not only in manufacturing companies, but also at the retail level, that is, in pharmacies.
“Such dual operations, legal and illegal, conduced by the same establishment are often the source supplying illicitly operating internet pharmacies. The methods used by drug traffickers to divert those products include theft from factories and wholesalers; pretended export; falsified prescription; and the supply of substances by pharmacies without the required prescriptions.”
The nature of the internet is another problem facing the authorities: it is ungoverned and ungovernable, paving the way for these sites to operate outside the law.
For instance, the Irish Examiner ordered Valium, a popular tranquilliser, and the drug amoxicillin from a website purporting to be based in Canada.
We paid in US dollars - $187.45 (€154.93) - and our amoxicillin arrived from Madras in India while all emails had a contact address in Harley Street, London.
This pattern was repeated every time we bought medicines: we’d pay in euros on a British website but then find the drugs arrive from an island in the Pacific Ocean.
This is why the authorities face an uphill battle in tracking down the people behind these illicit websites.
As the INCB report said: “Websites may go up, be moved or be taken down in a short period of time, making it difficult for authorities to track, monitor or shut down sites that are operating illegally and making it easier for the site owners to avoid impending or suspected law enforcement action.
“Having closed down, they can immediately relocate to another site and start up the business again.
“It appears that illegally operating internet pharmacies routinely relocate, without any real reason, just as a precaution.”
The ease with which they can dodge law enforcers means these sites are a virtual drugs supermarket - you diagnose your own condition and buy any medicine you think fit.
Our investigation uncovered sites offering everything from anti-retroviral HIV medicines, anti-depressants, human growth hormone, sex-drive drugs for women and even epilepsy tablets. Also freely available were diabetes drugs, weight cures, hormone replacement therapy for menopausal women, hormonal treatment for sex-swap patients, arthritis medicine, strong painkillers and even medicines for sick animals.
The lure of the internet is easy to see: no awkward consultations with the doctor, no €50 fees to see him or her first, and you are won over by what you think are low prices.
Why people are turning to the internet pharmacies for drugs - despite all the obvious dangers - is a mystery that baffles legitimate chemists in Ireland.
Ronan Quirke, who has a chemist’s shop in Clonmel, Co Tipperary, said: “We need to identify why patients are looking to the internet to access their medicines.
“I remain to be convinced that it is purely cost driven. On a daily basis in my pharmacy, people are bringing in things printed off the internet in relation to diseases or the medicines they have. In 50% of cases I would question the reliability of what they are reading.”
Worryingly, he says many people are simply choosing to believe what they read off the internet and are not seeking the advice of trained professionals like pharmacists.
On one hand this underlines the mistrust people have in the medical profession, instead placing greater faith in gut instinct and websites telling them what they want to hear.
The INCB, though, has identified another class of people who whom the internet is a saviour: the growing bank of people who abuse prescription drugs.
“Surveys indicate that the non-medical use of all major groups of prescription drugs has been increasing over the past 10 years and now rivals the abuse of all other drugs except cannabis,” it said.
So it is clear: whether you are an innocent patient trying to save money or a scheming abuser trying to dodge the doctor, internet pharmacies provide a deadly lifeline.
WHAT the law says about people who buy medicines from abroad online:
* Anyone found to be in breach of medicinal products’ legislation, on conviction in the District Court, may face a maximum fine of €1,927 and/or up to one year in jail per offence.
* On indictment to the Circuit Court, offenders may face a fine of up to €127,000 and/or 10 years in prison per offence.
* Subsequent convictions by indictment can lead to a maximum fine of €317,500 and/or up to 10 years’ imprisonment per offence.
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