Internet Prescribing 2005

Illegal prescribing and dispensing through the Internetcontinues to thrive. Some of the same methods arebeing utilized today as several years ago; however, somenew twists have developed in the past year or so.

I found that at least 25% to 30% of my daily e-mails areadvertisements for illegal prescription drug operations. Thequestion always remains as to which ones will actually senddrugs, which ones are total scams, or which ones are sendingthe receiver a counterfeit replacement. Once again, weneed to remember that very legitimate on-line pharmaciesexist, but I never seem to get e-mail advertisements fromthese establishments.

What is not new is that the sites often employ physicianswith borderline licenses, usually sanctioned in one or morestates, being paid a fee for each prescription written. Thesephysicians combine with equally questionable pharmaciststo create a team operating illegally while distributing millionsof dosage units of controlled substances, many ofwhich are abused by the receiver, or are sold to others topromote growing prescription drug addictions.

The only semblance of a doctor-patient relationship isusually an on-line questionnaire designed on the honor system.Although past history dictates that if you give thewrong answers, your drugs will usually still be shippedpromptly.

Schedule II drugs are virtually impossible to find, withCIII and CIV dominating the illegal market. Hydrocodonetablets will cost the Internet "patient"close to $3 per pill,but a strong market will still allow for them to double theirmoney on the street. Credit cards can still be used, but astrong part of this market now uses popular shipping companiesand sends the drugs cash on delivery (COD).

In one situation, prescription drug dealers having a cashflow problem would stop the shipping truck driver in themorning, even though their delivery would not occur untilthat afternoon. They would purchase 1 of the 2 packageswith cash, and tell the driver that they would be able to payfor the other package later in the afternoon. It was obviousto the driver that the trafficking profits from the morningpackage would pay for the afternoon supply.

Although offshore pharmacies are still in business, someof these Internet sites are now flourishing within the UnitedStates, closing up and moving to new physical and Website addresses periodically. COD charges have become popularwith scam-wary receivers who do not want to give outcredit card information, or have been ripped off when noproduct showed up at their doorstep.

I recently received an e-mail from an Ohio law enforcementofficer working as a school resource officer in a highschool. He told me that he had caught a 16-year-old studentselling Xanax to students on a regular basis. During hisinterview with the youth, he found out that the Xanax wasbeing purchased from the Internet. He was frustrated withthe fact that he was having trouble getting to the source ofthe drugs—the Internet pharmacy.

Unquestionably, millions of dosage units of controlledsubstances are being distributed to a drug-addicted and/ordrug-trafficking population within the United States. Sincethe supply is seemingly endless, it is no wonder that prescriptiondrug abuse seems to be rising each year, withincreased incidents of overdoses. It may also be one of themain reasons that a recent government study indicated asubstantial rise in prescription drug abuse for those adolescentsaged 12 to 17.

As I have mentioned before, this is not an easy problemto solve, but local, state, and federal law enforcement agenciesare attempting to stem this illegal tide of prescriptiondrugs. It is important that we strike a significant blow to thisprevalent and still growing national illegal drug source.

John Burke, director of the Warren County, Ohio, drugtask force and retired commander of the CincinnatiPolice Pharmaceutical Diversion Squad, is a 32-year veteranof law enforcement. For information, he can bereached by e-mail at burke@choice.net, via the Web sitewww.rxdiversion.com, or by phone at 513-336-0070.