Critics Claim Doctors Drive Online Pharmacy Abuse


An entry this month in the Annals of Internal Medicine describes the current, unacceptable situation with online pharmacies and the abuse of prescription medications they dispense. At the core of the problem are the doctors who write the prescriptions.

With prescription drug abuse now more frequent than any other category except marijuana, the medical community is taking a close look at the supply chain. Unlike other illegal substances (cocaine, heroin, methamphetamine, others) the supply of pharmaceuticals is highly regulated. Because Rx drugs are manufactured legally, at some point in the chain they move from a legal status to an illegal one. Finding and plugging those leaks would make a huge impact on the availability of these drugs. Online pharmacies are one of the major contributors.

There are two distinct problems when enforcing the laws against online pharmacies. The first is their mobility. They “live” in virtual space, the Internet. A site can be up and running in half a day, and closed down just as quickly. Currently, there is no way to prosecute offenders on this short a time scale. By the time evidence is collected, the business may be long gone.

The second problem, and one the article is most concerned with, is the way physicians participate in the process. Because these drugs start out legit, there are records and rules to follow. Having a licensed physician on staff who can generate a prescription meets the requirements and keeps the covers the shady practices with a veneer of respectability.

In practice, this means that someone who is never seen by the doctor fills out a form and the doctor reviews it. A prescription is then generated. This nod to regulatory agencies leaves them with the task of having to prove intent, a difficult thing to do in many cases.

What is more worrying is that new segments of the population are now vulnerable to becoming addicts as they self-treat their own problems. An actual, caring and present, physician isn’t in the loop. These folks may not even think of it as illegal drug abuse. Some would consider it a way to circumvent the expensive system and get what they need to treat legitimate problems. Only after some time do they become a more traditional addict, now dependent on drugs to get by.

The scope of the problem isn’t known. Much is hidden and difficult to track. Even when an operation is busted and records seized, you cannot tell by a prescription alone what the condition of the patient truly is – some may be legit, some addicted.


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