WASHINGTON — With a few computer keystrokes--and without ever seeing a doctor--Americans can buy powerful prescription drugs, including some not approved for sale in this country.
Supporters say consumers are savvy enough to buy medicines over the Internet. But health experts fear that the growing trend could endanger patients and even kill some. Several states are investigating Web sites, and the Drug Enforcement Administration has raided at least one Internet doctor as the government struggles with how to control drugs in cyberspace here and abroad.
"Consumers are taking a huge risk. . . . They may be risking their lives," warns William Hubbard of the Food and Drug Administration. "We're very concerned about this."
Yet some state regulators say they've never heard of the Web sites that post such ads as: "Need Viagra? No prescription? No problem!"
How easy are such purchases? An Associated Press reporter bought from a British Web site a controversial diet drug that the U.S. government has not yet decided is safe. The unmarked brown envelope bearing a month's supply of Xenical cleared U.S. Customs. The unseen British pharmacist had no way to know that the reporter had exaggerated her weight by 30 pounds to qualify for the drug.
A Viagra site promised to ship the little blue impotence pill after an AP reporter answered just one health question--and disclosed that she is a woman.
"That's very, very dangerous," said consumer advocate Dr. Sidney Wolfe of Public Citizen, saying both were drugs for which the "patient" did not medically qualify.
"There is a reason that some of these drugs have to be prescribed," added Larry Lessly, director of Nevada's Board of Medical Examiners, which recently barred over-the-Internet sales unless Nevada doctors see the patients. "People shouldn't just willy-nilly take them."
Colorado publicly reprimanded one doctor for selling Viagra over the Internet; Connecticut, Wyoming and Nevada ordered one Web site to stop selling in those states, and at least eight other states are investigating complaints.
North Carolina is probing Web sales of a computer program that teaches patients to diagnose their own problems and then pick a medication from foreign Web sites.
The government determines which drugs need prescriptions--because they're for serious medical problems and can cause serious side effects.
Yet U.S. Web sites tout Viagra, highly risky for certain men; Valtrex, which treats genital herpes but can kill patients with weak immune systems; Meridia, a diet drug that requires doctor monitoring because it can raise blood pressure; and the diet drug phentermine, a controlled substance considered dangerous to some.
Foreign sites offer stimulants, tranquilizers, antidepressants, antibiotics and drugs for epilepsy, dementia and hypertension.
Pharmacist William Stallknecht, who runs a popular Web site from his Pill Box Pharmacy in San Antonio, says patients should be free to choose certain drugs without the hassle or embarrassment of in-person doctor visits.
"Patients have rights," said Stallknecht, who sells Viagra, the anti-baldness pill Propecia and the antihistamine Claritin over the Internet. "We take the care necessary" by requiring online health questionnaires reviewed by doctors.
But critics say online questionnaires can't substitute for a doctor's exam.