Along the Internet's Main Street -- and its various side streets and alleys -- they are everywhere, promising easy access to the pills that pump you up, chill you out, slim you down and shift your sex life into overdrive. They are, to some Americans, a medicine chest of fun, purveyors of all the stuff that addicts need and the adventurous want to try but are afraid to request from their doctor.
Too shy to ask for Viagra? Worn out your welcome cadging pain-pill prescriptions from local doctors? No problem: There they are, these denizens of the Internet, relentlessly spamming America: "Need Vicodin for pain?" the e-mail enticement asks. "No embarrassing doctor visits! No waiting rooms! Free delivery! Discreet packaging!" Some sites offer a physician to write the prescription. Others waive that formality altogether: Click here and add to shopping cart; we'll overnight the stuff to you.
For The Record
Los Angeles Times Friday December 05, 2003 Home Edition Main News Part A Page 2 National Desk 1 inches; 31 words Type of Material: Correction
Internet pharmacies -- An article in Monday's Health section incorrectly identified Dr. James N. Thompson, president and chief executive of the Federation of State Medical Boards, as Dr. Robert N. Thompson.
For The Record
Los Angeles Times Monday December 08, 2003 Home Edition Health Part F Page 8 Features Desk 0 inches; 31 words Type of Material: Correction
Internet pharmacies -- A story in the same issue incorrectly identified Dr. James N. Thompson, president and chief executive of the Federation of State Medical Boards, as Dr. Robert N. Thompson.
These are not the online pharmacies of the nation's large chain stores or the cyber arms of legitimate retail pharmacies, although it is sometimes hard to recognize the difference. These are the Internet's "rogue pharmacies," and they have prompted wonderment from consumers, frustration from state and federal authorities and worry from the medical profession. They have also put a virtual street corner's worth of addictive and dangerous prescription drugs within reach of anyone, from an addict in Los Angeles to a sheltered teen in a small town in the Midwest with access to a computer.
Who are these pharmacists? Are they legal? Are they safe and is their product what they say it is?
The answers are as fluid and fast-moving as the Internet itself. If you order from them, there is little chance you'll get caught or punished. These online pharmacies are operating either at the edge of or outside the law, and the resulting unregulated market is rife with violations of privacy as well as medications that are counterfeit, improperly handled, addictive and, in some cases, unsafe for the people who buy them.
In short, this is not your corner pharmacist, and a trip to this store could cost you your money, your privacy or your health.
For Ryan T. Haight of La Mesa, Calif., the cost was even steeper. On Feb. 21, 2001, Haight died at age 18 of an overdose after mixing morphine and two prescription antidepressants with Hydrocodone, a potent and highly addictive painkiller that he bought off the Internet. Haight was 17 and complaining of back and joint pain when he started ordering prescription painkillers from Internet pharmacies, said his father, San Diego eye surgeon Bruce Haight. The high-school senior used the family computer late at night and a debit card his parents had given him to buy baseball cards on EBay. Ryan would intercept the packages when they arrived in the mail from suppliers abroad and from the Web site of a small Oklahoma pharmacy. Ryan grew up with the Internet. In an interview, his father said the teen was a habitue of chat rooms, scoured collectors' sites for baseball cards and enjoyed downloading music. When Ryan turned to more dangerous pursuits, the elder Haight said his son's cunning and recklessness was "diabolical," but he never had to risk arrest or harm on a dangerous street corner. Instead, he could turn to the familiar terrain of the Internet, operating under the screen name "Quiksilver."
For young people in particular, online pharmacies seem to be especially seductive, says University of Pennsylvania researcher Robert Forman. For this generation, the Internet is a familiar medium where friends hang out, and it feels safe. "Getting drugs off the Internet is as natural as downloading a song," says Forman. "And in their mind, it may be viewed as no more illegal or likely to be detected."
Online pharmacies began springing up in the late 1990s, largely to hawk "lifestyle drugs" such as Viagra, the erectile dysfunction medication that quickly achieved blockbuster status after its introduction in 1998. Other drugs that proved popular on the Internet included the baldness treatment Propecia, various diet pills and, after a wave of bioterrorist scares, the potent antibiotic Cipro, a medication prescribed for anthrax infection.
But in the last two years, investigators say, these rogue pharmacies have entered a new phase: selling drugs with wide appeal among abusers -- addictive drugs ranging from Xanax and Soma (anti-anxiety and muscle relaxant medications, respectively) to Percocet, Darvon and OxyContin (all powerful opiate-based painkillers).
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No doctors needed
In many cases, especially when the drugs originate in foreign countries, no physician is involved at all. But for those cyber pharmacies seeking to convey an air of legitimacy, a physician will review a purchaser's online questionnaire -- and sometimes conduct a brief telephone interview -- and write out a prescription. While widely recognized by physicians as unethical and unsafe, this medical practice is not uniformly illegal.
