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Rogue Sites Deal Dangerous Rx

The Internet has opened easy access to dangerous and addictive drugs sold by rogue Websites linked to disreputable doctors, The Washington Post reports.

Unlike legitimate online pharmacies that sell a full range of medications, the rogue sites specialize in painkillers, steroids and other drugs, including hydrocodone, Xanax and Valium.

While most sites require patients to submit written prescriptions, the rogue pharmacies connect buyers with doctors — many with financial problems and poor performance records — who write scripts for deadly drugs.

Federal officials admit they are playing catch-up to the rash of online sales.

"It's like rabbits," Wayne A. Michaels, a senior investigator for the Drug Enforcement Administration, told The Post. His agency has formed a six-person task force to monitor online drug sales, but officials conceded the DEA is afraid it would be overwhelmed.

While the Justice Department has shut down several sites, it can take years to do so. In the interim, some sites spin off numerous affiliates that can continue operations even if the original site is closed. Some of the sites are located overseas, beyond the reach of U.S. authorities.

The Post reported that one Website, prescriptiononline.com, filled 1,105 prescriptions in July 2001 despite having reported only 17 sales in the previous six months. Of the 30,000 orders filled by the site, 40 percent went to four southern states with well-known prescription abuse problems. Small towns were unusually big markets: In one example, tiny Church Hill, Tenn., received 1,013 pills for every 1,000 residents, compared to 14 per 1,000 in Memphis.

When Nevada officials finally closed the website in January 2003, owned by a 23-year old restaurant hostess but run by her convicted felon father, it was distributing 10 percent of the hydrocodone sold in the state.

According to the newspaper, a customer who logs onto a rogue site is usually redirected to a middleman who sets up a telephone consultation with a doctor. The doctor writes a prescription and sends it to the online pharmacy. If the drug was the painkiller hydrocodone, for example, the customer might pay $290 for 60 pills. The doctor gets $100 and the Website $190.

The Post reports that the boom in online sales is boosted by lax regulation. Congress considered requiring Web sites to disclose their ownership and affiliated physicians, but no law was passed. Licenses can be easy to come by — the owner of prescriptiononline.com obtained a license despite not being a pharmacist and being based out of state.

According to the National Institute on Drug Abuse, an estimated 9 million people aged 12 and older used prescription drugs for nonmedical reasons in 1999.

In January a government report found that a growing number of teenagers and young adults are abusing prescription drugs, with non-medical use of pain relievers and tranquilizers reaching record highs.

In 2001, nearly 3 million young people, age 12 to 17, reported that they had used prescription drugs for non-medical reasons at least once, the government said. The number of new users has been climbing since the mid-1980s.

"Abuse of prescription drugs can lead to addiction, misdiagnosis of serious illness, life-threatening circumstances and even death," said Charles Curie, administrator of the Substance Abuse and Mental Health Services Administration, a branch of the Department of Health and Human Services, which released the report.

A companion report, based on a survey of hospital emergency rooms, found a steady, significant rise in visits for opiate abuse since 1994.

In 2001, there were about 90,000 visits for abuse of these narcotics, a 117 percent rise over 1994, according to data from the Drug Abuse Warning Network. The largest increases were found in abuse of oxycodone, methadone and morphine.

The average age of these ER patients was 37.

The first report is based on the National Household Survey of Drug Abuse, an annual survey that included 69,000 people in 2001. That includes more than 45,000 people age 12 to 25.

It found that in 2001, 36 million Americans — 16 percent of all people age 12 and up — had used prescription drugs non-medically at least once in their lives. That includes people who took a drug that had not been prescribed for them and those who took drugs only for the experience or feeling they caused.

Among young adults, age 18 to 25, 7 million had used these drugs non-medically at least once.

Among teens, girls were more likely than boys to have misused drugs; it was opposite among young adults. Abuse was more common among whites than Hispanics, blacks or Asians.

The number of new users has risen sharply since the mid-1980s. The number misusing pain relievers climbed from about 400,000 then to 2 million in 2000.

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