Overpriced drugs drive people to go rogue online pharmacies, sometimes with fatal consequences

When 14-year-old Alexander Neville had a panic attack in June 2020, his mother Amy thought it was a symptom of puberty. The global pandemic had just been announced, and she allowed Alexander to use Snapchat so he could stay in touch with friends while they were gathering no more than six feet apart. The teenage years are a difficult time.

Amy described Alexander as smart and enthusiastic, a skateboarder and a young entrepreneur who ran his own eBay store selling his old toys. She said Alexander was an empathetic person, but he seemed to be acting out this week.

When Alexander told Amy he was acting differently because he was taking oxycodone, which he got through someone on Snapchat, and it was starting to “take over him,” she called a local therapy center the next day center to try to get him seen by professionals. helpful. But over the next 24 hours, while the center was advising him, Alexander took a pill contaminated with fentanyl, a powerful opioid, causing him to fatally overdose.

“I didn’t even think Alex was going to die,” Neville told Salon in a phone interview. “It doesn’t make any sense at all.”

More and more people are ordering drugs through illegal online channels, sometimes with fatal consequences. Last month, the FDA issued a statement warning of the dangers of potentially adulterated or counterfeit drugs purchased from “rogue” online sources, claiming that “purchasing prescription drugs from rogue online pharmacies can be dangerous and even deadly.”

But there’s still a long way to go to catch illegal sellers, let alone address the root causes that drive people to buy drugs online. The issues that drive people to self-diagnose and self-treat stem from drug price gouging, drug shortages, an overall lack of access to care, and stigma against those who struggle with mental health or substance abuse.

Buyers who shop online may buy medications that interact negatively with other medications they are taking, or buy something that is completely useless.

The National Association of Boards of Pharmacy (NABP) counted 40,000 online drug sellers and calculated that 96% were operating illegally. Most of these online marketplaces are considered illegal because they do not require a prescription to obtain prescription drugs or the licenses required to sell to consumers in certain areas. But that doesn’t stop them from doing business. However, an estimated 10 percent of these sources are selling substandard drugs that can be dangerous or even fatal, said pharmacist Dr. John Hertig, a member of the Alliance for Safe Online Pharmacies.

In addition to fatal poisoning or contamination like Alexander’s, online buyers may also buy drugs that interact negatively with other medications they are taking, or buy things like sugar pills that are completely useless.

“Maybe your son was in a car accident and to get through it they ordered Percocet, or maybe they were stressed about an upcoming test so they ordered Xanax, but the problem is, those drugs are laced with fentanyl,” Hertig told Salon in a phone interview. “Everyone who goes online [to buy medicines from rogue pharmacies] This risk arises due to the critical nature of selling these products through online pharmaceutical sellers. “

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Although people have been selling illegal drugs online since the dawn of the internet, data shows the problem has gotten worse every year, especially during the COVID-19 pandemic. Fentanyl’s entry into the street drug supply has made the situation even more dire: Among children, synthetic opioids such as fentanyl were responsible for more than It increased 30 times in 2013. JAMA Pediatrics last May. In 2021, the U.S. Drug Enforcement Administration (DEA) warned that drug supplies should be wary of a large number of counterfeit pills containing fentanyl.

In 2008, the Ryan Hite Online Pharmacy Consumer Protection Act, named for a teenager who died of a fentanyl overdose, was passed, banning the online sale of controlled substances without a prescription. A decade later, various other legislation was passed or introduced to regulate and prevent the sale of illegal or tainted drugs, including the Cooper-Davis Act, also named after a man who died of fentanyl poisoning. Children named. The legislation, introduced earlier this year, would require social media platforms to immediately report drug activity to the DEA.

However, the number of illegal dispensaries selling products online has remained relatively stable over the years, despite law enforcement efforts to shut them down. When the Department of Justice filed charges against Google for allowing illegal online pharmacies to buy ads on its website, the company turned to search engine optimization and social media to promote its products, according to a 2022 NABP report. Then, when credit cards restricted the sale of illegal products through their networks, many companies turned to cryptocurrencies.

Some of these illegal websites look more official than legitimate pharmacy websites, making it difficult for some consumers to know whether their medications are legal. Additionally, many rogue pharmacies operate outside of U.S. jurisdiction, which creates challenges for law enforcement and policing. Different domains will pop up after other domains are closed. As a result, policing them becomes a bit like a game of whack-a-mole, little different than shutting down meth labs or stopping international drug trafficking.

“Drug traffickers are often active on multiple social media platforms, internet websites and dark web accounts simultaneously.”

Additionally, features of social media platforms designed to ensure privacy between users, such as encrypted messages or disappearing content, could be exploited by these sellers, according to a report released by the Colorado Department of Law earlier this year. Making matters more challenging, some social media companies did not respond to requests for survey data in a timely manner to make them useful, the report said.

“Drug traffickers are often active on multiple social media platforms, internet websites and dark web accounts simultaneously, spreading their transactions across multiple platforms to evade detection,” the report states.

Because of the challenges of policing these sites, additional steps are being taken to address the root causes of why more and more Americans are turning to rogue online sources. More than two-fifths of American adults are uninsured or underinsured, but nearly half have at least one chronic condition.

But medication can be very expensive, or people may live in pharmacy deserts without access to medications. For example, many people seeking abortions in states that ban abortion turn to online pharmacies to order abortion pills like misoprostol and mifepristone. Meanwhile, as the amphetamine shortage enters its second year, other patients have scoured dozens of pharmacies trying to buy prescription Adderall, possibly desperate to find a drug that can help.

“People may need to take medications for their entire lives, and you can easily imagine they would want to try to save money,” said Sachiko Ozawa, Ph.D., an associate professor at Carolina’s Eshelman School of Pharmacy and Ph.D. who studies substandard and counterfeit drugs.

“The lack of financial protection for health care is a huge problem in the United States, which leads people to make risky choices like this to save money and ensure they can afford life-saving medications,” Ozawa told Salon in a phone interview 》.

In recent years, state and municipal governments have sued major pharmaceutical companies such as Eli Lilly, Sanofi and Novo Nordisk for gouging the prices of drugs such as insulin. Dr. Stephen Ecker, director of drug innovation services at the University of North Carolina Medical Center, said the companies have been accused of making unclear deals with pharmacy benefit managers that ultimately raised prices for consumers. Insulin rationing often leads to death.

“Patients may be deciding between dietary or other important expenses and the cost of medications, in which case patients may need to look for alternatives to find cheaper medications,” Ecker told Salon in a phone interview. “Since most people are used to buying things online and getting them through the mail, the next logical step is [to ask yourself]“Can I find a cheaper price on the Internet?”

In response to a question about what steps are being taken to regulate and shut down illegal rogue pharmacies, an FDA spokesperson cited the agency’s BeSafeRx campaign, which highlights red flags that indicate online pharmacies may be illegal, including no prescription required, no U.S. pharmacy or state board license, and there is no pharmacist available to answer questions.

“The lack of financial protection for health care in the United States is a huge problem, which leads people to make risky choices.”

“Generally speaking, these products pose significant risks to patients because they are not reviewed by the FDA to ensure safety, effectiveness, or quality before being marketed, and they are obtained without a prescription or prescriber supervision,” the spokesman said in the salon. e-mail.

NABP has a website where consumers can check whether an online pharmacy is legally registered to sell quality products to U.S. consumers, as is Legit Scripts. According to NABP, generally speaking, any website with a “.pharmacy” domain can be considered safe and legal. Hertig said he is also developing courses for medical professionals to learn best practices on how to counsel patients on this issue.

“Our health care professionals are relatively ill-equipped to educate and counsel patients on this issue,” Hertig said. “If our health care community is undereducated, how can we expect our patients to make the right decisions?” Decide?”

In Orange County, California, where Alexander died, fentanyl overdose was the leading cause of death among teenagers in 2022. Many of the children involved in these deaths unknowingly took super-strength opioids after ordering them online from illegal sources.

Since Alexander’s death, Amy Neville has worked to raise awareness about the risks of purchasing illegal drugs online, speaking with government officials and health care leaders in addition to groups of middle school and high school students across the country. Had a conversation. She also created the Alexander Neville Foundation to provide educational materials to families about social media and drug use. She is currently filing a lawsuit against Snapchat along with more than 60 parents whose children died after allegedly receiving illegal drugs through the social media platform.

Snapchat has a new policy in 2021 that redirects people who use certain drug-related phrases to educational materials. The company has also added protections to make it harder for strangers to contact teenagers, according to a Snapchat spokesperson.

“We continue to expand our support of law enforcement investigations to help bring resellers to justice, and we work closely with experts to share patterns of reseller activity on our technology platforms to help them bring resellers to justice,” a spokesperson for Snapchat told Salon in an email. Identify and stop illegal behavior faster.”

Still, illegal sellers continue to find loopholes, and such tweaks are not enough to stop adults and children from purchasing products online.

“Kids are out there and they’re feeling down or blue or whatever and they put their symptoms online and it comes back to you: This could be something like this and here are some prescriptions that can help you with this. ,” Neville said. “People think they’re getting a real prescription, but that’s not the case.”

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