![]() ![]() My colleagues and I have conducted more than 50 Internet-based studies in which the first 100 links were examined to determine whether the resulting Web sites offered to sell controlled substances without prescription. Our own research has documented that NPWs offering to sell opioids, stimulants, sedatives, and steroids are readily identified in Google and Yahoo searches when terms such as "no prescription codeine" or "no prescription steroids" are used ( 13, 14). ![]() Yet NPWs continue to operate openly and are easy to find. Leaders at the highest levels of federal law enforcement and policy ( 4, 5) have been aware of these Web sites since at least 1999. ![]() Ninety-one percent of the orders that were placed for hydrocodone and oxycodone were filled without a prescription (ten of 11 orders). In total, investigators placed 90 orders for prescription drugs without a prescription of these orders 45 (50 percent) were filled. General Accounting Office conducted an investigation in which it attempted to purchase prescription drugs without a prescription ( 12). To assess whether "no prescription Web sites" (NPWs) deliver drugs as advertised, the U.S. International Narcotics Control Board have all expressed concern that online pharmacies that sell opioid medications without a prescription may play a role ( 9, 10, 11). However, the leadership of the National Institute on Drug Abuse, the White House Office of National Drug Control Policy, and the U.N. The causes for this increase are unknown. The National Survey of Drug Use and Health ( 6), the Monitoring the Future study ( 7), and the Drug Abuse Warning Network Report ( 8) have each noted significant increases in prescription opioid use over the past five years, particularly among young people. The fluidity and semi-reality of cyberspace are ideally suited to illicit drug transactions, creating a complex challenge for law enforcement ( 4, 5). Moreover, all the links in this online enterprise can be changed easily in just a few hours. As a result, an online pharmacy can be hosted on a computer in Uzbekistan have its URL registered to a holding company in a Mexico have the drugs shipped from China, India, or Pakistan have payments deposited in a Cayman Islands bank and have an owner who lives in Miami. However, some countries have drug policies that differ from those of the United States or have similar laws but less enforcement. Controlled Substances Act prohibits the sale of schedule I drugs (for example, marijuana, heroin, psilocybin, and crack cocaine) and regulates access to schedule II-V drugs (for example, sedatives, analgesics, stimulants, and steroids) by requiring that prescriptions be written by licensed health care professionals ( 3). As a consequence, individuals who wish to engage in clandestine activities, such as illicit drug sales, can do so with reduced risk of detection. However the Internet differs from other media in that it can facilitate business transactions 24 hours a day, across the globe, with relative anonymity. The Pew Internet and American Life Project reported that in the United States 100 percent of college students, 78 percent of 12- to 17-year-olds, and 63 percent of all adults go online at least monthly ( 2). With approximately 200 million Internet users in the United States and more than 125 million individuals going online every week ( 1), the Internet is a vital medium for communication, entertainment, and commerce. ![]()
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