Virtual Pushers Target Real Pharmacies

Shoes, sports gear, clothing, groceries are available at the click of a button, but online shopping can become a dangerous addiction.

Using online pharmacies to fill prescription medications has pharmacists worried about more serious addictions -- and about being drawn into the fray.

An updated study released Wednesday by the National Center on Addiction and Substance Abuse at Columbia University has shown that online pharmacies continue to pose public health risks as they traffic prescription drugs to patients.

Although the report showed that the total number of such pharmacies has decreased in the last year due to tighter regulations, Susan Foster, an author of the report, suggested the companies are trying to shift their methods from direct drug delivery to fillable prescriptions to get more cooperation from local pharmacies. But pharmacists are having none of it.

"These Web sites are all illegal," said Jeff Holycross, a pharmacist from Russells Point, Ohio. "If the physician has not given a physical examination to the patient, there is no physician-patient relationship.

"Therefore, any prescription written in this manner is not a valid prescription."

The center's report found that 365 Web sites currently advertise or sell prescription drugs directly to consumers, down from 581 Web sites last year. Eighty-five percent of these sites sell potent drugs controlled by the Food and Drug Administration, such as OxyContin, Valium, Xanax, Ritalin and Vicodin without a prescription.

But Foster, vice president and director of policy research and analysis at the center, noted that there has been an increase in the number of sites that offer "online consultations" in which customers fill out a survey about their symptoms, and the site then sends them or their local pharmacy a prescription for medication that can be picked up.

"It can be very dangerous," said Hank Abbot, a pharmacist at the Bird's Hill Compounding Pharmacy in Needham, Mass. "This is how the addicts get their medications and unscrupulous people make money."

What's the Diagnosis, Doc?

But it is difficult, if not impossible at times, to tell the difference between a bona fide prescription from your doctor and a paper prescription from an online pharmacy, according to several pharmacists.

Although the online pharmacy may have an actual doctor reviewing requests for prescriptions, there may be too many questionnaires to go through to evaluate each one accurately. Someone may even have been hired simply to put a signature on each prescription as it goes out without any review.

Red flags and their personal sense of ethics help pharmacists catch online prescriptions before the drugs make it into a customer's hands.

"It is not unusual for a pharmacy to fill a prescription for a patient that doesn't come from a local doctor," said Kevin Gahm, a pharmacist working in West Portsmouth, Ohio. "But it is unusual for that patient to continue to see a doctor from very far away and return consistently to a local pharmacy."

Verifying prescriptions with the doctor who wrote it is another way pharmacists avoid giving wrong medications.

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