No Prescription? No Problem Online

Pharmacist Don Perdue and a member of the West Virginia House of Delegates, shown in his office on July 20, 2007, in Kenova, W.Va., says that Internet pharmacy sites are feeding drug addictions. Even as law enforcement agencies and state governments respond, rogue pharmacies continue to grow, filling hundreds of prescriptions a day, according to a recent study by the National Center on Addiction and Substance Abuse at Columbia University. (AP Photo/Jeff Gentner) (Jeff Gentner - AP)

Prescription drugs can legally be ordered online, but rogue pharmacies ignore the rules that legitimate pharmacies follow, like requiring a doctor-patient relationship and getting a certification from state boards. The difference between legitimate and rogue pharmacies can be confusing.

To make the distinction clearer, the National Association of Boards of Pharmacy has created a voluntary verification process for online pharmacies to establish that they comply with the law and only ship prescriptions to patients who have been examined by doctors.

So far, 13 sites have received verification, including those by Walgreen Co. and CVS Caremark Corp.

In May, the National Center on Addiction and Substance Abuse identified 581 Web sites that offer controlled prescription drugs, compared with 492 in 2004.

Both the center and the DEA say it's impossible to know exactly how many such sites there are, with estimates ranging from a few hundred to more than 1,400.

"These Web sites come and go very quickly," said Susan Foster, vice president of policy research and analysis at the center. "They could be up one day and operating under a different URL the next day."

Most of the sites identified by the center were so-called portal sites, which don't directly sell drugs. They lead browsers to anchor sites, where the drugs are sold.

The study identified 187 anchor sites. Of those, 157 did not require a prescription.

Experts warn that the sites are dangerous not only because they can be used to feed addictions, but because customers often don't know what they're getting. Ninety-one of the anchor sites identified by the center were located outside the United States, where there are often different safety standards for medicine.

"You have no idea what you're getting from these places," DEA spokeswoman Rogene Waite said. "It's just a very dangerous business."

Linda Surks of South Brunswick, N.J., knows better than most how dangerous rogue pharmacies can be.

She lost her 19-year-old son, Jason, three years ago when he overdosed on prescription medication he ordered from a Web pharmacy based in Mexico. His family had no idea he had been taking the drugs, since he didn't have prescriptions.

"One of the first questions they asked us in the emergency room was whether he was on any medications, and we said he wasn't," Surks said.

Some states have passed laws aimed at blocking the importation of pharmaceuticals from rogue Web sites.

All pharmacies shipping drugs to West Virginia and Kentucky have to be registered with those states' Board of Pharmacy. Some rogue pharmacies carry disclaimers saying they won't ship to those states.

Last year, West Virginia State Police intercepted hundreds of packages shipped to the cities of Huntington, Charleston, Beckley, Logan and Lewisburg, Cpl. M.T. Smith said.

But as more rogue pharmacies shift from a cash-on-delivery model to relying on credit cards, such seizures have become rare.

Since the passage of a 2005 law banning the importation of drugs from unlicensed online pharmacies, the Kentucky Bureau of Investigation has seized more than $1.5 million worth of controlled pharmaceuticals.

Other states passing laws to address online pharmacies include Idaho, Wisconsin, Arkansas and Texas, according to the National Conference of State Legislatures.