DrugBuyers.Com: Prescriptiononline.com article on Washington Post

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Internet Trafficking in Narcotics Has Surged

By Gilbert M. Gaul and Mary Pat Flaherty
Washington Post Staff Writers
Monday, October 20, 2003; Page A01

Second of five articles

LAS VEGAS -- In July 2001, regulators at the Nevada State Board of Pharmacy noticed something unusual among the reams of data that flow into the busy agency each day. Buried along with the other numbers was a report from a small Internet pharmacy that had filled 1,105 prescriptions for painkillers and other dangerous drugs that month.

The same tiny pharmacy had dispensed just 17 prescriptions in the prior six months.

Virtually overnight, prescriptiononline.com had become one of the largest distributors of controlled substances in Nevada. Over the next year, the online pharmacy shipped nearly 5 million doses of highly addictive drugs to customers scattered across the country. By the time regulators shut the Las Vegas firm in January, prescriptiononline.com accounted for 10 percent of all hydrocodone sold in Nevada, regulators said.

It turned out that the booming business was owned by a 23-year-old former restaurant hostess. But it was run by her father, who had been convicted of a felony in 1992.

"For any single pharmacy to account for 10 percent of any drug is incredible," said Louis Ling, general counsel to the Nevada pharmacy board. "The fact that it was a highly addictive painkiller and an Internet site run by a convicted felon was even more troubling. This was unlike anything we had ever seen."

With little notice or meaningful oversight, the Internet has become a pipeline for narcotics and other deadly drugs. Customers can pick from a vast array of painkillers, antidepressants, stimulants and steroids with few controls and virtually no medical monitoring.

There are dozens of legitimate online drugstores and mail-order pharmacies. Unlike rogue sites, they require customers to mail in prescriptions from their doctors. Typically, the legitimate sites offer a full range of medications, with painkillers accounting for less than 20 percent of their business.

In contrast, a majority of the rogue sites' sales are for hydrocodone, Xanax, Valium and a few other addictive drugs. Many work with middlemen who set up the sites' customers with doctors who are veritable script-writing machines. Some of those doctors have financial problems and histories of substance abuse or medical incompetence, records show.

The online merchants now feed a sprawling shadow market for prescription drugs, frustrating medical leaders alarmed by the threat to public health and investigators hard-pressed to keep up with nimble Web sites that can open and close at a moment's notice.

"It's like rabbits," said Wayne A. Michaels, a senior investigator for the Drug Enforcement Administration. "Every day, there are more of them. They're up, they're down, they're foreign, they're domestic."

The agency recently created a six-person task force solely to track the online trade in narcotics. But officials acknowledged the effort is a form of "triage" amid an escalating crisis. "We're afraid it's going to overwhelm us, once we've identified all these sites," said Elizabeth A. Willis, chief of the DEA's drug operations section.

The multimillion-dollar industry has appeared overnight, pumping millions of pills into some of America's smallest and most economically distressed communities.

The Washington Post obtained and analyzed a Nevada pharmacy board database of 30,000 orders filled by prescriptiononline.com. The analysis found that four of every 10 pills poured into four southern states with widely documented prescription-abuse problems. A disproportionate share of those drugs went to customers in small towns.

Some small Tennessee towns received 50 times more painkillers per capita than large cities, the analysis found. For example, Church Hill got 1,013 pills for every 1,000 residents; Nashville, just 26. Bristol got 1,584; Memphis, 14.

"It's a no-brainer why you see high volumes in these little places," said Tammy Meade, a narcotics prosecutor in Nashville. "Users and people who want to get their hands on enough to distribute can't doctor shop in places like that. And if they use the Internet, someone like me . . . is going to have a tougher time finding out."

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