"Get a prescription for oxycodone here --no prescription required-- free online consultation."
All it takes is a click of the mouse to circumvent the law, according to the Food and Drug Administration and the Drug Enforcement Agency.
"Cyberspace has opened up a whole new illicit market for dealers and addicts," the DEA's website reports. "Online pharmacies headquartered offshore have been able to avoid legal issues involved with selling products like OxyContin."
Narcotic painkillers such as Vicodin and OxyContin are considered highly addictive and fall under the Controlled Substances Act which tries to regulate their use and distribution. Rogue websites have allowed addicts and dealers another option for procuring these kinds of drugs.
Escalating drug problem in Payson
According to Payson Police Lt. Don Engler, narcotics officers are seeing an increase in trade and use of prescription painkillers.
"We see a lot of hydrocodone," Engler said. "We are seeing more OxyContin abuse, too."
The police department is frequently involved when they are notified by a pharmacy that someone is using a fraudulent prescription.
"The pharmacists alert us," Engler said. "They watch the records of people who are receiving scheduled narcotic drugs. They know how much they should be receiving for pain management."
Engler said addicts use a variety of techniques to get painkillers and other scheduled drugs such as anti-anxiety medications.
"Some use fictitious names, forge prescriptions, make copies of a prescription," Engler said. "Sometimes it gets pretty elaborate. We had one guy who was a printer and he just printed his own. That worked well for him for awhile."
Yet, what people are purchasing on the Internet that comes delivered to them in a discreet package the next day is impossible to control.
Surfing the web
Payson Roundup reporters found at least 30 websites that advertised anything from morphine to anabolic steroids which could be ordered without a prescription.
Staff was able to place orders that took no longer than four minutes for the diet drug phentermine and a muscle relaxant. Both are listed under the controlled substances act as schedule IV drugs.
The form had a short section of questions, most of which had the "right" answer as defaults.
The following day, FedEx delivered the muscle relaxant Carisoprodol (generic Soma). The prescribing doctor was Hannibal Edwards and the pharmacy had a Pennsylvania address. No warning stickers were on the bottle.
Universal Pharmacy Solutions in Huntingdon Valley, Pa., where both prescriptions were mailed from, is a licensed pharmacy in good standing, according to the Pennsylvania State Bureau of Professional and Occupational Affairs.
The Roundup could not find a license for Dr. Edwards or Dr. Ranvir Ahlawat, who prescribed the phentermine, in Pennsylvania.
The owner of Universal Pharmacy Solutions is Roy Rogers Atlas of Galloway, New Jersey.
Pharmacist Jennifer Bosgra at Safeway compared samples of the carisoprodol and phentermine to those in the pharmacy. Although she could not analyze their chemical makeup, she could check the numbers on the pills.
"They are real," Bosgra said. "These are controlled substances. Did you get these without a prescription?"
Technically, Dr. Hannibal Edwards and Dr. Ranvir Ahlawat did prescribe the medications, but never had any direct contact with the patients.
"Wow! I can't believe that," Bosgra said. "Somebody needs to do something about that."
The question is who -- customs, state governments, the federal government? In whose jurisdiction was the alleged crime committed?
What are you taking?
While the DEA and the FDA have made some headway in closing down illegal online pharmacies, there are jurisdictional issues with those based in foreign countries.
Thailand is a growing supplier of medication to some rogue, U.S. based websites.
A reporter from a Connecticut news station ordered a drug said to be similar to Vicodin from a Thai site for $100. They received a plastic bag with 50 tablets.
A pharmacist from the Yale New Haven Hospital was asked to test the medication and although it was a potent painkiller, the medication showed no resemblance to Vicodin and could cause very dangerous side effects to the user.
This past March, the House of Representatives Government Reform Committee held hearings on issues with online pharmacies.
According to the meeting transcripts, many representatives argued that the cost of prescription drugs is so prohibitive that many of the legal sites are crucial to people on fixed incomes and any regulation should not impede those who rely on the Internet discounts.
An FDA official told the committee that the agency actively pursues illegal online pharmacy activity, such as dispensing drugs without a doctor's supervision, but a lack of national definition for a valid prescription is hampering national efforts.
According to the FDA Office of Criminal Investigations, about 90 cases are under way in which the FDA, the DEA, and state law enforcement agencies are joining forces to shut down online pharmacies.
Battling the high price of prescription drugs
Corey Houghton, Director of Payson Regional Medical Center's Senior Circle, said she warns seniors to be very cautious when using online pharmacies.
"I won't use those websites," Houghton said. "I would never order drugs off the Internet because they all require a credit card and you are putting yourself at risk," Houghton said. "You don't know the quality of the drugs that you are getting. What's in them? Where do they come from?"
Cracking down on rogue pharmacies
In December, following a lengthy investigation by the FBI, DEA and FDA, a federal grand jury returned a 108-count indictment against 10 individuals and three companies, charging them with illegally selling controlled substances and other prescription drugs over the Internet, according to the DEA website.
"This case is a dangerous new spin on an old problem," United States Attorney Paul J. McNulty said on the site. "Drug trafficking in cyberspace is just as harmful to public safety as drug trafficking is on street corners. The advent of the Internet does not mean doctors and pharmacists can bypass rules concerning the dispensing of prescription drugs."
But they do, according to Robert Forman, PhD, a treatment researcher at the University of Pennsylvania.
"There are jurisdictional complications," Forman said. "The website might be in the U.S., then the money goes to a second country and the drug is dispensed from a third."
A solicitation for Xanax prompted an attorney for the Florida Pharmacy Association to place an order with a South Florida online company. She never talked to a doctor, but a signed prescription from a physician in Curacao was in her package of Xanax, which was mailed to her from the Netherlands, according to the FDA's website.
U.S. Customs is attempting to stop some of the illegal importation of prescription narcotics, said an article on salon.com. Customs officials seized more than 10,000 packages with illicit prescription drugs in 2000.
Fighting the drug war in cyberspace has proven to be a daunting task. Capitalists, opportunists, and anyone with a computer and a credit card can find a way to circumvent the laws that govern controlled substances.