Unbelievable facts from February 2024 revealed the risks of buying counterfeit drugs online. In February 2024, a 45-year old Army National Guard veteran was looking for relief from her pain. She visited a website that identified pills and looked up “M 30 round and blue” pills. She was misled to believe she purchased oxycodone – a genuine painkiller – and ended up with pills that led her to death.
Her mother found her dead five days later with 46 pills in her vicinity. Emergency responders confirmed her death. Testing revealed that the pills weren’t oxycodone but deadly fentanyl. The heartbreaking event highlights the risks of purchasing prescription medications from online unregulated sources.
Nine victims were named in an indictment filed by the federal government in September 2024, which targeted 18 people in the United States as well as in the Dominican Republic and India. They allegedly ran a criminal network to advertise, sell, produce, and ship millions of fake pills disguised in the form of genuine pharmaceuticals via nine websites that were confiscated by federal investigators. The websites have been shut down.
Despite the efforts of the U.S. Drug Enforcement Administration, unlicensed internet pharmacies still operate and deceive unsuspecting consumers. Some of the rogue online pharmacies appear to have been linked to domains that were previously confiscated, which illustrates the challenge faced by the DEA in controlling the illegal sale of drugs on the internet.
Marya Lieberman from the University of Notre Dame is a chemist who specializes on detecting fake and substandard drugs. Her work highlights the massive task regulators have in trying to close down illicit online pharmacies. Effective enforcement is extremely difficult due to the sheer number of these online pharmacies and their deceptive tactics.
It’s a boom in the illicit drug market
In recent years, the reliance of online pharmacies has increased. This has led to concerns over drug safety. The Alliance for Safe Online Pharmacies Foundation (ASOP), in a December 2023 study, revealed that 52% American consumers had bought medications online. That’s a 10 percent increase since 2021.
Online pharmacies are a growing phenomenon due to this demand. ASOP Foundation estimated that twenty new illegal pharmacy websites were created every day. The survey 2024 also revealed that 54% believed all online pharmacy websites were FDA-approved. It shows the lack of knowledge among consumers.
U.S. Customs and Border Protection’s (CBP) seizures are a further indication of the magnitude of the problem. CBP seizes 1.5 million fake medicines in fiscal year 2023. Pharmaceuticals are the most common category of counterfeit goods.
Lieberman says that consumers often turn to online pharmacies when they need medications they can’t afford through normal channels, that require prescriptions that they don’t have, or that address conditions that they feel uncomfortable talking about with their doctor. The reliance of individuals on sources that are not regulated exposes them to serious health risks.
Lieberman explained that, “the increase in gray-market sources might indicate the need for a more effective healthcare system to serve the uninsured or those without access to primary physicians. Or, it may be that these individuals are struggling to get treatment for addictions.” These individuals may feel that online illegal pharmacies are their only choice.
As a response to an unfolding crisis in October 2024 the DEA released a public alert warning about the growing presence of counterfeit pills containing fentanyl, methamphetamine, and other drugs sold via illegal online pharmacies.
Food and Drug Administration(FDA) recommends that a legitimate online pharmacy requires a doctor’s prescription. They also require an address and phone number in the U.S. they must be licensed to operate within each state and have at least one pharmacist. A verified internet pharmacy practices sites (VIPPS), seal, can also help customers identify safe online pharmacies.
In a statement, a spokesperson for the DEA stated: “In October 2024, we issued DEA’s public safety alert warning Americans of the dangers online pharmacies. The DEA encourages Americans to be cautious when buying medications online. “The only prescription drugs that are considered safe by the FDA and by doctors is those prescribed from a licensed medical practitioner, and distributed by an accredited pharmacy.
How to Identify Fake Websites
A suspect website registered in 2017 on a Russian domain falsely states that it has been operating for 16 years. The first website is linked with two others that share identical information in their “About Us”, even though the websites claim to represent different companies registered in different countries.
Two separate websites are registered under a domain that is redacted in Belarus. They pretend to be companies registered in Canada, but corporate databases show they don’t even exist. A website of one Canadian business even has an address belonging to New York University. Another website, registered for 2023, claims that it has been operating since 16 years. One is registered privately in Iceland.
Warner claims that one Bitcoin address transferred $6,780 from one address to another with links to twelve other websites. One of these websites was seized by DEA in a criminal investigation conducted earlier that same year. Nine websites are still operational. The Bitcoin address was able to receive $164,097 in total, which is the money that came from illegally selling counterfeit pills.
Consumers’ Risky Perspective
Another online user said: “I’m not too worried about safety, because I only take drugs to have fun.” The quote above is evidence that some people are well aware of the risks of purchasing drugs online, but still choose to buy them.
Shabbir Saffar, Executive Director of The Partnership for Safe Medicines, an organisation of 45 non-profit groups fighting the counterfeit drug trade stresses the importance of international collaboration in shutting down websites and domain names. The domain name registrars play a part as well.
Lieberman emphasized that effective regulations require resources including dedicated staff to monitor ecommerce platforms and Social Media for fake pharmacy websites and issue takedown order.
Libby Barney Senior Advisor of ASOP Global notes that urging customers alone isn’t a good strategy for public health. Even trained pharmacists have been shown to struggle in identifying legitimate and illegal pharmacies websites.
Barney’s conclusion was that “we need to pass new laws, and enforce them effectively both at home and abroad in order to curb the sale of illegal medications online.”