Increasing access to rogue online pharmacies -- those which dispense medications without a doctor's prescription -- may be an important factor behind the rapid increase in the abuse of prescription drugs. In a report that was released May 12 online by the journal Health Affairs and will also appear in its June edition, investigators from Massachusetts General Hospital (MGH) and the University of Southern California (USC) find that states with the greatest expansion in high-speed Internet access from 2000 to 2007 also had the largest increase in admissions for treatment of prescription drug abuse.
"We know we face a growing problem with prescription drug abuse in the United States. One need only look at statistics for college campuses, where prescription drugs are fast replacing illegal substances, to see the magnitude of the problem," says Dana Goldman, PhD, director of the Schaeffer Center for Health Policy and Economics at USC, the study's senior author. "Our findings suggest that Internet growth may partly explain the increase in prescription drug abuse, since it is well known that these drugs are easily available online." Goldman is also the Norman Topping/National Medical Enterprises Chair in Medicine and Public Policy at USC.
In their report, Goldman and lead author Anupam B. Jena, MD, PhD, of the MGH Department of Medicine, note that the recent marked rise in the abuse of prescription narcotic painkillers -- drugs like Percocet and Oxycontin -- corresponds with an increase in the presence of online pharmacies, many of which do not adhere to regulations requiring a physician's prescription. Drugs that are frequently abused -- painkillers, stimulants, sedatives and tranquilizers -- often can be purchased from rogue sites that may be located outside the U.S. The current study was designed to examine the potential link between online availability and prescription drug abuse, an association that has been suspected but not investigated in depth.
Using data available from the Federal Communications Commission, the researchers first compiled statistics on access to high-speed Internet service in each state during the years studied. Since actual rates of prescription drug abuse would be difficult if not impossible to calculate, they used information on admissions to substance abuse treatment facilities from a database maintained by the U.S. Substance Abuse and Mental Health Administration. Changes in both measures over the seven years were analyzed on a per-state basis, and treatment admissions were categorized by the particular types of abused substances involved.
The analysis indicated that each 10 percent increase in the availability of high-speed Internet service in a state was accompanied by an approximately 1 percent increase in admissions for prescription drug abuse. The increases were strongest for narcotic painkillers, followed by anti-anxiety drugs, stimulants and sedatives. During the same period admissions to treat abuse of alcohol, heroin or cocaine, substances not available online, showed minimal growth or actually decreased.
"The lack of an increase in abuse of drugs not available on the Internet suggests that an overall growth in drug-seeking behavior cannot explain the rise in prescription drug abuse," Jena says. "Further studies need to better evaluate how easily commonly abused prescription drugs can be purchased online and explore the importance to the problem of foreign Internet pharmacies, which are outside the jurisdiction of the U.S. government."
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