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Scores of web sites do not require a prescription to buy narcotics, stimulants, and other controlled substances -- and none of those sites has controls to prevent children from making such purchases, a study shows.

A report released today by the National Center on Addiction and Substance Abuse at Columbia University reveals that 85% of web sites selling potent prescription drugs such as OxyContin, Valium, and Ritalin do not ask Internet users for a proper prescription from a doctor. Many explicitly state that no prescription is needed.

"Anyone of any age can obtain dangerous and addictive prescription drugs with the click of a mouse," Joseph A. Califano Jr., chairman and president of the National Center on Addiction and Substance Abuse and former U.S. secretary of Health, Education, and Welfare, says in a news release. "This problem is not going away."

The report, titled "'You've Got Drugs!' V: Prescription Drug Pushers on the Internet," details the advertising and selling of controlled substances online. It is the fifth annual report on the subject. The report tracks the availability of prescription opioids such as OxyContin and Vicodin, depressants such as Valium and Xanax, and stimulants such as Ritalin and Adderall.

The analysis showed that fewer web sites are selling and promoting controlled substances than last year (361 vs. 581); in the new report, 206 sites were found to advertise drugs and 159 offered drugs for sale. However, only two are "legitimate" pharmacy sites, meaning they have received certification by the National Association of Boards of Pharmacy as a Verified Internet Pharmacy Practice Site (VIPPS). To receive VIPPS accreditation, a pharmacy site must comply with the licensing and inspection requirements of their state and each state that they dispense prescriptions in.

Califano credits improved state and federal efforts to crack down on Internet drug trafficking for the decline.

The "most disturbing" finding, the authors write, is that "there are no controls on any of these sites blocking access by children." Most Internet users are adolescents and young adults; 78% of kids 12 to 17 have online access. Nearly all college students do, too.
Nearly one in five teenagers has abused prescription drugs in their lifetime, according to a 2005 survey. Many think prescription drugs, particularly painkillers, are easier to get than illicit drugs like cocaine or crack.

Children easily gained access to the online pharmacies by typing in a fake age. Yet in some cases, a child may still buy and receive drugs by providing true information -- even when their answers should raise red flags. A previous report revealed how a supervised 13-year-old ordered and received Ritalin after entering her own age, height, and weight on a site's questionnaire.
American consumers often wonder whether it's okay to purchase a prescription drug from a foreign pharmacy and bring it back to the United States. The rationale for doing so is clear, particularly at a time when healthcare costs are skyrocketing in the U.S.:

The costs of brand-name drugs are usually substantially lower overseas.
Some drugs are available in other countries but not in the U.S.
Some prescription drugs here do not require a prescription overseas.
So why wouldn't a person already strapped with medical bills or high co-pay costs take advantage of these savings? Mainly because it is illegal.1

Current laws in the U.S. disallow the foreign purchase of drugs for "personal importation" or "reimportation." This includes driving ​​over the border to Canada or Mexico to buy the same, exact drug legally approved and licensed here.

Despite this legal barrier, many Americans are still willing to take the risk, particularly if it means not having to choose between the rent and getting the medications you may desperately need.

To this end, here are four things you should know if you intend to buy a prescription drug from a foreign pharmacy:

Understanding Personal Importation and Re-Importation
Bottles of prescription drugs.
Vstock LLC/Getty Images
Personal importation is defined by the U.S. Food and Drug Administration (FDA) as the act of bringing a prescription drug into the U.S. from another country for personal use. Re-importation is the practice of purchasing a drug overseas that was manufactured in the U.S. and bringing it back into the U.S.

Both practices are against the law. And, this applies to any drug, whether or not it is FDA-approved and whether you purchase it in person or by mail.

There are a number of reasons for this:

The FDA is responsible for ensuring that all prescription drugs in the U.S. are safe and authentic, and they cannot do this if the drug is outside of their chain of custody or quality oversight.
Even if a drug is manufactured at an FDA-approved facility in, say, India (as many are), there is no recourse if there is a problem with the drug (as sometimes happens).
Prescription drugs discontinued here may be available overseas, but there is usually a serious reason why it was discontinued. Purchasing a drug like this is akin to self-prescribing, and that is something that you should never do.
Experimental drugs used for cancer and other illness are more likely than not to have been inadequately tested, meaning that you're taking your life into your own hands.
On the other hand, there is also some truth to the conceit that the drug lobby in the U.S. is strong and that many of these laws are in place to protect the interests of pharmaceutical companies. It is why certain U.S.-manufactured HIV drugs, for example, cost over $2,000 per month here and less than $100 for consumers in Africa and India.

When Importation Is Allowed
A hand reaches for a prescription bottle.
Tetra Images/Getty Images
While the FDA is incredibly strict about drugs being brought into the U.S. for resale or commercial distribution, they are less stringent about individuals doing the same for their own personal use.

For its part, the FDA provides guidelines which clearly spell out when a prescription can or cannot be filled overseas and brought back to the U.S.

These include:

When a drug is not yet approved in the U.S. but is prescribed for a serious condition for which there is no equivalent at home
When the amount being imported is no more than a three-month supply
When the drug is declared as Customs with the appropriate prescription or documentation
Dealing With US Customs
U.S Customs and Border Protection at an airport.
Joe Raedle/Getty Images
The U.S Customs and Border Protection is responsible for ensuring that illegal goods are immediately identified and seized as they reach the border.

If you decide to bring home a three-month supply of drugs for personal use, here is what will need to do to prepare:

Make sure that you declare any and all drug purchases. If you don't and the customs officer finds out, you may be hit with sizable penalties.
If a drug purchase is suspicious, it will be confiscated and set aside for review by the FDA to determine whether the medications meet the legal requirement for import. If not, they will be destroyed.
Prescription drugs should be stored in their original containers along with a copy of the original prescription.
Purchasing Drugs From an Online Pharmacy
Reordering a prescription on a tablet computer.
JGI/Jamie Grill/Getty Images
Purchasing a drug from an online overseas pharmacy may save you money, but it can end up costing you more if the provider is disreputable.2 Having a great-looking website should never be considered a sign that a provider is either legitimate or trustworthy.

Even beyond the legitimacy of a provider, the FDA warns that certain brand names used abroad are not the same used in the U.S. In some cases, the non-active ingredients or even active ingredients may be completely different.

For example:

In the U.S., the prostate medication Flomax is the brand name of the drug tamsulosin. In Italy, the active ingredient for Flomax is morniflumate, an anti-inflammatory drug.
Norpramin is sold in Spain for peptic ulcers, while the Norpramin sold in the U.S. is for depression. Getting those two mixed up could have dire consequences.
Whether purchasing online or in person, always check the label closely and never buy a product if the list of ingredients is not clearly displayed in a language you can fluently read.

Moreover, double-check the currency conversion rates before making a purchase to ensure you're actually saving money. This includes any shipping or handling charges the pharmacy might add.

In the end, it's important to use your best judgment. If something doesn't feel right to you, follow your instincts and find another provider.

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