ABUSES ARE FOUND IN ONLINE SALES OF MEDICATION

A large majority of 365 Internet sites that advertise or sell
controlled medications by mail are offering to supply the drugs
without a proper prescription, according to a new study. The online
trade is stoking the rising abuse of addictive and dangerous
prescription drugs, the authors and federal officials say.

Drugs offered online include generic versions of opiates like
OxyContin, methadone and Vicodin, which are legitimately prescribed as
painkillers; benzodiazepines like Xanax and Valium, which are
prescribed for anxiety; and stimulants like Ritalin.

Federal and state efforts to crack down on Internet sales appear to
have reduced the number of sites offering such drugs, from 581 last
year, said Joseph A. Califano Jr., director of the National Center on
Addiction and Substance Abuse at Columbia University.

"Nevertheless, anyone of any age can obtain dangerous and addictive
prescription drugs with the click of a mouse," Mr. Califano said.
The center is issuing the study, the latest of five annual surveys, on
Wednesday.

The Drug Enforcement Administration found that 85 percent of all
Internet prescription sales involved controlled drugs, compared with
just 11 percent of those filled through regular pharmacies, suggesting
that online sales often are destined for misuse.

"Abuse of prescription drugs has exploded among college students,
and we think that one way they get these drugs is over the
Internet," Mr. Califano said. The use of prescription opioids and
anxiety drugs, especially in combination, accounts for a growing share
of deadly overdoses nationwide.

"The Internet made it easy for the drug dealers to sneak into your
living room," said Francine Haight of La Mesa, Calif, whose son Ryan
died in 2001 at the age of 18 from an overdose of hydrocodone, generic
Vicodin, which he had secretly ordered online with a debit card. An
A-student and varsity tennis player, he had claimed in an online
questionnaire to be a 25-year-old with back pain, got his prescription
and was mailed the drug. Ms. Haight, a registered nurse, has since
fought against online sales.

Federal law bars dispensing dangerous medications without a
prescription from a doctor who has a bona fide relationship with the
patient. But officials have had a hard time catching up to rogue
Internet pharmacies that sometimes ship the drugs from foreign
countries in disguised packages.

For the last several years, the Drug Enforcement Administration and
others have worked to halt the illegal trade and prosecute involved
doctors and suppliers, with limited success.

"oeOne of the main problems is that the sites can literally open up
for a week, close and open up under a different name," said Michael
Sanders, a spokesman for the Drug Enforcement Administration.

In a more recent practice, the new study found, some sites sell
written prescriptions that can then be used at local pharmacies.

Using popular search engines like Google, Yahoo and MSN, the Columbia
researchers found 365 sites offering controlled drugs by mail. Of
these, 206 were advertising sites, directing consumers to a seller. Of
the 159 sites that directly sold controlled drugs, 135, or 85 percent,
did not require a prescription or provided them on the basis of online
questionnaires.

In an effort to make their surveys consistent, in each of the last
five years the researchers have spent the same amount of time
searching, 210 hours, for the same list of drugs. The number of sites
rose to 581 in 2007, then fell to 365 this year. The study will be
available online on Wednesday at www.casacolumbia.org.

In April, the Senate passed the Ryan Haight Online Pharmacy Consumer
Protection Act, which would require certification of online pharmacies
and that doctors see patients before prescribing controlled drugs. The
bill is now in committee in the House.

At least eight states have passed laws barring electronic prescribing
or sales without a legitimate prescription. Minnesota passed a law in
2007 requiring doctor-patient consultations but found that "the Web
sites went around us, doing 30-second consultations on the phone,"
said Dan Pearson of St. Cloud, Minn., whose son Justin died of drug
poisoning in 2006, aged 24, after obtaining large quantities of
hydrocodone and Xanax from 17 online pharmacies. The law was
strengthened this year to require face-to-face consultations.

"Anyone can have these drugs at their door within 48 hours,"
usually using a credit or debit card to pay for an online prescription
and then a money order to pay for express delivery, C.O.D., Mr.
Pearson said.

Federal drug authorities have begun working with credit card companies
and banks to try to prevent such transactions, while major Internet
search engines have used a verification program called Pharmacy
Checker to confirm that advertisers are legitimate. But the system
appears to be full of holes, critics say.

Mr. Califano sent letters this week to senior officials of Google,
Yahoo and MSN asserting that they were "profiting from
advertisements for illegal sales of controlled prescription drugs
online," and calling for stronger action.

Diana Adair, a spokeswoman for Google, said the company took the
problem seriously and in addition to using Pharmacy Checker, had
consulted with federal agencies on ways to stem the trade. Kelley
Benender, a spokeswoman for Yahoo, said the company was "working to
identify the illegal sites and will take appropriate action."

A spokesman from MSN said the company had no comment.