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E-Pharmacies – Do you ‘Doctor’ yourself?

 Ireland's Big Issue 17 October 2019

Buying prescription drugs online may be a crime but according to one grieving parent it is as easy as shopping at Amazon. Samantha Baille investigates how the internet has come to replace the Doctor’s Surgery in both the Republic and Northern Ireland with potentially fatal consequences. (1100 Words) - By Samantha Baille

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The internet has brought about a significant change to the way in which prescription drugs can be obtained. It is estimated that up to 90% of all illegal pharmaceuticals are sold on the internet and the global trade in online drugs  is expected to reach around €53 billion this year All that is needed is a credit card and an internet connection and any number of drugs from Ritalin (for hyperactivity) to Tamoxifen (for breast cancer) are available.

While there are legitimate pharmacies available online there are also illegal chemists who will sell you anything if you are willing to pay. A survey by the UK's National Audit Office suggests that 600,000 Britons purchase medication from illegal sites. A survey carried out by irishhealth.com states that one in seven Irish people have purchased medication from an illegal e-pharmacy.

This clandestine market surprises many. The normal access to medication, through a GP, is not seen as an option to some. For example embarrassment may be a factor for buying on the internet; Viagra and birth control being two 'favourites'. A recent study suggests that erectile dysfunction drugs are the most common counterfeited product because men are embarrassed by the prospect of speaking with their GP.

Medical researchers have stated that many of the drugs on offer are fakes and men who are buying such medication face major health risks. (Some estimates suggest that as many as 2.5 million men in the EU are using counterfeit Viagra. Tests of bogus drugs have shown that some contain active ingredients, while others contain potentially hazardous substances. The contraceptive pill is another common purchase, and the risk here is that the end user in this case may be young girls.

It is not only erectile dysfunction and birth control pills that are big sellers; many medications, including those given to children, are sold. A  treatment for children with ADHD, Ritalin, has become something of a 'trendy' or 'edgy' drug and is used to boost concentration as a study aid.

The BBC recently spoke to a young girl about using Ritalin who stated: "It helps me stay awake and stimulates my mind." She purchases the drugs at 40p a time - pocket money prices - a fact that makes this online pharmacy business affordable to the young.  Even if a child has no access to a debit or credit card, there are still means to obtaining a card number for the internet, as many companies such as O2 sell Money Cards, which work like gift cards but operate as credit cards. Credit can be loaded onto the cards in store using cash, thus removing the need for any credit facility.

Brian Murphy, from the Irish Pharmaceutical Healthcare Association (IPHA) states when you order medicines online, in the majority of cases you run the risk of getting medicines with: "sub-optimal doses or contaminants." He goes on to say: "People who need prescription medicines need to access these through their GP and pharmacist. These safeguards are in place for a very good reason. A prescription drug is something you should not take without care and without the involvement of a healthcare professional." Murphy concern is that even if you do happen to receive medication with the correct ingredients, you are still opening yourself up to potential problems as you are diagnosing and treating yourself without the advice of a GP or healthcare professional. Apart from potentially harming yourself (or your children), you are breaking the law. Murphy says : "All prescription drugs bought online are illegal. You have to ask how these drugs were manufactured or how they were acquired."

Prescription charges in Northern Ireland have been free since April 2010 yet this has not deterred online consumers. The death of Matthew Davidson a 26 year old man highlights the dangers. He purchased medication called Tramadol over the internet and died as a consequence.  Tramadol is a strong painkiller only available in the UK and Ireland on prescription.. He obtained the drug from Egypt where a prescription is not required.  The particular site has since been closed down and the agency that regulated pharmaceutical drugs, the Medicines and Healthcare Products Regulatory Agency (MHRA), state they are pursuing an alleged doctor involved with this website in Egypt.

Matthew's father Mike Davidson found him after he had overdosed: "We broke down the door and found him lying on the floor I realised what had happened and just put my arms around him. I am just really thankful that I had the opportunity to be with him when he died. It could have been very different if a policeman had come and said he had taken his own life."

Matthew's parents want to highlight what they see as a failing in legislation. Online pharmacies registered outside the country can sell medication to any address, even if that medication requires a prescription here. Many of these medications include opiate based drugs that can kill. Matthew's parents state that he was never asked any questions by medical staff in Egypt - he was simply sold what he asked for and that was it. Matthew's father states "If you know what you want and you have the website, credit card and a postcode, it can be delivered within days. It's as easy as buying a book from Amazon."

The lack of free prescriptions in the Republic of Ireland may lead to a temptation to purchase prescriptions drugs online. The Website irishhealth.com states that "A factor that that may be encouraging people to search the internet for drugs is the high cost of pharmaceuticals in Ireland."  One commenter on the website stated "Tonight I intend to surf the internet and price my seven drugs for cancer and heart ailments. I have no intention of continuing to contribute to the outlandish prices charged for drugs in rip-off Ireland. Monthly contributions have been stealthily climbing to the now €120 per month (threshold above which the State covers the cost)."

It is perhaps understandable during times of recession that as consumers are looking to reduce the costs of their medical treatments, they turn to online pharmaceuticals. The dangers of such a course of action need to be made explicitly clear. Until an effective method of prevention of the online trade is put in place awareness of these risks is the most effective method of discouragement. Matthew Davidson's story, and others like it, serves as a warning to anyone turning to the internet to provide their healthcare.

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