The Internet has become a virtual pipeline for the abuse of prescription drugs, according to a five-part investigative series by the Washington Post.

Rogue Internet pharmacies operate with little regulation, target small towns with a record of drug abuse and specialize in painkillers and other addictive drugs, according to the series. In some cases patients can obtain a prescription without ever seeing a doctor.

Physicians with troubled histories–including drug and alcohol abuse, malpractice and financial problems–write prescriptions for patients they’ve never met, through a middleman and often only after a phone call, the stories continue.

America once had the world’s safest, best-regulated system for distribution of prescription drugs, but that system is now being undercut by a shadow drug market fed by dishonest wholesalers, Internet sites and foreign pharmacies, the newspaper reported.

The problem contributes not only to drug abuse, but also allows the introduction of tainted or weakened medications into legitimate distribution chains.

The stories reportedly culminate a yearlong investigation by two Post reporters, which included 500 interviews and poring over 100,000 pages of court filings, regulatory cases, investigative reports and computer records.

There are dozens of legitimate online drug stores and mail-order pharmacies, which require patients to mail in prescriptions from their doctors. Legitimate sites typically offer a full range of medications, with painkillers accounting for less than 20 percent of their business.

Rogue Internet pharmacies, by comparison, do about 80 percent of their business selling hydrocodone, Xanax, Valium and other drugs of choice for abusers. Given the elusive nature of online activity, overworked regulators say new sites open up as fast as they can shut them down.

In a typical purchase, a customer logs on and orders a narcotic. The Web site steers him to a middleman, often another Web site, who arranges a phone consultation with a doctor. The doctor and patient talk briefly by phone. The doctor writes a prescription to an Internet pharmacy, which ships the pills, at a handsome profit. The doctor and middleman split a consultation fee. There are no face-to-face meetings, lab tests or follow-up visits.

One online pharmacy profiled in the series filled 18,499 prescriptions in six months in 2001, compared to 17 the prior half year.

The series also described a doctor, himself an addict, who earned as much as $1,500 a day for writing thousands of prescriptions for painkillers for an Internet pharmacy.

“This is not Albert Schweitzer on the other end of the computer box,” said Dr. Lee Anderson, president of the Texas State Board of Medical Examiners, according to The Post. “The people who are doing this know exactly what they are doing—and they are doing it for the money.”

Internet sellers move tens of millions of doses of hydrocodone, Xanax, Valium, Ritalin, OxyContin and other controlled substances, according to the series. Scores of customers have become addicted, overdosed or died after taking the drugs.

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