According to research by the National Center on Addictive Substance Abuse at Colombia University, reported in the New York Times, hundreds of online stores are selling controlled prescription drugs freely to anyone with a debit card. It's a fascinating (and worrying) piece of research, but one I think is seriously flawed in a few places.

The researchers found that a "large majority" of 365 websites they identified as selling controlled drugs by mail, were offering to supply the drugs without even a proper prescription, potentially fuelling the rising abuse of addictive and dangerous prescription pills. The drugs available included, "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."

The interesting/worrying thing is the way that these sites operate. Federal and state officials have attempted to shut down these websites, supposedly (although I'm far from convinced - see below) with some success since the number identified in this years study was down 581 last year, but their efforts are being frustrated by the tactics being used by the pushers.

On the internet, you can pretty much do anything in a day, from publishing a book, to starting a campaign website. Of course selling prescription drugs is no different, so by the time enforcement agents close down one site, a new one can spring up in its place. While the front-end of the operation simply disappears when touched, the solid back-end of the operation is safely tucked away. Many import pharmaceuticals from abroad, often in disguised packages. More recently, some have begun selling fake prescriptions rather than the drugs themselves, which customers can simply have filled at the local pharmacy.

How do people find these sites if they keep moving? Well the tactic that the new research doesn't seem to mention is spam, and this is something my fellow bloggers may know something about. Because I sometimes post articles about drugs, layscience.net appears under a lot of searches for things like Policosanol, anti-depressants, vicodin, et cetera. As a result, this site has been absolutely inundated with spam comments and trackbacks linking to this pharmaceutical sites. Until I figured out a way to more-or-less stop them dead, they were piling up at a rate of 50 or more a day.

Even now, some of the spam bots are so intelligent that they are able to defeat the Captcha system protecting forms on this site (the annoying text you have to fill in when you comment to verify that you're human), and even create user accounts on the Drupal installation that powers this site. It's scary stuff.

Now, I mentioned earlier that I wasn't convinced by the figures reported. To explain why, here's their methodology:

"Using popular search engines like Google, Yahoo and MSN, the Columbia researchers found 365 sites offering controlled drugs by mail. 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." Additionally, some poor minion had to spend his days picking through the URLs in thousands of spam e-mails they collected.

They may as well have come up with the numbers by throwing a few darts. Search engine algorithms have change dramatically in 5 years, but more to the point so has the net. With the intertubes based much more around social networks, forums and blogs than they used to be, and with the rise of spam bot networks, the fall in sites found on the major search engines could easily be attributable to changes in the way that they are advertised. This is especially true for sites which are only up for a week or so, and therefore aren't likely to be dependant on Google ranking for exposure - it was a good fortnight before layscience.net was indexed on the major search engines, for example.

What worries me are statements like this, attributed by the NYT to the report's lead author: "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" Well, frankly they might, or they might not have - from the methodology there's no sure way of knowing.

In fact, Califano seems to have a bit of a thing about the major search engines. "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."

(I'm reminded there of Conservapedia's entry on Google: Much of Google's business depends on pornography. For example, 25% of search engine requests are for pornography")

There are lots of arguments about the responsibility Google has in this sort of situation, too many to go into in this post, but there's a much more relevant and basic truth - the world moves on. If Califano wants to campaign against Google then that's all very good, but the ads will simply move elsewhere. Of course if that happens, and they stick with the same methodology, the problem will simply cease to exist on paper...

The core message of the report - that a person with a debit card can get hold of restricted prescription drugs - is shocking and should be listened to, especially in a nation where deaths asssociated with abuses of such drugs are on the rise. However, I find the methodology they use to be very limited, and the risk is that they fail to appreciate either the scale or the nature of the problem.

[1] Califano, J.A. (2008). You’ve Got Drugs!” V: Prescription Drug Pushers on the Internet.. Colombia University White Paper, 5