Should I buy drugs on the internet?

Should I buy drugs online?

If you have a prescription from your doctor and you want to fill it online, no problem. The big question is what do you do when you haven't got a prescription. The best bet - and the only thing we can recommend - is to go and see your GP and get one. If you're tempted to buy prescription drugs online without a prescription, you need to think very carefully indeed.

How many of the medicines bought and sold online are illegal, fakes or counterfeits?

A lot. The Royal Pharmaceutical Society of Great Britain (RPSGB) reckon that a third of all medicines sold online are counterfeit. (And that includes the legal sites filling prescriptions so, if you go to a non-prescription site, the odds are pretty short on you not getting what you want.)

The global counterfeit medicines market is worth about £20bn a year. Almost 60% of all spam sent across the internet is related to medicines -the spammers wouldn't be sending them if there wasn't money to be made.

In the UK, the Medicines and Healthcare Products Regulatory Agency (MHRA) seizes more than £3m worth of stolen or fake Viagra every year and are beginning to take action against counterfeiters. A number have been sentenced to long jail terms recently.

How do I know if a website selling drugs is legal?

A registered UK pharmacy should - eventually - carry the RPSGB logo (right) on its website. But it was only introduced in January 2008. Moreover, the logo is voluntary so some legal sites may not have it while on the other hand, some illegal sites may try to use a fake logo.

Other checks that you should make include:

• Ensure the URL (internet web address) matches the name of the site. If not, this is a worrying sign that someone is trying to hide something. Check both the site name and its address out thoroughly.
• Find the name and address of the pharmacy operating the website. (This is vital: the World Health Organisation estimate that half of medicines from websites that conceal their physical address are fake)
• Is there a phone number? Phone it.
• Find out if the pharmacist and pharmacy are registered. You can check UK registrations with the RPSGB or use the European Alliance for Access to Safe Medicines website's list of other national regulators.
• It should go without saying that you need to be suspicious of any websites that offer to supply prescription-only medicines without a prescription. Be wary also of 'bulk discounts' or 'sample packs' of different medicines. Similarly, an 'online consultation' is probably just being offered to create an impression of respectability and legitimacy.
• Check that you are asked questions before purchasing your medicine. Registered pharmacies are legally required to check that a medicine is suitable for you before selling it.
• Check who owns the website you're planning to use. Use the website 'whois' to find out who owns the online pharmacy's website and where it is registered. (Just type 'whois' in your search engine). Another tool is 'reversewhois'. This way you can find out what other websites the owener of the 'online pharmacy' owns. The EAASM say: 'If the owner of the website you are investigating owns several sites and they are based in, for example, Beijing, perhaps their service is not right for you.'

But what are the real risks with buying online?

The three main risks with buying online are:

• that you might be sold a fake that does nothing or, worse, is dangerous. (Read our feature articles Inside the Internet Drugs Factory and Pesticides and Paint: Available Now Without Prescription.) 
• that you might be sold the real drug but it is not right for you because of your age or health or because of the other medication you are on (only a doctor can tell you this)
• that the problem you are treating may be a symptom of something more serious. Here's a classic example: erection problems can be a sign of heart problems - a potential killer. Viagra can be dangerous in people with heart problems.  In other words if you diagnose yourself as needing Viagra to improve your erections, you may be risking your life if the real cause of your erection problems is a heart problem. (Again, you need a doctor to tell you this stuff.)

Are all drugs fake?

No, some of the drugs you can buy online illegally might be the real drug but often they are available online as the result of parallel trading.

Parallel trading involves buying drugs in one market and selling them in another where prices are higher. Even within Europe prices vary enormously between west and east.

You may think that the only people who appear to suffer from this are the drug companies and their profits but this is not so. The parallel traders do not pass on much of their saving if anything to their customers so you pay pretty much the same as you would for a genuine product.

What's more, often the medicines have to be repackaged by parallel traders so that the patient information is in the right language. This means the packets have been opened and resealed. You can't therefore be sure that the drugs haven't been interfered with in other ways or that the wrong or weaker versions of the drugs or even fakes haven't been inserted instead.

There are umpteen counterfeit drugs. In the past couple of years in the UK, the authorities have seized or recalled counterfeits of not just the well-known drugs for erectile dysfunction but also drugs for cholesterol reduction, arthritis, hair loss, anti-platelet drugs, anti-obesity drugs, anti-psychotics and prostate cancer treatments.

Aren't the fakes easy to spot?

Not at all. Even pharmacists are often fooled by the high quality of the packaging. (The real and fake boxes of Serostim, right, are among the easier to spot.) However, there are some things you should look out for.

Many medicines have a two-dimensional barcode, an RFID (Radio Frequency Identification) tag, a hologram, or a label printed in a special ink that changes colour when you move the pack in a certain way. Ask your pharmacist if your medicine has any of these features and then routinely check each new pack before you use it.

Some packaging goes further than this and uses covert (invisible) technologies like those on banknotes to ensure that the real packages can be distinguished from the fakes.

You can improve your chances of spotting a fake by familiarising yourself with every aspect of the packaging and the medicine itelf. Compare the pack to previous ones. You are looking for even the tiniest difference in print, colour, seals, etc. Check that the medicine is in date, the dosage is correct and the patient information leaflet in the correct language. Check that the drug itself has the right colour, texture, smell and taste.

Check any concerns with your high street pharmacist

Where do I report any problems?

If you have concerns about a website that is supplying medicines and the website is not operated by a registered pharmacy premises in Great Britain, you should contact the: Medicines and Healthcare products Regulatory Agency (MHRA) on 0207 084 2000. The RPSGB can also help.