Pesticides and paint: Available now without prescription

Have you ever bought drugs on the internet? Quite a lot of malehealth visitors have. And they could be risking their lives. Jim Pollard reports.

In our readers' survey over the summer, we asked you about what you bought on the internet. Among the replies:

• 4.5% had bought drugs to help erections and sexual performance;
• 2.7% had bought drugs to help body-building or sporting performance; and
• 1.9% had bought drugs to help them lose weight.

Small percentages but, if they're in any way representative of the male population as a whole, still a large number of people. But what exactly are they getting for their money?

Recent press reports have uncovered DIY Viagra factories making fake versions of the erectile-dysfunction drug in a cement mixer. Blue paint features in the recipes.

Pfizer, who make Viagra, say that the most common bulking agent used in fake drugs is boric acid, a pesticide that kills cockroaches and termites by attacking their nervous systems.

Fake drugs factories have turned up in India, Egypt, Thailand and even the UK. Last December three men were jailed for running one in north London.

The World Health Organisation (WHO) value the global market in fake drugs at around $30,000,000,000 a year but the true scale of the problem is difficult to gauge because the main players find it difficult to agree over exactly what the main issue is.

The pharmaceutical industry is concerned that its profits are being undermined while the regulators — the Medicines and Healthcare Products Regulatory Agency (MHRA) in the Britain — are more concerned about the dangers to patients.

A particular concern of the drugs companies is so-called parallel trading whereby genuine drugs from one market are repackaged for sale in another more lucrative one. Branded drugs prices are about 30% higher in the UK than in, for example, Spain so there's an obvious buck to made in buying drugs over there and then selling them on over here. Julian Mount, the European Director of Trade at Pfizer reckons that 140 million medicines are parallel traded every year and that most of these — 70% - are headed for the UK.

While this is obviously annoying for the drugs companies, it is less of a worry for patients who, provided they are getting the right drug, do not have the same concerns about where it comes from.

The real problem for patients is the safety of drugs that are not being made by recognised parmaceutical manufacturers. The main outlets for such fakes, according to the MHRA, are the internet and the clandestine market in pubs, clubs and gyms.

In the summer, 120,000 packets of a fake version of another Pfizer drug, Lipitol which lowers cholesterol, were seized. This was the third case of fake drugs reaching the British public inside a year. The other two drugs involved were Cialis (for erectile-dysfunction) and Reductil (which may aid slimming). There had been no such cases in the previous nine years suggesting a growing problem. Currently, the MHRA has more than 400 investigations in progress including, according to the Daily Telegraph, 15 for alleged counterfeiting and dozens for selling prescription drugs without a licence.

The MHRA have played this down stressing that this is just three cases and that 600 million prescriptions are being written every year. Others see the handful of seizures as merely the tip of the iceberg.

Graham Satchwell, a former policeman who now works as an internet security analyst, reckons that while the drug companies may be overestimating the size of the problems, there is no way of knowing accurately as there is no proper monitoring system.

Stachwell believes the WHO estimate that something between 8-10% of pharmaceuticals are counterfeit worldwide is too much but points out that even 3% would mean that there are 3.6 million fake medicines floating around.

He believes these drugs are killing people but, of course, it's difficult to prove. 'When someone dies from a preexisting condition, there will always be the assumption that the drugs they have used have been genuine,' he told The Scotsman.

In the USA William Hubbard of the Food and Drug Adminstration told Congress that internet drug-buyers 'are at risk because they often don't know what they are getting. Although some patients may purchase genuine product, others may unknowingly buy counterfeit copies that contain inert ingredients, legitimate drugs that are outdated and have been diverted to illegitimate resellers, or dangerous sub-potent or super-potent products that were improperly manufactured.' He says that examples of all of these have been uncovered by the FDA.

The internet operators are cunning.

One tactic is to buy up the URLs of spelling mistakes. One company bought the URL for a common mispelling made by surfers looking for the site of the Depression Alliance. This mispelt URL will lead surfers, who are obviously concerned about their mental well-being, to a site where they can buy anti-depressants. You don't have to be a drug company executive to be concerned about such exploitation of people at a vulnerable time.

And what exactly will the drugs bought on this or any other website be — repackaged versions the real thing or fakes made in a cement mixer? Without the sort of high-tech analytical gear that nobody has at home, there's simply no way of knowing.

But if you think about, people who sell drugs by buying up the URLs of mispellings of an organisation helping people deal with a serious health problem like depression are unlikely to be too concerned about their products' contents.

Two things are clear.

One, the malehealth survey proves that there is a market for drugs on the internet. (Those in our survey who said they'd bought drugs on the internet were of all ages and had a range of occupations and incomes suggesting that this is far from a niche market.)

Of course, it's difficult to be precise about numbers but our survey suggests three-quarters of a million men or more could be buying erectile dysfunction drugs over the net. (Click here to see how we calculated the figure - you'll need pop-ups enabled)

Two, the recent seizures of drugs and exposures of factories suggest that there are a lot of fake drugs about. The conclusion has got to be think before you buy, especially from any site that does not require a doctor's prescription.

It's not hard to find reasons for buying on the internet. It's convenient, avoids any face-to-face emabarrassment, enables you to buy drugs your doctor won't or can't prescribe and, compared to other outlets for private prescriptions, it's relatively cheap. But none of these are worth risking your life for.

What do you think? 

Jim Pollard is editor of malehealth.