The Availability of Web Sites Offering to Sell Opioid Medications Without Prescriptions

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American Journal of Psychiatry (Impact Factor: 12.3). 08/2006; 163(7):1233-8. DOI: 10.1176/appi.ajp.163.7.1233
Source: PubMed

ABSTRACT This study was designed to determine the availability of web sites offering to sell opioid medications without prescriptions.
Forty-seven Internet searches were conducted with a variety of opioid medication terms, including "codeine," "no prescription Vicodin," and "OxyContin." Two independent raters examined the links generated in each search and resolved any coding disagreements. The resulting links were coded as "no prescription web sites" (NPWs) if they offered to sell opioid medications without prescriptions.
In searches with terms such as "no prescription codeine" and "Vicodin," over 50% of the links obtained were coded as "NPWs." The proportion of links yielding NPWs was greater when the phrase "no prescription" was added to the opioid term. More than 300 opioid NPWs were identified and entered into a database.
Three national drug-use monitoring studies have cited significant increases in prescription opioid use over the past 5 years, particularly among young people. The emergence of NPWs introduces a new vector for unregulated access to opioids. Research is needed to determine the effect of NPWs on prescription opioid use initiation, misuse, and dependence.

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    • "Products are sold as intranasal spray but are more commonly injected subcutaneously by reconstituting the lyophilized powder (10, 20, 30, 40, 50 and 100 mg) with 2 ml of sterile water (Langan et al., 2010; Paurobally et al., 2011, 2013). Of public health concern is that these products are unregulated, untested, potentially adulterated, and sold without prescription (Evans-Brown et al., 2009; Gordon, Forman & Siatkowski, 2006; Knudsen, Kjergaard & Dalhoff, 2012; Langan et al., 2010; Mataix, 2012; McVeigh et al., 2012; Paurobally et al., 2013). Clinuvel Pharmaceuticals (2009) has warned consumers of counterfeit products using the names 'melanotan I and II'. "
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    ABSTRACT: Cultural values placed on tanned skin equating with perceived health and attractiveness in the Western world have stimulated the development, sale and use of synthetic tanning agents. These agents are synthetic analogues of the naturally occurring melanocyte-stimulating hormones (α-MSHs) which stimulate melanogenesis or pigmentation of the skin. There is a lack of research on prevalence of use, user experiences and outcomes, despite evident 'health marketability' and diffusion of use via the Internet. We present a unique, intensive, holistic and exploratory single case study analysis of an active user's experiences of synthetic tanning product's labelled as melanotan, with rich description of the case's meanings and identities attached to being tanned, motives for use, injecting experiences and practices, sourcing routes, outcomes and future intentions to use. The case, an exotic dancer, had no prior drug injecting experience and did not identify as 'injecting drug user'. Introduction to injecting of synthetic tanning products occurred with peer assistance. She was conscious of safe injecting practices, which were described as not using needles twice, keeping the product refrigerated, disinfecting and rotating injecting sites, and using sterilised water to dissolve the product. She was aware of synthetic tanning products being unlicensed, unregulated and possibly contaminated. She appeared assured in the self-administration of double dosage and self-management of nausea with benzodiazepines and by injecting before sleep. Experiences of synthetic tanning were positive, with reported feelings of enhanced self-confidence and perceived attractiveness grounded in her confidence in the product's effectiveness to achieve a desired darkened skin tone. No long term or chronic negative outcomes were reported. Development of tolerance and awareness of dependence on synthetic tanning agents was described. We discuss her expert account as it relates to the synthetic tanning product outcomes, risk heuristics, sourcing routes and make recommendations for policy.
    The International journal on drug policy 11/2013; 25(3). DOI:10.1016/j.drugpo.2013.10.008 · 2.54 Impact Factor
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    • "Perhaps of equal or even more significance in terms of this mainstream transfer is the role of the Internet in terms of marketing and access. It is notable that the cited literature is beginning to identify a prime conduit for both supply and information amongst users as being online sites and suppliers (Gordon et al. 2006; Forman et al. 2006; Larance et al. 2008; Feick and Werle, 2010; Evans-Brown et al. 2012; McVeigh, Evans-Brown, and Bellis 2012; Van Hout and Bingham, 2013). Researchers continue to emphasise the lack of our understanding of these unregulated HE products despite this evident diffusion of such products via web retail and online pharmacies (Boase et al. 2006; Benkler, 2007; Hassan, 2008; Halavais, 2008; Burgess and Green, 2009; Orizio et al. 2009, 2010, 2011; Schnetzler et al. 2010; Baym, 2010; Glover-Thomas and Fanning, 2010; Dutton and Blank 2011; Kuzma, 2011). "
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    ABSTRACT: Research underscores an emergent public health challenge due to the increasing use of human enhancement (HE) products for aesthetic purposes. Of particular interest is the injecting use of HE products, and the degree to which injecting of these products for muscle building, tanning and body ‘site’ enhancement has entered into mainstream society. The aim of the research was to identify what is currently known about the injecting use of HE products within the context of public health concern. The findings provide a unique consumer profile of users, health consequences and sourcing mechanisms. Users do not identify as injecting drug users and are less informed about risks associated with the injecting of these unregulated products, potential for contamination and needle sharing. Cost-benefit forms of risk negotiation are grounded in inaccurate information via peer groups and online forums. We present a risk heuristics and public health discourse approach to understanding and addressing this concerning form of aesthetic enhancement grounded in the emphasis on appearance as the indicator of being healthy and attractive. We comment on the role of the Internet as driving force for availability and information retrieval, and offer suggestions for potential health educational approaches.
    International Journal of Health Promotion and Education 08/2013; 51(4):212-227. DOI:10.1080/14635240.2013.818295
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    • "Since the early 1990s there has been a steady increase in prescription rates for opiates (Substance Abuse and Mental Health Services Administration [SAMHSA], 2009), including prescribing for conditions ranging from routine dental procedures to menstrual cramps. This escalation in prescribing, coupled with increased availability of these substances online (Forman et al., 2006), and the advent of long-acting forms of opiate analgesics such as OxyContin®, have combined to create a dangerous upsurge in both the medical and non-medical use of prescription pain medications (Paulozzi et al., 2006; Cai et al., 2010). Of great concern is the increased use of these potent opiates in adolescent populations (Sung et al., 2005), with 60.6% of respondents in a recent survey reporting initiation of use before the age of 15 (Wu et al., 2008). "
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    ABSTRACT: The non-medical use of prescription opiates, such as Vicodin(®) and MSContin(®), has increased dramatically over the past decade. Of particular concern is the rising popularity of these drugs in adolescent female populations. Use during this critical developmental period could have significant long-term consequences for both the female user as well as potential effects on her future offspring. To address this issue, we have begun modeling adolescent opiate exposure in female rats and have observed significant transgenerational effects despite the fact that all drugs are withdrawn several weeks prior to pregnancy. The purpose of the current set of studies was to determine whether adolescent morphine exposure modifies postpartum care. In addition, we also examined juvenile play behavior in both male and female offspring. The choice of the social play paradigm was based on previous findings demonstrating effects of both postpartum care and opioid activity on play behavior. The findings revealed subtle modifications in the maternal behavior of adolescent morphine-exposed females, primarily related to the amount of time females' spend nursing and in non-nursing contact with their young. In addition, male offspring of adolescent morphine-exposed mothers (MOR-F1) demonstrate decreased rough and tumble play behaviors, with no significant differences in general social behaviors (i.e., social grooming and social exploration). Moreover, there was a tendency toward increased rough and tumble play in MOR-F1 females, demonstrating the sex-specific nature of these effects. Given the importance of the postpartum environment on neurodevelopment, it is possible that modifications in maternal-offspring interactions, related to a history of adolescent opiate exposure, plays a role in the observed transgenerational effects. Overall, these studies indicate that the long-term consequences of adolescent opiate exposure can impact both the female and her future offspring.
    Frontiers in Psychiatry 06/2011; 2:29. DOI:10.3389/fpsyt.2011.00029
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