Online medicines and recreational drugs: a real risk

New psychoactive substances (NPS) and their commercialization on the Internet

In the last years the United Nations and the European Union have often reported the appearance, on the illegal drug market, of new psychoactive substances (NPS), purely synthetic and characterized by particularly harmful pharmacological and toxicological properties. This mainly refers to synthetic cannabinoids and cathinones, piperazines, tryptamines, phenethylamines, benzofurans etc, highly toxic molecules, responsible for over 70 intoxications in Italy and tens of deaths in Europe and in the United States. In Italy, more than 300 new psychoactive substances have been registered in 2009 and their number keeps growing in rapid increase.¹ The market of new psychoactive substances goes along with the market of counterfeit or illegally sold medicines, available at reduced prices with no need of medical prescription.
In this scenario, the Internet provides a lot of information on drugs and psychoactive substances, even though often imprecise, unreliable and misleading.² The Internet makes these products available for an infinite number of customers, anywhere in the world, does not require particular investments from the providers, guarantees anonymity to the buyers and is available 24/7.³ According to the European Monitoring Centre for Drugs and Drug Addiction, the websites that commercialize drugs in Europe quadrupled from 2010 to 2012, going from 170 to 693 in only two years.⁴ The offer for online medicines is a phenomena that invades the emails of millions of citizens daily, by means of pressing and misleading advertisements, offering drugs for several diseases and disorders (obesity, baldness, sexual and sportive performances etc).
The websites that sell drugs directly without medical prescription are defined “online pharmacy”. Italian customers are not used to buy online yet, in respect to other European customers (national regulations do not allow to sell drugs on the Internet), however it has been estimated that hundreds of thousands of Italian citizens have been using foreign online pharmacies.

Buying and selling modalities

The new psychoactive substances and drugs can be purchased by means of traditional or prepaid credit cards; the products are home delivered, using the usual mail couriers, in anonymous packages. Very often gadgets are included in the packages, small quantities of substances that aim at creating curiosity in the consumers and loyalizing them.
The organizations offer the new psychoactive substances or drugs through a so-called “showcase websites”, that advertise the substances with fancy commercial names, particularly attractive polychromatic packages, or websites that sell new psychoactive substances as products for chemical research. The new psychoactive substances and drugs are commercialized also through classified advertising websites, where messages can be posted for selling or buying products that are generally harmless (machines, gardening tools etc). In this case, the substances are offered in sections of the website normally dedicated to the selling of generic products and therefore masked among them.

An issue for public healthcare

The availability on the Internet of psychoactive substances, legal or not, and medicines sold without medical prescription represent a serious issue from a healthcare point of view, because these substances expose customers to high risks of toxicity or, in the worst scenario, death. Some of these substances have documented capability of inducing addiction in the consumers⁵ and, in case of intoxication, the lack of precise information in regard to the real active principles contained within the products bought online makes difficult for the health professionals to draw a precise diagnose and, then, provide prompt assistance to the patient. There is no guarantee on the quality and the safety of the purchased products⁶ nor on their composition. It should be noted that some studies highlighted how often the products delivered to the buyer contain active principles very much different from those declared online.⁷
The Internet is an environment where systematic controls and investigative actions by law enforcement agencies are difficult. The websites, in fact, are developed and managed from a multitude of “agents”, very often single persons or new organizations, different from the traditional criminal organizations voted to drug traffic. Besides, these websites, once identified and put under control or closed by the police, often re-appear in few days, under other semblances, on other servers. This has facilitated the arisen of new drug traffickers and dealers able to organize new markets easily and rapidly through the web, uncontrolled and uncontrollable.

The web monitoring by the National Early Warning System

The Italian Antidrug Policy Department of the Presidency of the Minister Council, through the National Early Warning System, monitors the Internet for identifying the websites that commercialize drugs and reporting them to the law enforcement agencies in order to affect the supply chain of these products. Between July 2011 and November 2013, 47 different typologies of illegally sold substances have been identified, among which psychoactive substances and medicines. In total, 514 webpages have been reported to the Police, resulting in a decrease by 69.9% in the product offers, the black out of the webpages in 22.4% of cases and the complete website blockage in 1.6% of cases.⁸
By monitoring the web it is possible to understand in which direction is moving the demand for new drugs among the consumers, what are their “tastes” and preferences and, consequently, to foreseen the future movements of the market. This would be useful for activating early prevention actions and for better directing the police controls, which are necessary for preventing the circulation of these drugs on the territory. The achieved result is surely important, but it is essential that we always stay on guard, especially when it concerns the youngsters. For this reason, the Department has also developed a software for computers, smartphones and tablets that parents will be able to download for free and that will prevent their underage children from accessing websites selling drugs, therefore protecting their health. Nevertheless, it is essential to promote educational measures for increasing awareness among the youngsters on drugs and abuse of medicines.