In calendar year 2006, thirty-four known or suspected rogue Internet pharmacies
dispensed 98,566,711 dosage units of hydrocodone combination-products.4 To put this in
perspective, controlled substances account for 11 percent of dosages at legitimate “brick and
mortar” pharmacies in the United States versus 95 percent at these rogue Internet pharmacies.
These thirty-four pharmacies alone dispensed enough hydrocodone combination-products to
supply over 410,000 actual patients with a one-month supply at the maximum amount
recommended per prescription.5

Controlled pharmaceuticals in the United States are legitimately prescribed and dispensed
within a closed system of distribution. Importers and manufacturers of controlled substances as
well as physicians who dispense or prescribe them and pharmacies that fill controlled substance
prescriptions are all DEA registrants subject to the Controlled Substance Act and the Code of
Federal Regulations. As a closed system there are built-in checks and balances. Each registrant
has a corresponding liability to keep the integrity of the closed system intact. However, with
rogue Internet pharmacies there is complicity amongst all of the participants, effectively
eliminating all of the normal checks and balances. Even some major corporations may turn a
blind eye to obvious warning signs when supplying these rogue pharmacies.

Common methods of drug diversion, by their nature, provide some constraints on the
amount of controlled substances individuals can acquire over a given period of time. These
methods place the “patient” at a greater risk of being caught by law enforcement because the
DEA registrant is frequently not complicit in the scheme and will report the suspicious behavior.

The sheer volume of controlled substances being dispensed anonymously over the Internet contributes significantly to other downstream methods of diversion, (e.g. children and young adults getting controlled substances from the medicine cabinet or family and friends). While studies such as National Survey on Drug Use and Health indicate that only a small percentage of youth get controlled pharmaceuticals via the Internet (the majority obtaining them from family and friends), it’s important to remember that when these individuals obtain these substances they generally acquire only a few pills at a time. In contrast, individuals ordering via the Internet frequently receive 100-120 pills at a time,
making it a potentially much higher-volume source than friends or the family medicine cabinet.

But the consequences to those individuals who seek controlled prescription drugs
illegally over the Internet can be just as dangerous and deadly as the consequences of those
abusing more traditional substances, such as cocaine or heroin. Many parents of young people
who died from the misuse of prescription drugs have told us that they were unaware of the
source of the pills which killed their sons and daughters. However, in some cases, parents such
as Francine Haight and others discovered that their children were using the Internet as the source
for pharmaceuticals.

Linda Surks, mother of Jason Surks, testified before Congress last year about the tragedy
which befell her family when they discovered that Jason had overdosed on prescription drugs at
the age of 19. A pre-pharmacy major as an undergraduate, he had an academic curiosity about
prescription drug formulas and combinations.

What they didn’t know was that Jason had been drawn in by the Internet facilitators who
made it far too easy to order dangerous controlled substance pharmaceuticals from illicit online sites. A search of his computer after he died revealed that he had visited multiple Internet
pharmacies. One in particular had automatically renewed his order regardless of whether or not
Jason had actually placed it himself, even after he died. The drugs just kept coming.

Vigil for Lost Promise

In June of 2006, DEA hosted the Candlelight Vigil for Lost Promise, in remembrance of those who have died from drug use. Several hundred parents and family members joined together to share their tragic stories of loss in an effort to raise awareness of the dangers of substance abuse and in hope that through awareness other families could avoid the loss they have suffered.