Aislinn Antrim: Hi, I’m Aislinn Antrim with Pharmacy hours, and I speak with Al Carter, Executive Director of the National Association of Boards of Pharmacy, about their Buy Medicines Safely campaign. This campaign aims to educate clinicians and consumers about the dangers of buying drugs from unsafe sources, especially online. Can you tell us what these sources are?
Al Carter, MS, PharmD, RPh: Sure, and thanks for having me, it’s great to be here. Thus, with online pharmacies, nearly 95% of sites offering online prescriptions operate illegally. And in recent years, particularly in relation to COVID-19, we have seen an alarming increase in the number of sites that do so, whether offering prescription drugs, opioids, or even self -called COVID treatments. It’s basically skyrocketed with the pandemic over the last two years.
Plus, with many of these sites, they don’t follow the FDA’s stringent requirements to ensure a drug is safe and effective. And so, we don’t have those same safety protections in place to make sure they go through the same process as all the drugs within our supply chain.
Lastly, many of these sites claim to be from Canada, or Canadian sites, but honestly and sincerely, they ship these drugs from all over the world. And many of these flights have not even been approved by Canadian regulators. And so the campaign that we’re running right now is really to educate and inform patients and the general public about some of the concerns and risks of buying from these sites.
Aislinn Antrim: Absolutely, it’s really worrying. And you talked about it, but can you explain the legality of these sites? And how are they allowed to operate?
Al Carter, MS, PharmD, RPh: It’s very difficult to regulate something that you can’t see or touch, isn’t it? And many of these sites—again, it’s about 95%—operate illegally, because many of them dispense drugs without a prescription. And that should be a first red flag, when you see an online pharmacy, that is, they can dispense you, you know, let’s go with Viagra or what have you, or an opioid. When you can get your painkillers without a prescription, it should be alarming. And that’s what a lot of these sites do. And they often sell drugs that are not FDA approved.
And so it’s very difficult for a regulator, per se, to find these pharmacies, because once they’ve been discovered or there’s some kind of investigation or whatever on that specific pharmacy, so they close that website and open another one and open a different domain. And so, we are working with Congress and trying to look at different regulations and laws to provide additional responsibilities to these websites. But at the moment there is no such restriction. So that makes things very difficult.
Aislinn Antrim: Absolutely. And as you said before, the COVID-19 pandemic has caused an increase in the supply of these drugs from these websites. And can you discuss that a bit more? Do you have any numbers or sort of what that increase was? What did that look like?
Al Carter, MS, PharmD, RPh: I don’t necessarily have the numbers, but I know it was important. And really, the pandemic provided online activity for everyone because we couldn’t go out to our pharmacies or the pharmacies were closed. Due to the pandemic, many people have visited online pharmacies, or you have placed mail order. And so, the pandemic has presented this opportunity to these illegal online drug sellers. And it’s a great marketing opportunity, I might add, to tackle fearful customers and consumers. And you know, these websites were offering falsified and substandard drugs, they are offering treatments for COVID-19. You know, we see full marketing campaigns focused on hydroxychloroquine. And, you know, now ivermectin and really, it’s too bad that’s the case, but there’s really no reliable way to ensure prosecution whether criminal networks have profited from the pandemic or not. But all the assumptions and all the signs lead to say that they’ve benefited greatly from the pandemic and just the fear factor of being able to offer a solution to consumers or patients who otherwise wouldn’t have it, you know, or who have delayed access to appropriate medications.
Aislinn Antrim: Yes, absolutely. And now that you’ve sort of explained what these sources are, what dangers do they really pose to patients?
Al Carter, MS, PharmD, RPh: There are a lot of dangers. And one is that patients often choose to buy drugs online because they are cost effective and easy. But what you see with illegal websites and social media accounts selling bogus, substandard and counterfeit drugs is that it continues to be a growing risk to public health. You get these drugs that are fake or substandard, and you don’t know what’s in them, you don’t know if it’s the total amount of the drug or the chemical that you’re supposed to have, or if it is less potent or more potent, it brings different risks. You take diabetes, for example. If you receive a diabetes medication online that does not have the proper dose prescribed by your doctor, it may alter your diabetes to the point where you can no longer maintain your proper glucose levels, or whatever the case may be. These are therefore health risks.
Also, you know, what we’re seeing is you’re starting to see drugs that contain synthetic fentanyl. And so, the potential for overdose or death from these synthetic drug products is also a huge health risk. But the product you get from the community pharmacy is almost guaranteed to be legit. There is no worry with the products you receive from your community pharmacy, because they go through the proper channels, they go through the proper US supply chain. And there are measures and regulations in place to protect the patient and protect public safety.
Aislinn Antrim: Absolutely. And just to clarify and make sure it’s clearly stated here, these are entirely separate from your licensed regulated mail order pharmacies.
Al Carter, MS, PharmD, RPh: That’s correct. Your licensed mail-order pharmacies must follow the appropriate regulations, just like your community pharmacy around the corner.
Aislinn Antrim: And how does the campaign really work to address these concerns and what are they doing about these issues?
Al Carter, MS, PharmD, RPh: It’s really about education. Thus, this campaign aims to alert patients to the facts of these dangerous websites and social media accounts that exist. It also provides them with an easy to use search tool, to see if the online pharmacy they are going to use is validated and if it has done so according to the relevant requirements and regulations and the accreditation that all other pharmacies have. pass. And you know, so we can make sure they verify that the sites they use are legit. And it also helps patients with tips to find out what are the signs of a rogue pharmacy not taking action or saying you don’t need a prescription. You know that 10 out of 10 times that pharmacy is going to be a rogue pharmacy, especially if you have a prescription that you don’t get, or get without a prescription. And so, it helps to provide education and affiliates a risk associated with buying drugs online.
Aislinn Antrim: Wonderful. Well, finally, how can pharmacists work to educate their patients on these issues and these projects?
Al Carter, MS, PharmD, RPh: There are two things. First, pharmacists are certainly a patient’s first point of access to educate them about, you know, the tools they can use to recognize pharmacies, is one. Second, provide them with questions about buying online. And that, you know, is really if something seems too good to be true, it probably is. And so doing, you know, making sure they recognize legit pharmacies, how to understand them and you know, and what are some of the different signs to do that. And then also, you know, again, telling them to visit a pharmacy and check that their site is a good place to buy and buy the prescription drugs.
Aislinn Antrim: Wonderful. Well, thank you very much for telling me about it.
Al Carter, MS, PharmD, RPh: Thank you very much too, Aislinn. I appreciate the opportunity to do so.