Warning over string of fatal overdoses from online pharmacies selling dangerous drugs

Despite a string of deaths over the past decade, dangerous drugs are still “freely marketed,” experts warn.

Medicines bought through online pharmacies have led to the deaths of a number of people in the UK, analysis of coroner’s records has shown.

But despite a number of recommendations designed to restrict the supply of prescription and unlicensed drugs over the Internet, a lack of regulation means the potentially deadly drugs are still available.

A study by the Pharmaceutical Journal looked at Regulation 28 reports – also known as “Prevention of Future Deaths” reports – from July 2013 to March 2023 for internet and online pharmacy listings.

They found 20 reports in which coroners expressed concerns, with one warning in 2014 that more people will die “unless the central government takes steps to screen and shut down websites” that sell dangerous, non-prescription drugs.

Online drugs include opioid acetylfentanyl – 15 times more potent than morphine

Drugs purchased online ranged from the unlicensed disease, which studies have shown is 15 times more potent than morphine, to the so-called “diet pill” 2,4-dinitrophenol.

But searchers also found that prescription-only and highly addictive drugs, such as the strong painkiller codeine, are available for purchase through both UK and foreign websites.

A loophole means that patients can “game” the system by ordering drugs in rapid succession from several online pharmacies, without providers knowing.

Duncan Rudkin, chief executive of the General Pharmaceutical Council, said the lack of a requirement for prescribers to contact a patient’s primary care physician before supplying medicines online leaves it open to abuse.

It means that someone could potentially go to a number of different providers “in a short period of time” to get the medication.

He said: ‘Each of them can do a more or less good job of mitigating the risks associated with each transaction, but no one is able to put the whole picture together…then there is a kind of concatenation of risks. that come together. ‘

Regulation 28 reports are required by law from a coroner when they believe action should be taken following a death they have investigated.

But as of last year, a coroner said it was not clear which organization or department of the government should be responsible for monitoring such sites.

Officials have responded to several coroner’s concerns, citing a list of measures taken to reduce the risk of drugs delivered over the Internet.

These included being part of the European Falsified Medicines Directive (FMD), which required the UK to introduce a national scheme to register suppliers of medicines remotely.

In one case, the Home Office responded by saying it had shut down a website used to purchase drugs, including benzodiazepines, that were responsible for Jason Houghton’s death.

The 24-year-old from Manchester died in 2014 after he started taking the pills to help him sleep while working irregular shifts as a paramedic.

A loophole means patients can ‘game’ the system by ordering drugs in quick succession from several online pharmacies, without providers knowing

However, on March 6, 2023, The Pharmaceutical Journal discovered that the Pakistan-based website is still selling prescription drugs, including diazepam for US$5.99 and tramadol for US$7.50.

His father Keith said, ‘How many others have died since Jason in 2014? How many more parents have since grieved because those sites that sell drugs to our kids are still accessible at the click of a button?

“Unless stricter controls are put in place, the problem will not be solved.”

Coroner Catherine McKenna wrote to Health Secretary Steve Barclay on Feb. 7, 2023 following the death of Ania Sohail of Prestwich, Greater Manchester, who was able to obtain propranolol medication seven separate times from four different online pharmacies.

“Each time, Ania had completed an online questionnaire in which she… refused to allow the prescriber to share information with her GP,” she wrote.

“As a result, it is now possible for a patient to obtain large quantities of medication simply by placing multiple orders with different online pharmacies.”

The Medicines and Healthcare products Regulatory Agency (MHRA) participates in an annual international initiative to tackle the illicit Internet trade in medicines, led by Interpol.

Last year, law enforcement shut down more than 4,000 websites advertising illegal products.

Andy Morling, MHRA Deputy Director of Criminal Enforcement, said: “The MHRA Criminal Enforcement Unit works hard, working with law enforcement, the wider government and cross-sector partners at home and abroad, to help protect the public and defeat harmful trade. .’