Dangerous drugs are still being ‘freely marketed’ online despite a series of deaths over the past decade, experts have warned.
Medication bought through online pharmacies have led to the deaths of a number of people in the UK, analysis of coroners’ records found.
Yet despite a number of recommendations designed to clampdown on the supply of prescription and unlicenced drugs over the internet, a lack of regulation means the potentially fatal drugs are still available.
An investigation by the Pharmaceutical Journal looked at Regulation 28 reports – also known as ‘Prevention of Future Deaths’ reports – from July 2013 to March 2023 for mentions of internet and online pharmacy.
They found 20 reports in which coroners listed their concerns, with one warning in 2014 that more people will die ‘unless steps are taken by central government to screen and close down websites’ that sell dangerous non-prescribed medication.
In one case, the Home Office responded to say that it had shut down a website used to purchase drugs, including benzodiazepines, responsible for the death of Jason Houghton
Online drugs include opioid acetylfentanyl- 15 times more potent than morphine
Drugs purchased online ranged from the unlicensed disease, which studies have shown to be 15 times more potent than morphine – to the so-called ‘diet pill’ 2,4-Dinitrophenol.
But searchers also found prescription-only and highly-addictive medicines, such as the strong painkiller codeine, are available to buy through both UK and foreign-based websites.
A loophole means patients can ‘game’ the system by ordering drugs from different online pharmacies in quick succession, without providers knowing.
Duncan Rudkin, chief executive of the General Pharmaceutical Council, said the lack of requirement for prescribers to contact a patient’s GP before supplying medicines online left it open to abuse.
It means someone can potentially go to a number of different providers ‘over a short space of time’ to get the medication.
He said: ‘Each of them can be doing more or less a good job at mitigating the risks associated with each transaction, but nobody’s in a position to put the whole picture together… then there’s a kind of a concatenation of risks that come together.’
Regulation 28 reports are legally required from a coroner when they believe action should be taken following a death that they have investigated.
But as of last year, one coroner said it was not clear which organisation or department of Government should have responsibility for monitoring such sites.
Officials have responded to several of the coroners’ concerns, citing a list of measures undertaken to mitigate the risk of drugs supplied over the internet.
These included being part of the European Falsified Medicines Directive (FMD) which had required the UK to introduce national arrangement to register suppliers of medicines at a distance.
In one case, the Home Office responded to say that it had shut down a website used to purchase drugs, including benzodiazepines, responsible for the death of Jason Houghton.
The 24-year-old, from Manchester, died in 2014 after he started taking the pills to help him sleep while working irregular shift patterns as a paramedic.
A loophole means patients can ‘game’ the system by ordering drugs from different online pharmacies in quick succession, without providers knowing
However, as of 6 March 2023, The Pharmaceutical Journal found that the Pakistan-based website is still selling prescription-only medicines, 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 grieved since then because those sites selling drugs to our kids have still been accessible at the click of a button?
‘Unless there are tighter controls implemented, then the problem is not going to be solved.’
Coroner Catherine McKenna wrote to health secretary Steve Barclay on 7 February 2023 following the death of Ania Sohail , from Prestwich, Greater Manchester, who was able to obtain propranolol medication on seven separate occasions from four different online pharmacies.
‘On each occasion, Ania had completed an online questionnaire in which she… declined consent for the prescriber to share information with her GP,’ she wrote.
‘As a result, it is currently possible for a patient to obtain excessive quantities of medication by simply placing multiple orders with different online pharmacists.’
The Medicines and Healthcare products Regulatory Agency (MHRA) participates in an annual international initiative to target the illegal internet trade in medicines, which is led by Interpol.
Last year, it saw law enforcement officials shut down more than 4,000 websites containing adverts for illicit products.
Andy Morling, MHRA deputy director of criminal enforcement, said: ‘The MHRA’s Criminal Enforcement Unit works hard, in collaboration with law enforcement, wider government and cross-sector partners both at home and abroad, to help protect the public and defeat this harmful trade.’