Close to 10 percent of high school seniors have used an addictive, dangerous prescription narcotic within the past year. This is more than 10 times the rate of heroin use. Only tobacco, alcohol, and marijuana are abused more frequently. Many young people wrongly believe that prescription painkillers, even if taken without a prescription, are not addictive and are much safer than street drugs. They also say that prescription drugs are "available everywhere."
Although we don't know how much prescription narcotic drug abuse is fueled by Internet purchases, we can get a sense of their availability by going online. Search engines immediately identify thousands of websites that advertise drugs without prescription and offer to take any major credit card in payment. The reach of the Internet makes it as easy for American teens to buy drugs as it is for them to buy books or music. If the Internet is not already the primary enabler of this epidemic, it will soon.
Stiffer penalties on the sellers of these drugs will not make an appreciable dent in Internet sales. Most of the websites offering these drugs are hosted outside the United States, with the sellers well beyond the reach of US law enforcement. A site selling Vicodin without a prescription can be created on a computer in Uzbekistan, registered to a business address in Pakistan, and deposit payments to a Cayman Islands bank. The drugs can be produced in a country that doesn't require prescriptions for narcotics. To believe that international law-enforcement cooperation will make this globalized business dangerous for the sellers would be a tragic mistake.
Tougher standards for what constitutes a valid online prescription, as Sen. Dianne Feinstein's pending legislation would mandate, are important if the whole system of legitimate Internet sales of prescription drugs is not to collapse. But rogue pharmacies operating in lawless locations will continue selling narcotics to teenagers without prescriptions – or with the phoniest pretense of a prescription – happily using the unwitting cooperation of US search engines, Internet service providers, and credit-card companies. We need additional legislation to require the legitimate businesses that are key intermediaries in illegal online drug transactions to withdraw their assistance.
Specifically, credit-card companies and their sponsoring financial institutions should prohibit the use of their services for illicit sales of controlled substances and should enforce that prohibition. A credit-card company could easily identify customers involved in such sales by putting through a "test" order when it learns of a website offering drugs illegally and accepting its credit card for payment. When such a site is identified, the credit-card company should notify US law enforcement, who in turn would be obligated to notify Internet service providers, search engines, and delivery companies.
Search engines that profit from ads attached to their listings of Vicodin sources – such ads include "Buy Prescriptions" and "No Prescription Needed. Overnighted Totally Legal. Want To Know How?" – should automatically provide a banner warning that such purchases are illegal and describe the dangers of the drugs whenever searches for such terms are requested. In addition, Internet service providers should, in a highly public way, offer customers the use of spam filters to exclude from their homes offers for illegal sales of any controlled substance, such as prescription narcotics.
None of these steps is costly or technologically challenging. The corporations whose services facilitate online drug sales to our children should have taken action years ago. It is not enough for Congress to try once more to target foreign dealers beyond the reach of our laws. The way to curtail online sales of dangerous drugs is to enlist American credit-card companies, search engines, and Internet service providers in the fight.
Mathea Falco, president of Drug Strategies, is a former assistant secretary of State for international narcotics matters. Philip Heymann is a professor at Harvard Law School and former deputy attorney general. ©2008 The Washington Post.