A recent study has found that General Practitioners (GPs)in the United Kingdom reported treating 1 in 4 patients for side effects from medications ordered online. The side effects ranged from allergic reactions to ill-effects of counterfeit medications. Says Telegraph.co.uk:

The findings prompted warnings from GPs, regulators and pharmacists that patients should be careful about buying drugs online, highlighting the prevalence of fake medication.

The study focused on practitioners in the UK, which leads us to wonder if the findings would be similar here in the US. In any case, the study speaks to the need for caution in confirming that Internet pharmacies meet baseline criteria for legality and safety.

In July of last year, LegitScript and spam fighter KnujOn sent out letters to eight US-based registrars requesting that they terminate or suspend websites they were sponsoring that offered to sell steroids, a Schedule III controlled substance, without a prescription, from overseas (both illegal and dangerous). Eventually, six of the eight registrars terminated all of the sites. The sole exceptions were Parava Networks, supposedly in Texas, and eNom.

LegitScript and KnujOn sent Parava a letter to the address it had provided to the Internet Corporation on Assigned Names and Numbers (ICANN). Not only did Parava not respond and not terminate the illegal websites, the letter bounced back to us, with the US postal service indicating that there is “no such address.”

Well. In other words, this was a domain name registrar that was sponsoring rogue Internet pharmacies, couldn’t be reached, and had apparently provided ICANN with false registration about its location. Meanwhile, it continued to register rogue Internet pharmacy domains, including several affiliated with (probable-) Russian-crime-sponsored 33drugs.com. No response to our continued notifications.

KnujOn spearheaded the complaint process to ICANN. Due in significant parts to KnujOn’s efforts, and as a direct consequence of Parava’s refusal to adhere to ICANN requirements following our requests, ICANN has now informed Parava that it is deaccrediting Parava as a registrar, and shutting Parava down.

This is an important development in the fight against rogue Internet pharmacies. It’s important to note that the provisions used to terminate Parava were not directly related to its knowing sponsoring of illegal Internet pharmacies, but rather its lack of an accurate address and other factors. But this is similar to ICANN’s termination of rogue Internet pharmacy sponsor Estdomains a few months ago, which was also de-accredited for ostensibly different reasons than its sponsorship of criminal websites. As a practical matter, registrars that knowingly sponsor criminal websites and fail to adhere to ICANN requirements may be susceptible to increased attention, including arguments that they are failing to adhere their contractual obligations under ICANN agreements.

Following the passage of the Ryan Haight Online Consumer Protection Act in October 2008, the DEA has issued interim regulations. These interim regulations go into effect on April 13, 2009; the public comment period on the interim regulations ends on June 5, 2009. After that, the permanent regulations will be enacted.

Additionally, any pharmacist who operates an online pharmacy within the definition of the new law must, starting on April 13, 2009, update their DEA registration to obtain permission to operate as an online pharmacy.

The 30+ page interim regulations were just released yesterday (April 6, 2009) and LegitScript staff are poring through them now. We’ll be working with the online pharmacies we’ve approved over the next few weeks to ensure that all online pharmacies are up-to-speed and in compliance with both the law and the regulations.