LegitScript’s primary focus is on Internet pharmacies. However, today, the Houston Chronicle published an op-ed by LegitScript President John Horton talking about a related problem: the growth of the “celebrity-overdose club” from prescription drug abuse. Using Anna Nicole Smith and Michael Jackson as examples, the op-ed says that prescription drug abuse figures “are alarming”:

Let’s put the figures in perspective. Remember the crack cocaine crisis of the 1980s? At its height in 1988, there were just over half a million crack users. What about the methamphetamine “epidemic” of a few years ago? Actually, in 2004, there were just under 600,000 meth users. And prescription drugs? Brace yourself. In 2006 and 2007 (the last years for which complete estimates are available) an estimated 7 million Americans were abusing these regulated pharmaceuticals. That’s nearly double the 3.8 million estimated for 2000.

The op-ed goes on to discuss the problem of “celebrity enablers” such as Howard K. Stern and Dr. Conrad Murray, who are alleged to have either directly furnished, or enabled the furnishing of, prescription drugs that were supplied without a legitimate medical need:

If this is America’s new drug problem, who are the drug dealers? Certainly, over-prescribing “rogue” Internet pharmacies and doctor-shopping all share some part in the blame. But the celebrity cases highlight a disturbing trend: the “hanger-on” who clamors to fill a need in the star’s life, and in return, gets to bask in the glow of the limelight. In the case of prescription drugs, the hanger-on could be a doctor or an intermediary with access to physicians. Either way, these enablers help facilitate the person’s prescription drug abuse, then addiction, and even overdose, just as surely as a street-corner drug-pusher.

The op-ed states that most doctors are responsible, and distinguish between a legitimate medical need for prescription drugs and requests for drugs to feed an addiction, but notes that a few unscrupulous doctors are simply “drug dealers in white coats.” The op-ed concludes:

If unwarranted requests for prescription drugs continue to be met with an easy supply chain — among celebrities and the general public — we should prepare ourselves for a frightening growth in membership to the overdose club.

One of the most important misperceptions about Internet pharmacies is that if a “Canadian Internet pharmacy” has been verified as possessing a Canadian pharmacy license, that it must be acting legally and safely, and that the drugs must be coming from Canada. After all, drugs “from Canada” are just as safe as drugs here in the United States, correct?

The truth is disturbing. First, to back up, let’s be clear that real Canadian pharmacies are generally just as safe as US pharmacies. If you walked into a Canadian pharmacy, you’d have the same protections and drug safety system (not identical, but close enough) that US residents enjoy. Part of those protections, both in Canada and the US, include a prohibition against importing prescription drugs from outside of those respective countries.

The assumption is, of course, that if you order from an Internet pharmacy that has been verified as “having” a Canadian license, that they are actually using the license for it’s intended purpose and simply sending you drugs from their own pharmacy shelves. But remember, Canadian laws only apply in Canada, so if you are a customer located outside of Canada, that isn’t really what’s going on. Rather, as we explained in our report on approved Yahoo Internet pharmacy advertisers, they are simply re-routing at least some drug orders to locations like India or Turkey, and the drugs never come from or go through Canada at any point, but are sent directly to US residents. This is unsafe and illegal.

To put this in context, consider our expose of CheapoDrugs.com. That Internet pharmacy became an approved Yahoo! advertiser by virtue of showing a Canadian pharmacy license (the same one used by CanadaDrugs.com) to PharmacyChecker. But remember, the purpose of a Canadian pharmacy license is to dispense drugs from a Canadian pharmacy. Despite claiming to be Canadian, that Internet pharmacy says it cannot do business in Canada because it would be illegal to import prescription drugs into Canada. (Repeat: This “Canadian” Internet pharmacy says it can do business anywhere but Canada. Sound fishy?) And the website told us, when we asked, that the drugs would be routed into the US from India via Barbados.

Does this sound like a bona fide Canadian pharmacy? Of course not. This would be blatantly illegal in Canada, in fact. CheapoDrugs.com is hiding behind a Canadian pharmacy license in order to become a search engine advertiser and illegally ship drugs to US residents from India, Turkey, Barbados, or similar locations.

Why would CheapoDrugs.com want to hide behind a Canadian pharmacy license? Two big reasons. First, Internet users that are squeamish about ordering from India or Turkey may assume, incorrectly, that they are using a licensed Canadian pharmacy to order drugs. Second, being able to point to a Canadian pharmacy license (even one that it doesn’t utilize) gives this website the ability to advertise on Google, Yahoo! or Microsoft, which require that the Internet pharmacy “be based in the US or Canada.”

Think about it. Search engine advertising policy would prohibit a pharmacy or drug supplier in India, Africa or Turkey from advertising and selling drugs into the US. So if you are a drug supplier located in one of those countries and want to advertise with Google or Yahoo! to illegally sell drugs to US residents, what should you do? Simple: become an affiliate of a licensed Canadian Internet pharmacy. You don’t actually have to sell drugs from Canada, let alone a real Canadian pharmacy. All you have to do is get permission to write down the Canadian pharmacy license number in your Yahoo! application, advertise as a “Canadian pharmacy” and then ship the drugs from somewhere else like India, Turkey, or wherever you’d like to.

Make no mistake: this isn’t about Canadian pharmacies or drugs from Canada. This is about drugs from India and Turkey, and an advertising system that is allowing them to deceptively market themselves as “Canadian.” This isn’t legal or safe. We deserve better from the search engines, which should require that their Internet pharmacy advertisers adhere to US law, rather than allow advertisements placed by websites that facilitate illegal prescription drug activity online.

The American Pharmacists Association released a statement today in support of LegitScript’s and KnujOn’s report on rogue Internet pharmacy Yahoo! advertisements.

The statement says:

The American Pharmacists Association (APhA) applauds the efforts of LegitScript and KnujOn to bring attention to the threat posed to patient safety by sponsored search engine results for rogue Internet pharmacies appearing on the nation’s top Internet search engines. In a co-authored report entitled “Analysis of Yahoo! Prescription Drug Sponsored Search Results,” released on August 18, 2009, the companies examine the Web sites selling prescription medications that advertise through Yahoo!’s online advertising program.

Earlier this year, APhA expressed similar concerns for patient safety in letters to Microsoft MSN, Google and Yahoo! for returning sponsored search results for Internet drug sellers that appeared to be operating in violation of law and/or accepted standards of pharmacy practice in the United States.

“Allowing the posting of sponsored search results of Internet drug sellers that dispense prescription medications without a valid prescription supports practices that are contrary to U.S. law, are deceptive to American consumers who are relying on your site to provide them access to legitimate Web sites, and most importantly may be unsafe to U.S. consumers who are relying on these medications to manage their health care needs,” said APhA Executive Vice President and CEO Thomas Menighan.

APhA encourages Yahoo! and other search engines to revise their current policies and standards for prescription drug Web site sponsored search results to, at a minimum, limit postings to Internet sites that are legitimate and comply with U.S. law.

LegitScript and KnujOn both appreciate the continued support of reputable organizations like the APhA that are dedicated to protecting patient safety.

The National Association of Boards of Pharmacy and National Center on Addiction and Substance Abuse at Columbia University have each released a statement regarding LegitScript’s and KnujOn’s report on Yahoo-sponsored rogue Internet pharmacy websites.

The NABP’s statement calls on Yahoo! and other search engines:

…to hold advertisers selling prescription medications accountable to the same laws and practice standards required of any legitimately operating pharmacy.

The National Center on Addiction and Substance Abuse (CASA) at Columbia University’s statement, by former HEW Secretary Joe Califano, Jr., says:

CASA has written to all three major search engines urging them to block such ads from rogue pharmacies. Continued failure of these companies to take strong and decisive action contributes to the ease with which anyone –adult or child – can purchase highly addictive and harmful drugs online without a prescription.

LegitScript appreciates the efforts of reputable organization like the NABP and CASA Columbia to make this problem smaller.

Today, we released another report, co-authored with Internet compliance guru KnujOn, detailing our concerns with search advertisements for rogue Internet pharmacies, focusing this time on Yahoo online advertisements. Our report indicates that more than 80% of Yahoo’s Internet pharmacy ads that we reviewed were operating contrary to US federal and state laws.

So, what did we find? Well, first, we indicate that we purchased prescription drugs without a valid prescription from Yahoo Internet pharmacy ads, including of potentially habit-forming medications. In one case, the drugs came from India. (The direct importation of medicines from outside of the US, including India, is prohibited by law.)

The report also touches on PharmacyChecker.com, Yahoo!’s Internet pharmacy verification service. We were able to get prescription drugs without a prescription from an Internet pharmacy (in this case, shopeastwest.com) approved by PharmacyChecker and listed on PharmacyChecker.com. The drugs also came from India. (This wasn’t the first time, as we note in a previous blog or two.)

Yahoo!, Google and Microsoft require their Internet pharmacy advertisers to be verified as legitimate by PharmacyChecker.

Dan Pearson, father of Justin Pearson, after whom Minnesota’s Internet pharmacy law is named, said, “My daily trip to the cemetery to visit my son only reinforces my resolve to address this national travesty. The search engines have said for years that they are taking effective steps to stop no-prescription-required Internet pharmacies from advertising. Until they get serious about this, parents like myself will continue to bury our children.”

In an earlier report, we announced that we had purchased prescription drugs without a prescription, and been sent counterfeit medications, from bing.com online pharmacy advertisers. A few days after Microsoft responded that it had manually reviewed its pharmacy ads and removed all offenders, KnujOn announced that it had conducted yet another purchase of addictive drugs from a bing.com advertiser without a valid prescription.

Furthermore, our report tackles the issue of “licensed Canadian Internet pharmacies.” Yahoo’s policy requires Internet pharmacy advertisers to be “based in” the United States or Canada. The report reviewed three Internet pharmacies that were approved as advertisers based on having a Canadian pharmacy license. In all three cases, the Internet pharmacies indicated that the drugs would actually be shipped from places like India, Singapore or Barbados, not Canada.

To drive this point home, in one case, an Internet pharmacy advertiser approved as a licensed Canadian Internet pharmacy (CheapoDrugs.com) stated that it could fill prescriptions anywhere in the world except for Canada, because prescription drug importation illegal in Canada.

The report indicates that over the last year and a half, three national organizations, including the American Pharmacists Association, National Association of Boards of Pharmacy, and National Center on Addiction and Substance Abuse (CASA) at Columbia University, had written to all three search engines to warn them that they were profiting from ads placed by online pharmacies that sell prescription drugs without requiring a valid prescription, or that illegally import drugs from outside of the United States, increasing the possibility that the medicines are counterfeit or adulterated.

“We’re making this a public issue because it’s time for this to stop,” KnujOn President Garth Bruen said. “If the search engines continue to knowingly facilitate illegal prescription drug sales, then we’ll continue to issue these reports. Our reports stop when the problem is fixed.”

“Yahoo! needs to require that its Internet pharmacy ads adhere to US laws and National Association of Boards of Pharmacy standards,” LegitScript President John Horton said. “These are the same standards that govern brick-and-mortar pharmacies used throughout the US everyday. Shouldn’t American Internet users be assured of the same safeguards online?”

According to government data, prescription drug abuse is now the second largest drug abuse problem in the United States, with more primary abusers than methamphetamine, powder cocaine, crack cocaine heroin, ecstasy, PCP and LSD combined. Counterfeit drugs are estimated to be a $32 billion dollar industry.

LegitScript is the only Internet pharmacy verification organization in the United States identified by the National Association of Boards of Pharmacy as adhering to its standards for certifying Internet pharmacies as safe and legitimate. KnujOn tracks Internet criminality and has succeeded in removing over 100,000 spam websites from the Internet.

Last week, we released a report with Internet compliance guru KnujOn.com about rogue Internet pharmacies in bing.com’s ad space. In the original report, we ordered a prescription drug from a Microsoft-sponsored advertisement that tested positive as counterfeit, and ordered prescription drugs without a prescription from other bing.com advertisements. The company subsequently announced that it had manually reviewed all pharma-related keywords to sweep out advertisers in violation of their policies, and that it believed the violation percentage to be substantially smaller than the report indicated.

Unfortunately, the problem hasn’t yet been fixed. Today, we are releasing a short follow-up report indicating that we got addictive drugs again, without a valid prescription, from a bing.com, just days after Microsoft says that it manually reviewed all of its Internet pharmacy ads. KnujOn simply logged on, went to bing.com, and ordered an addictive prescription drug within a matter of minutes…again, from a bing.com ad (not an organic search result). The KnujOn researcher never saw a doctor or had a medical condition.

But wait…was this a new advertiser that somehow slipped through bing.com’s filters that we happened to observe right before it got caught? Was it a hijacked landing page? No. This is not a game of “gotcha.” This website has been a bing.com advertiser for months. In fact, we specifically notified Microsoft about this advertiser in February 2009, six months before KnujOn made the purchase. We never received a response, and the advertiser continued to display bing.com ads unabated, despite our notification. Somehow it survived bing.com’s manual review, which naturally leads to the question of whether Microsoft thought this was a legitimate Internet pharmacy, and if so, why.

The drug in question is Soma (carisoprodol), an addictive muscle relaxant that is a controlled substance in some states and requires a valid prescription and medical supervision everywhere. The drug is sometimes abused in combination with drugs like hydrocodone (Vicodin) and has been responsible for overdoses, even fatal ones. To get this drug, all you have to do is fill out an online form with the website in question. In addition to the obvious legal and safety implications, it violates Microsoft’s stated policies.

As Garth Bruen, KnujOn President said, “This isn’t about an occasional abusive advertiser that slips through Microsoft’s filters. This is about a system that isn’t working.”

Today, LegitScript and KnujOn, an Internet compliance company, released the first in a series of reports about US companies that facilitate, and profit from, the illicit sale of prescription drugs. Our first report is about Microsoft, and how rogue Internet pharmacies are being allowed to participate in its online advertising program for bing.com.

What is our report fundamentally about? Well, bing.com displays online advertisements (at the top and right side of the page) when you conduct a search. Because most Internet users don’t go beyond the first page of search results, that’s valuable virtual real estate. Every time an Internet user clicks on one of those ads, Microsoft receives advertising revenue. Microsoft also has the ability to control what kind of ads are displayed, and which ones are prohibited.

In short, Microsoft has the ability, and responsibility, to make sure it isn’t displaying, much less profiting from, Internet ads for websites engaged in illegal activity— like selling prescription drugs without a license or a prescription.

Unfortunately, that’s just what we found. Among our findings:

• 89.7% of the bing.com Internet pharmacy ads that we reviewed are acting unlawfully in some way.

• We successfully purchased prescription drugs without a prescription from bing.com Internet pharmacy advertisers.

• We submitted some of the drugs for testing, and the drugs tested positive as counterfeit.

• We identified serious security gaps in Microsoft’s online advertising program, allowing a rogue Internet pharmacy like store.k2med.com to advertise under the name of a domestic, US-licensed pharmacy but redirect traffic to the no-prescription-required, fake website. This happened in several cases, which is bad news for bing.com’s advertisers.

• Many of the rogue Internet pharmacy advertisers are members of criminal networks responsible for much of the world’s spam, counterfeit drugs, and cybercrime, like GlavMed.

Inexplicably, these dangerous websites are allowed to sell prescription drugs with the imprimatur of Microsoft approval. The problem is, some Internet users looking for a safe, legitimate Internet pharmacy might assume that if it is “sponsored” by Microsoft on bing.com (as online advertisements are said to be), it is okay to use it, since Microsoft is a reputable company.

Our report focuses on ten sample bing.com Internet pharmacy ads, explains why they are “rogue” Internet pharmacies, and tells you what we know about the criminal networks that control these websites.

LegitScript and KnujOn are releasing this report in the hope that it will encourage Microsoft to discontinue allowing such websites to participate in bing.com’s online advertising program.

In our report released today, LegitScript and KnujOn take a look at several bing.com Internet pharmacy ads for fake or rogue Internet pharmacies. Here’s a quick list of the ten rogue Internet pharmacies we focused on in the report, and what they are doing wrong.

1. choice-rx.com. This Internet pharmacy does not require a prescription and sells drugs purportedly from India or the Seychelles. The order is processed by a website in Panama sponsored by Russian company. The website is registered to Joel Troska of Minnesota.
2. k2med.com. This fake Internet pharmacy linked to a Russian organized crime group called “33 Drugs” fraudulently advertises under the name “dailymedrx.com,” a licensed Internet pharmacy in Indiana.
3. canadian-healthcare-shop.com. Some Microsoft advertisements for canadadrugs.com or prescriptionpoint.com fraudulently redirect to this no-prescription-required website controlled by a Russian spam network.
4. expressdelivery.biz. This rogue websites advertises under affordabledrugs.com, but redirects to expressdelivery.biz. The website claims to sell drugs from Canada, but the authors submitted an order, and received counterfeit Cialis, without a prescription from India.
5. bestrxcanada.com. This Microsoft advertiser sells potentially counterfeit drugs, does not require a prescription, and has a connection to Russian organized crime.
6. jutcom.com. This advertiser appears to be a mini search engine, but primarily displays Internet pharmacies selling controlled substances without a prescription.
7. rx-medical-center.com. LegitScript successfully ordered and received a prescription-only prescription muscle relaxant without a prescription from this Microsoft advertiser.
8. toppharmacymulti.com. Controlled by a Russian/Eastern European network, this fake Internet pharmacy has hijacked an advertisement placed by a licensed US pharmacy.
9. genericshotsale.com. This no-prescription-required website is controlled by Russian organized crime, does not require a prescription, and pretends to be “Canadian.”
10. rx-line.com. This Microsoft advertiser is actually based in Calcutta, India, sends potentially counterfeit drugs, and does not require a prescription.