Like many other girls, Lucy (not her real name) grew up in an upper-middle-class New Orleans neighborhood, occasionally drinking with her friends at an Uptown bar on weekends and later going to Louisiana State University and joining a sorority. Her education at college, however, diverged from the lessons contained in her textbooks and increasingly focused on using drugs recreationally, culminating in a stay at a psychiatric hospital after a passerby noticed her in a parked car beside an interstate. She had no pulse and had stopped breathing.
Lucy's odyssey with drugs began with occasional smoke-out sessions with a nearby fraternity at college and increased as she became involved with the burgeoning rave scene of the late 1990s. She began using painkillers, LSD, Ecstasy and other so-called "club drugs" with a little cocaine on the side and eventually discovered her drug of choice, gamma-hydroxybutyrate, or GHB, which was sold over-the-counter as a growth hormone stimulant until it was outlawed in March 2000. That same year Lucy came out of her second round of treatment for addiction to the substance.
Access was easy. She initially could get a bottle of liquid GHB at any local health store, and a $90 bottle would last her for three days. "What people didn't realize is how fast it became physically addictive," says Lucy.
Although GHB has been banned in the United States, it's still legal in many other countries and can be ordered off the Internet. A name, an address, a credit card and few clicks of the mouse can now get people high through online pharmacies. And GHB is not the only drug available. There is a wealth of prescription painkillers, sleep aids and other controlled substances for anyone with the time and the cash.
"It's a growing problem," says Dr. Dean Hickman, medical director for the Addictive Behavior Unit at Ochsner Clinical Foundation. "There's a lot of sources out there." Whether interested in feeding an addiction or looking to sell substances for profit, people have several online options to obtain controlled substances and use them for illegal purposes.
"You have Dr. Feelgoods out there who are unknowledgeable or unscrupulous," Hickman says, adding that some physicians may even recommend that patients go to a specific pharmacy with less stringent prescription guidelines to have an order filled. Then, there's the easy access afforded by the Web. "If you can get it freely on the Internet," Hickman says, "you may not need to see a doctor at all."
Malcolm J. Broussard, executive director of the Louisiana Board of Pharmacies (LABP), says his organization is concerned about patients who obtain and use drugs without medical supervision. "Patients take a risk when they do that," he says. He points out that he has no problems with legitimate online pharmacies, but unfortunately the Internet also gives people who traffic in drugs a new avenue of dissemination.
"People play like online questionnaires can be a prescription," he says. "Electronic prescriptions are not substitutes for a legitimate patient/physician relationship. This is where the Internet has not helped. People have access and can bypass a doctor."
The LABP requires any pharmacy doing business in Louisiana to be licensed. On the other hand, "if they're out of the country, we don't have any resources" to stop them, says Broussard. Currently, his organization works alongside the FDA to go after "the places that play like a pharmacy." But there is no national or even statewide network or database to monitor illegal prescription purchases.
A greater concern of the LABP on the subject of Internet prescriptions is the importation of drugs. "We have seen a recent problem with the introduction of counterfeit drugs in this country," says Broussard. "You may not be getting what you thought." This could lead to developments even worse than physical harm or fake pills. "It certainly does enable someone who wishes to inflict harm," Broussard explains. "It certainly does make terrorism easier."
The possibility of terrorism in online pharmaceutical sales is a very real problem, says Linda Phillips, a senior special agent with Immigrations and Customs Enforcement (ICE), and one that has come into sharp focus with the agency after the 9/11 terrorist attacks. She says prescription drug abuse and illegal online pharmaceutical purchase are on the rise across the nation and even across the world. "We're all feeling the epidemic," she says. Although Phillips and other agents from the Cyber Crime Center in Fairfax, Va., deal mostly with child pornography, she says the recent boom in e-commerce has spawned an overwhelming amount of illegitimate online pharmacies. ICE agents troll the Internet and identify possible illegal pharmacies and possible illegal activities.
There are several ways an agent can go after companies suspected of illegal activity and most involve working with other agencies or, sometimes, foreign attaches. Because the ICE enforces 400 regulations from 40 other federal agencies, the whole process is a "juggling act," Phillips says. "The best we can do is screen, but we don't get everything." Currently, the agency has a Washington, D.C.-based mobile laboratory group with a sole purpose of visiting international mail branches and performing tests on both controlled and uncontrolled substances entering the country "for a possibility of terrorism attacks through our medications," says Phillips.
"People could do anything," says Debbie DiFalco, director of Cyber Crime Division. "We have no idea what they're putting in. It's a safety issue."
And one that promises to swell. "By 2003, it's estimated that 500 million people worldwide will be connected to the Internet," Commissioner Raymond Kelly told a Customs Cybersmuggling Center Open House in 2000. "It defies our traditional responses and challenges us to develop new ways of thinking about methods to combat crime in an increasingly borderless world."
Not only are prescription drugs now easily available on the Internet, they also are increasingly being abused by Americans across the board. A recent survey by the Federal Drug Administration shows that 15 percent of 18- and 19-year-olds used prescription drugs without medical reasons in the last year, and nearly 8 percent of children ages 12 to 17 also abused prescription medications. In 1999, almost half (46 percent) of the 44,000 people admitted to hospitals for primary prescription and over-the-counter drug abuses were for prescription narcotics, according to a recent report by the Drug and Alcohol Services Information System.
For Lucy, recreational use of illegal drugs and getting a legal over-the-counter GHB buzz led to her ingesting a capful of GHB once an hour every day and landed her on a respirator six times in less than six months, she says. One night while driving on an interstate, her heart stopped and she quit breathing. Fortunately, her car ended up in park on the side of the road and a passing motorist called an ambulance. "Honestly, at that time, I had been sober for a month," she says. "I had gone out and just taken a little, one or two, and my body just had enough." Within days, she was in a psychiatric ward, under doctor-ordered treatment. "Part of the disease of addiction is the complete and utter denial," says Lucy. "It really messes with your head." The first time she came out of treatment she went right back to GHB. Later that week, she toppled over at an Uptown gas station and decided to call it quits, telling herself, "I'm going to die if I keep on doing it."
Because GHB is a central nervous system depressant, an overdose can cause unconsciousness, a slowed heart rate, respiratory depression, seizures, hypothermia, nausea, vomiting and coma or death, reports the National Institute on Drug Abuse. The drug sometimes is surreptitiously slipped into a person's drink, making them an easy target for a sexual assault because it causes a loss of muscle coordination and confusion. Along with Rohypnol and the animal tranquilizer Ketamine, GHB is a notorious "date rape" drug.
For those who take it willingly, it also can be addictive, as Lucy learned. Although detox was very unpleasant, she had to go through treatment twice before she freed herself of her addiction. "You want to crawl out of your skin, you can't sleep, you have a fever, you shake like a leaf," Lucy says of withdrawals. "It's the most uncomfortable feeling you've ever felt in your whole life."
These days, Lucy is confident she won't go back to her former lifestyle. "All human respect and privileges were taken away," she says. As for the future, she's been clean for three years and is taking life one day at a time.