Drugs offered online include generic versions of opiates like OxyContin, methadone and Vicodin, which are legitimately prescribed as painkillers; benzodiazepines like Xanax and Valium, which are prescribed for anxiety; and stimulants like Ritalin.

Federal and state efforts to crack down on Internet sales appear to have reduced the number of sites offering such drugs, from 581 last year, said Joseph A. Califano Jr., director of the National Center on Addiction and Substance Abuse at Columbia University.

“Nevertheless, anyone of any age can obtain dangerous and addictive prescription drugs with the click of a mouse,” Mr. Califano said. The center is issuing the study, the latest of five annual surveys, on Wednesday.

The Drug Enforcement Administration found that 85 percent of all Internet prescription sales involved controlled drugs, compared with just 11 percent of those filled through regular pharmacies, suggesting that online sales often are destined for misuse.

“Abuse of prescription drugs has exploded among college students, and we think that one way they get these drugs is over the Internet,” Mr. Califano said. The use of prescription opioids and anxiety drugs, especially in combination, accounts for a growing share of deadly overdoses nationwide.

“The Internet made it easy for the drug dealers to sneak into your living room,” said Francine Haight of La Mesa, Calif, whose son Ryan died in 2001 at the age of 18 from an overdose of hydrocodone, generic Vicodin, which he had secretly ordered online with a debit card. An A-student and varsity tennis player, he had claimed in an online questionnaire to be a 25-year-old with back pain, got his prescription and was mailed the drug. Ms. Haight, a registered nurse, has since fought against online sales.

Federal law bars dispensing dangerous medications without a prescription from a doctor who has a bona fide relationship with the patient. But officials have had a hard time catching up to rogue Internet pharmacies that sometimes ship the drugs from foreign countries in disguised packages.

For the last several years, the Drug Enforcement Administration and others have worked to halt the illegal trade and prosecute involved doctors and suppliers, with limited success.

“One of the main problems is that the sites can literally open up for a week, close and open up under a different name,” said Michael Sanders, a spokesman for the Drug Enforcement Administration.

In a more recent practice, the new study found, some sites sell written prescriptions that can then be used at local pharmacies.

Using popular search engines like Google, Yahoo and MSN, the Columbia researchers found 365 sites offering controlled drugs by mail. Of these, 206 were advertising sites, directing consumers to a seller. Of the 159 sites that directly sold controlled drugs, 135, or 85 percent, did not require a prescription or provided them on the basis of online questionnaires.

In an effort to make their surveys consistent, in each of the last five years the researchers have spent the same amount of time searching, 210 hours, for the same list of drugs. The number of sites rose to 581 in 2007, then fell to 365 this year. The study will be available online on Wednesday at www.casacolumbia.org.

In April, the Senate passed the Ryan Haight Online Pharmacy Consumer Protection Act, which would require certification of online pharmacies and that doctors see patients before prescribing controlled drugs. The bill is now in committee in the House.

At least eight states have passed laws barring electronic prescribing or sales without a legitimate prescription. Minnesota passed a law in 2007 requiring doctor-patient consultations but found that “the Web sites went around us, doing 30-second consultations on the phone,” said Dan Pearson of St. Cloud, Minn., whose son Justin died of drug poisoning in 2006, aged 24, after obtaining large quantities of hydrocodone and Xanax from 17 online pharmacies. The law was strengthened this year to require face-to-face consultations.

“Anyone can have these drugs at their door within 48 hours,” usually using a credit or debit card to pay for an online prescription and then a money order to pay for express delivery, C.O.D., Mr. Pearson said.

Federal drug authorities have begun working with credit card companies and banks to try to prevent such transactions, while major Internet search engines have used a verification program called Pharmacy Checker to confirm that advertisers are legitimate. But the system appears to be full of holes, critics say.

Mr. Califano sent letters this week to senior officials of Google, Yahoo and MSN asserting that they were “profiting from advertisements for illegal sales of controlled prescription drugs online,” and calling for stronger action.

Diana Adair, a spokeswoman for Google, said the company took the problem seriously and in addition to using Pharmacy Checker, had consulted with federal agencies on ways to stem the trade. Kelley Benender, a spokeswoman for Yahoo, said the company was “working to identify the illegal sites and will take appropriate action.”

A spokesman from MSN said the company had no comment.

By ERIK ECKHOLM from The New York Times

“When people hear the word ‘cancer,’ there’s kind of an assumption that it’s a death sentence,” says Dr. Marvin Seppala, chief medical officer for the Hazelden Foundation. “That’s not the case, since so many cancers are treatable nowadays. Yet there’s still a chance that people in the midst of addiction treatment might say to themselves: ‘Why bother to get clean and sober? I’m not going to go through with it because I’ve got cancer.’ ”

Studies suggest that rates of substance abuse in people with cancer are lower than in the general population. However, these figures are difficult to interpret. They could simply mean that people in cancer treatment routinely hide their problems with alcohol and other drugs.

Secrecy is just one problem. “If you’re in the midst of an active addiction, you’ll also be undermining any kind of healing process related to cancer,” Seppala says. “And there’s always the question of whether some of the addictive drugs will interfere with medications used to treat cancer.”

In addition, a record of substance abuse can strain the human relationships that underlie cancer treatment. If doctors and nurses suspect that their cancer patients are lying about drug use, they may doubt anything that these patients say about their health.

People with cancer might sense this mistrust, doubt the goodwill of their health care team, and decide not to follow through with their cancer treatments. When this happens, prescriptions go unfilled, medical appointments are missed, and people with cancer can get sicker or die earlier.

A report on substance abuse issues from the National Cancer Institute underscores these problems. It also suggests ways to help people face cancer and abstain from alcohol and illicit drugs at the same time:

Gather facts without judgment. When taking a health history, doctors and nurses sometimes avoid questions about alcohol and other drug use. They may feel awkward about raising the issue, or simply assume that they’ll never get honest answers. This assumption undermines cancer treatment. When health professionals ask about drug use with a non-judgmental attitude, people with cancer are more likely to speak candidly.

Involve a multidisciplinary health care team. Treatment for people with cancer and addiction should involve specialists in mental health and addiction medicine. Many people with a history of substance abuse–including those with cancer–also struggle with anxiety, depression, or personality disorders.

Treat pain with an accurate understanding of addiction. People can become physically dependent on opioid drugs such as codeine and oxycodone (OxyContin) that are used to treat cancer pain. This means that withdrawal symptoms will occur if the drugs are suddenly stopped. In this context, however, physical dependence and addiction are not the same. Addiction refers to the compulsive use of drugs for reasons other than pain control. Careful treatment planning can relieve withdrawal without triggering such use.

Current treatments also offer many options for treating cancer pain without drugs. Examples are acupuncture, acupressure, biofeedback, chiropractic treatment, osteopathic medicine, massage therapy, and meditation.

Set realistic treatment goals. There’s a saying among members of Alcoholics Anonymous: “Getting clean and sober is simple–just change everything about your life and do it now.” This slogan reminds us that recovery from addiction requires a transformation in thinking and behavior, which calls for decades of sustained effort. The risk of relapse is high, especially with the added stress of a cancer diagnosis.

Cancer specialists need to be realistic about this fact. Treatment planning for people in recovery should set up a structure for preventing relapse–and dealing with it openly if it does occur.

For more on this topic, visit the National Cancer Institute Web site at http://www.cancer.gov/ and click on “Cancer Topics” and “Coping with Cancer.”

Source: Hazelden

People in business circles can find themselves with an Oxycontin addiction and not pinpoint it as such, much like those in other circles.  However, people in business circles can go to the doctor and get a prescription and be hooked quite easily.  They can go to each other’s doctors as referrals, and before one knows it, several are hooked and sharing and passing it around.

The soccer mom, the bank executive, the pastor’s wife, the attorney, all and more are subject to an Oxycontin addiction that can ultimately take over, and thanks to others in their social and business circles using it, Oxycontin can get passed around like one would borrow a mower or a hammer.

Oxycontin addiction is not unheard of in business circles, it is simply not spoken of as an addiction.  Someone can walk up to someone else and say, “I feel a little sore, I left my prescription at home” and presto, the second person pulls out his or her own pills and shares.  The double standard of thinking someone who is addicted to drugs is just on the streets, homeless, on the rougher side of town helps these people to deny their own addictions for a longer period of time.  There is help, though, and it is up to the very people who make decisions that affect their employees and extended families to realize they have a problem and deal with it effectively.

A leave of absence or vacation is a good way to get help discreetly, for an Oxycontin addiction, or for any addiction.  Private treatment programs are available for those in business circles. It is time for those who have the brains to successfully pull ahead in business to realize they can pull ahead successfully in this area as well and beat an Oxycontin addiction.

Finding support in aftercare will also make the business person aware of just how rampant an addiction can be in his or her own circle or environment.  Taking the steps to break free of the addiction is just as sure a sign of success as any bank account or stock report.  Make the ultimate decision today and you will understand the truth behind that statement.

Source: Narconon

WASHINGTON — Many doctors may lose their ability to prescribe 24 popular narcotics as part of a new effort to reduce the deaths and injuries that result from these medicines’ inappropriate use, federal drug officials announced Monday.