Not long ago, the sale of prescription medications over the Internet was commonplace, and it was difficult to avoid online ads for pharmacies offering to sell powerful controlled substances, including pain medications and anti-anxiety medications, without a prescription. Although the number of illegitimate online pharmacies has been significantly reduced, there remain overseas pharmacies that attempt to circumvent U.S. laws and regulations in order to sell pharmaceutical products to U.S. consumers. While laws and regulations have significantly improved safety, lobbying by the pharmaceutical industry has also resulted in laws that make it more difficult for consumers to save money by purchasing prescription medications from pharmacies outside of the United States.
There are valid health concerns associated with online prescriptions, including whether the patient has other health concerns which might be affected by a prescription drug. Although most legal pharmacies that offer online prescription services limit themselves to offering drugs that are relatively safe even when misused, any prescription medication may potentially pose health risks or may result in a negative interaction with other prescription and non-prescription medications, or even with dietary supplements. A doctor can advise a patient about side-effects, and warning signs that indicate that the patient should stop taking a medication. An online pharmacy may provide little guidance, typically at most providing written instruction about taking the drug.
Additionally, overseas pharmacies may be selling a different formulation of a medication. Even if the patient has been physically examined and was issued a prescription in person, the dosage may not be optimal if the overseas formulation is different.
Some medications must be refrigerated or stored in a controlled environment. Some pharmacies do not take proper care of the medications they store or obtain their medications from sources that exercise inadequate care, creating a risk that the medication will be ineffective, contaminated or potentially dangerous.
Some pharmacies have been known to sell expired or counterfeit medication. While this risk is relatively low if a patient is able to confirm that the purchase is being fulfilled through a U.S. or Canadian pharmacy, or even a reputable Mexican pharmacy, some vendors intentionally defraud consumers. When using a pharmacy that sells counterfeit drugs, the customer may be paying hundreds of dollars for nothing more than a few cents worth of sugar pills.
There is a secondary market for medications which are approaching their expiration dates, and those products as well as expired products may be sold by an online pharmacy that is more interested in maximizing its profits than in providing quality product.
The U.S. government has responded to intensive lobbying by the pharmaceutical industry by limiting the import of prescription medications. When people order prescription medications from other countries, the lower prices they pay translate into lower profits for drug manufacturers. While groups that represent older Americans and concerns over rising health care costs are lobbying sympathetic members of Congress to legalize the import of prescription medications, the trend has instead been toward increased restriction.
At present, while you can bring up to a 90 day supply of a medication with you on your person when you return from a foreign country, you may no longer import certain controlled substances. Import by other means, such as by mail order, is no longer permitted, and any drug shipments that are detected will be seized at the border.
For a period of time there was a huge business in the sale of controlled substances over the Internet, from websites that offered online consultations with a doctor who would prescribe potentially addictive medications to consumers. The government has cracked down on those sites. These days if you find a site selling Schedule II and Schedule III controlled substances to people without a prescription from their own doctor, you are taking a big risk in dealing with the company. Chances are they're located overseas and will keep your money, potentially send you expired or counterfeit medication, or send you something that is intercepted at the border - and such an interception could lead to your getting in to legal trouble. Some will simply pocket your money without sending you anything.
Some states have cracked down on doctors from other states prescribing medication to their residents following a telephone or Internet consultation across state lines, bringing both ethics and criminal charges against doctors who have engaged in those practices. Some doctors have lost their licenses or have gone to prison for the manner in which they've prescribed controlled substances and other medication across state lines.