Evaluation of herbal dietary supplements marketed on the internet for recreational use.
BACKGROUND
The Internet is a popular tool for marketing and purchasing herbal dietary supplements (DS). Various Web sites sell these products purely for recreational use.


OBJECTIVE
To describe the content of Web sites that advertise and market herbal DS for recreational use (ie, for the purpose of altering mood/behavior/or perception, "getting high," or as a substitute for a drug of abuse).


METHODS
Four major search engines and the search terms "buy herbal high" and "buy legal high" were used to identify Web sites selling herbal DS for recreational use. Web sites were evaluated for their country of origin and for compliance with the Dietary Supplement Health and Education Act (DSHEA). Products were evaluated for their ingredient lists, effect claims, comparisons with illicit drugs, adverse effects, drug interactions, and contraindications.


RESULTS
Twenty-eight unique Web sites with 119 products were evaluated. Most sites were in the US (54%) and were in compliance with DSHEA. Forty-seven percent of the products were likened to illicit drugs, typically marijuana (48%) or 3-,4-methylene dioxyamphetamine (Ecstasy; 23%). The most common product ingredients were ephedra alkaloids (27%), Salvia divinorum (17%), kava (10%), guarana (10%), Acorus calamus (10%), and damiana (10%). Effect claims frequently involved the products' use as a hallucinogen (51%) or stimulant (39%). Sixty-four percent of the sites mentioned adverse effects, and 54% mentioned drug interactions.


CONCLUSIONS
This study demonstrates that herbal DS are being marketed for use as legal alternatives to illicit drugs of abuse. Healthcare professionals need to be aware of this trend and the products that are involved.
Dennehy
Cathi E
CE
School of Pharmacy, University of California, San Francisco, CA 94143-0622, USA. dennehyc@pharmacy.ucsf.edu
Tsourounis
Candy
C
Miller
Amy E
AE
D000329:Advertising; D019587:Dietary Supplements / Q000600:supply & distribution*; D004347:Drug Interactions; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects / Q000494:pharmacology / Q000600:supply & distribution*; D020407:Internet; D040541:Marketing / Q000379:methods* / Q000592:standards / Q000639:trends; D010353:Patient Education as Topic; D028321:Plant Preparations / Q000009:adverse effects / Q000494:pharmacology / Q000600:supply & distribution*
D013287:Illicit Drugs; D028321:Plant Preparations