title: The availability of web sites offering to sell opioid medications without prescriptions.
abstract: OBJECTIVE
  This study was designed to determine the availability of web sites offering to sell opioid medications without prescriptions.
  
  
  METHODS
  Forty-seven Internet searches were conducted with a variety of opioid medication terms, including "codeine," "no prescription Vicodin," and "OxyContin." Two independent raters examined the links generated in each search and resolved any coding disagreements. The resulting links were coded as "no prescription web sites" (NPWs) if they offered to sell opioid medications without prescriptions.
  
  
  RESULTS
  In searches with terms such as "no prescription codeine" and "Vicodin," over 50% of the links obtained were coded as "NPWs." The proportion of links yielding NPWs was greater when the phrase "no prescription" was added to the opioid term. More than 300 opioid NPWs were identified and entered into a database.
  
  
  CONCLUSIONS
  Three national drug-use monitoring studies have cited significant increases in prescription opioid use over the past 5 years, particularly among young people. The emergence of NPWs introduces a new vector for unregulated access to opioids. Research is needed to determine the effect of NPWs on prescription opioid use initiation, misuse, and dependence.
authors.affiliation: Medical Affairs Alkermes, Inc., 88 Sidney St., Cambridge, MA 02139, USA. robert.forman@alkermes.com
authors.forename: Robert F
authors.initials: RF
authors.lastname: Forman
authors.forename: George E
authors.initials: GE
authors.lastname: Woody
authors.forename: Thomas
authors.initials: T
authors.lastname: McLellan
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Lynch
mesh_terms: D000082:Acetaminophen / Q000600:supply & distribution; D000701:Analgesics, Opioid / Q000600:supply & distribution*; D003061:Codeine / Q000600:supply & distribution; D003132:Commerce / Q000379:methods*; D019992:Databases as Topic / Q000706:statistics & numerical data; D004338:Drug Combinations; D011307:Drug Prescriptions; D004335:Drug and Narcotic Control / Q000331:legislation & jurisprudence*; D006266:Health Education / Q000706:statistics & numerical data; D006801:Humans; D006853:Hydrocodone / Q000600:supply & distribution; D020407:Internet / Q000458:organization & administration* / Q000706:statistics & numerical data; D016015:Logistic Models; D010098:Oxycodone / Q000600:supply & distribution; D019966:Substance-Related Disorders / Q000517:prevention & control / Q000523:psychology
chemical_list: D000701:Analgesics, Opioid; D004338:Drug Combinations; C083640:acetaminophen, hydrocodone drug combination; D000082:Acetaminophen; D006853:Hydrocodone; D010098:Oxycodone; D003061:Codeine