title: Impact of Internet pharmacy regulation on opioid analgesic availability.
abstract: OBJECTIVE
  Access to prescription opioid analgesics has made Internet pharmacies the object of increased regulatory scrutiny, but the effectiveness of regulatory changes in curtailing availability of opioid analgesics from online sources has been not assessed. As part of an ongoing investigation into the relationship between the Internet and substance abuse, we examined the availability of prescription opioid analgesics from online pharmacies.
  
  
  METHODS
  From a pharmacy watch Web site, we constructed a data set of postings entered every 3 months beginning November 1, 2005, that were related to the purchase of prescription opioid analgesics. Trained examiners assessed whether the final post described accessibility of pain medications that was increasing or decreasing.
  
  
  RESULTS
  We identified 45 threads related to the availability of opioid analgesics from Internet pharmacies. Of the 41 (91%) threads describing the declining availability of opioid analgesic agents from Internet pharmacies, 34 (82%) received posts on November 1, 2007. Despite the subjective nature of the research question, there was high interobserver agreement between coders (kappa= .845) that availability of opioid analgesics from online pharmacies had decreased. This finding was supported by a dramatic rise in the number of pageviews (an accepted measure of Web site visitor interest in a page's content) of Web pages describing decreased availability of opioid analgesics.
  
  
  CONCLUSIONS
  These data suggest striking decreases in the availability of prescription opioid analgesic pharmaceuticals. This self-reported change in drug availability may be related to increased regulation of and law enforcement operations directed against Internet pharmacies.
authors.affiliation: Division of Medical Toxicology, Department of Emergency Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, Massachusetts 01655, USA. edward.boyer@childrens.harvard.edu
authors.forename: Edward W
authors.initials: EW
authors.lastname: Boyer
authors.forename: James D
authors.initials: JD
authors.lastname: Wines
mesh_terms: D000701:Analgesics, Opioid / Q000600:supply & distribution*; D003132:Commerce / Q000331:legislation & jurisprudence / Q000639:trends; D004335:Drug and Narcotic Control / Q000379:methods*; D006801:Humans; D020407:Internet / Q000331:legislation & jurisprudence*; D009293:Opioid-Related Disorders / Q000517:prevention & control; D010593:Pharmaceutical Services / Q000331:legislation & jurisprudence* / Q000600:supply & distribution
chemical_list: D000701:Analgesics, Opioid
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