
Amazon’s Illegal Drugs: Steroids, Muscle Relaxants, Prescription Antibiotics - tehrania
http://www.slate.com/articles/health_and_science/medical_examiner/2014/05/amazon_illegal_drugs_muscle_relaxants_steroids_prescription_drugs_delivered.html
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epochwolf
Nothing surprising in this. People are using an automated online marketplace
to sell illegal goods. Online marketplace takes down products when they are
reported.

It's a game of whack-a-mole and Amazon is doing the bare minimum. The company
has no incentive to do otherwise.

~~~
y4mi
until someone dies because of a drug sold through their website and the
surviving family members feed the media a horror story with which they can
create the black sheep, amazon, which profits from the deaths of its customers

~~~
bronson
If people don't care about all the doctors currently overprescribing oxy,
xanax, etc, seems like they shouldn't care too much about this.

~~~
codezero
Most of those people are still under a doctor's care, so while they may not
need the medication that much and may pay the price later, there is at least
some accounting/supervision going on. When/if someone dies in a case of
overprescription, there is clearly someone to be held accountable. A possibly
overly sensational case of this is Michael Jackson's doctor who was found
guilty of manslaughter.

When you self prescribe foreign prescription medication, and die/suffer some
massive side effect, there's no real recourse.

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KerrickStaley
I got some topical clindamycin over-the-counter when I was in Thailand, and it
worked better than any other acne drug I had tried. I couldn't find it in any
pharmacies after returning to the US, however. I emailed the FDA about it, and
they responded:

Clindamycin is an antibiotic, whereas benzoyl peroxide is not. Necessary
characteristics for OTC drugs include an acceptable safety margin, low misuse
and abuse potential, and adequate labeling. In addition, consumers must be
able to self-diagnose, self-select the medication [self-selection is the
decision a consumer makes to use or not to use a drug product based on reading
the information on the drug product label and applying knowledge of his or her
personal medical history], self-treat and self-manage the condition for which
the OTC drug is intended, and additionally, a health care practitioner is not
needed for the safe and effective use of the product. An OTC drug is
considered to be safe and effective for use by the general public without a
prescriber's authorization. At this point in time, FDA believes that
clindamycin does not qualify as an OTC drug.

I'm slightly disappointed at this decision.

~~~
jarrett
There are legitimate concerns with unrestricted access to antibiotics. If you
misuse them, you're possibly not just hurting yourself. You might be hurting
everyone, because you might be breeding resistance bacteria.

~~~
mullingitover
And thank goodness for that. Can you imagine if farmers could just buy
antibiotics by the truckload and feed them to healthy livestock as a growth
enhancer?

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userbinator
Note that "illegal" is always relative - there are many drugs that are
prescription-only in some countries but available freely in others, illegal in
some and not in others, etc.

~~~
CanSpice
So? What does that have to do with anything? It's illegal in the United States
to import these drugs into the United States. Amazon is based in the United
States. What does it matter if they're legal or not in any other country? This
story is all about importing these drugs into the United States.

~~~
ars
> What does it matter if they're legal or not in any other country?

From a legal point of view? None. From a moral? Not so simple. A lot of drugs
are prescription only in the US for really no reason whatsoever.

Two examples are Nystatin and Mebendazole.

I even emailed the FDA about Nystatin and they said that to become OTC it
would need a sponsor, which is a stupid reason to leave them prescription
only.

~~~
refurb
For a drug to make the switch from Rx to OTC, you need to prove a lot of
things. Can consumers understand how to correctly diagnosis the disease it
treats? Can consumers correctly dose themselves? Will consumers knows when to
stop treatment and seek professional help.

You have to remember that not everyone follows directions or uses medications
correctly. I don't blame the FDA for not making a drug OTC unless they can
prove it will be used safely.

~~~
ars
Both those drugs are very easy to use.

For Nystatin: Does your baby have a rash that looks like raised red dots?

For Mebendazole: Did you drink or come in contact with potentially infected
water?

There are plenty of OTC drugs with far more complicated symptoms. It's really
completely arbitrary - or more accurately, it's driven by companies wanting to
expand their market into OTC (as soon as it goes off patent) rather than
anything actually medical.

Take Nexium for example: It was prescription only (and very expensive) till
the patent ended. The day the patent expired it turned OTC.

~~~
aestra
The thing about those two drugs is there are already OTC drugs that treat the
same thing.

~~~
ars
And surprisingly those OTCs have worse side effects!

How does that make any sense?

And what would you use instead of nystatin - a broad spectrum antifungal?

Mebendazole is OTC in almost all countries except the US - it's even given
routinely without evidence of infection.

~~~
aestra
athletes foot cream (which depending on the type there are 2-3 drugs to choose
from. clotrimazole, tioconazole, Miconazole... When my husband had jock itch
they just told him to use OTC athletes foot cream on it.

~~~
ars
Nystatin is used for babies diaper rash, not athletes foot. It's a different
organism - the stuff for athletes foot doesn't work as well.

There's also terbinafine which works better than the 3 you listead (but more
expensive).

~~~
aestra
Diaper rash is not alway a fungal infection (and could potentially be a
bacteria infection in addition to/instead of a fungal infection). It is
usually a contact dermatitis and a fungal infection is only a secondary
infection.

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nhangen
I have zero problem with this.

The day doctors sold out and started accepting bribes from pharma reps is the
day that I stopped trusting them, and I certainly don't care what they think
as it relates to steroids, pain killers, and antibiotics.

These are drug dealers complaining that they are being circumvented. Boo hoo.

~~~
pavel_lishin
I have quite a bit of a problem with people ordering antibiotics, and breeding
antibiotic-resistant bacterial strains both inside their bodies, and in our
sewers once they feel better and flush the rest of the pills.

~~~
crazy1van
So instead they should go to the their local doctor, pay their $15 co-pay and
then take their antibiotics.

Come on, we all know that if you have insurance and see your doctor with the
sniffles, you can leave with a antibiotic prescription if you want.

I'm not defending the illegal online drug markets, but the problem of
resistant germs is a much bigger problem and it has nothing to do with Amazon
resellers.

~~~
criley2
I dislike your casual dismissal of medical expertise, it smacks of ignorance.

No offense, but "i don't trust doctors for arbitrary subjective reason X" is,
to me, the exact kind of garbage I hear from non-scientific "global warming
skeptics".

They find some arbitrary, subjective reason to validate their distrust of
experts in a field they are a laymen in.

I don't see how you're not doing the same thing. Vilify an industry, smear
doctors because of your subjective vilification, and then apparently come
online and promote your false "skepticism" rooted wholly in what sounds like a
laypersons understanding of their work and industry.

~~~
crazy1van
I humbly ask that you please reread my comment. I didn't say anything about
not trusting doctors. Nor did I say anything about vilifying them. I certainly
didn't mean to be offensive. In fact, I am very much aware that there's a real
chance at some point in my life I will be in a situation where a doctor will
save my life.

I said if you have insurance, you can easily walk into most doctors' office
with the sniffles (my poor choice of words for an illness with symptoms, but
most likely not needing antibiotics) and walk out with a script for an
antibiotic. Perhaps my sample set is very abnormal, but I see this constantly
among my friends and colleagues. When they get a cold, they go to the doctor
after a few days and leave with a prescription. When I've asked folks about
it, it seems mostly out of habit. You feel bad, you go to the doctor. I find
it odd, because if I ever get really sick and need antibiotics to keep me
alive, I want them to be maximally effective.

~~~
pavel_lishin
> _I didn 't say anything about not trusting doctors. _

Yes you did:

> _The day doctors sold out and started accepting bribes from pharma reps is
> the day that I stopped trusting them_

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mindcrime
I have no problem with this either. I don't believe it's a proper role for
government to regulate what substances people can buy and ingest. I would
happily shut down the FDA altogether. If you're stupid enough to buy and
ingest something poisonous, well... so be it.

Note that none of this is mean to say that sellers should not be held liable
for _fraud_ if they ship something other than what they claim to be shipping.
But that's a separate issue.

~~~
peteretep

        > I don't believe it's a proper role for government to
        > regulate what substances people can buy and ingest
    

Your free-thinkin' Wild-West Libertarian views directly impinge on my right to
use antibiotics that work.

~~~
neurobro
Just don't neglect people's right to store some antibiotics in their
preparedness kit without wasting a doctor's scarce time and engaging in
medical fraud.

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atdrummond
Many of the steroids for sale on amazon are not explicitly illegal, as they
are designed specifically to circumvent the current controlled substances
list. This is why so many suppliers rushed to liquidate the supplement known
as "Superdrol" when the active designer steroid was added to the federal
controlled drug registry.

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justizin
is it bad that i was hoping this was a link to amazon?

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mindslight
If we are to respect the law for legitimate public health reasons like
antibiotic resistance, then its administrators shouldn't _rot it from the top_
for misguided moral, economic, and bureaucratic reasons.

Until eminently self-prescribable things like Adderall and cocaine are
retailed at the corner store, I'll cheer on _any_ "illicit" package that gets
through CBP.

