Cicero Theodore J, Shores Christopher Neil, Paradis Alethea G, Ellis Matthew S
Departmentof Psychiatry, Washington University School of Medicine, St Louis, Missouri 63110, USA.
Pain Med. 2008 Sep;9(6):718-23. doi: 10.1111/j.1526-4637.2007.00323.x.
There has been a sharp increase in the abuse of prescription opioid analgesics in the United States in the past decade. It has been asserted, particularly by several governmental and regulatory agencies, that the Internet has become a significant source of these drugs which may account to a great extent for the surge in abuse. We have studied whether this is correct.
We asked 1,116 prescription drug abusers admitted for treatment, through standardized questionnaires, where they obtained their drugs. We also attempted to purchase scheduled II and III drugs from a random sample of Internet sites offering such sales.
Dealers, friends or relatives, and doctors' prescriptions were listed as a source of drugs with equal frequency ( approximately 50-65%), with theft and forgery far behind at 20%. The Internet was mentioned by fewer than 6% of the total responders. Because these data suggest either lack of availability or that our sample has not yet realized that the Internet is a potential source, we attempted to purchase scheduled II and III opioids and the unscheduled opioid, tramadol, from a random sample of 10% of the sites listing such sales. We were unsuccessful in purchasing a single scheduled opioid analgesic, but found that tramadol, as an unscheduled drug, was freely available.
The assertion that the Internet has become a dangerous new avenue for the diversion of scheduled prescription opioid analgesics appears to be based on no empirical evidence and is largely incorrect.
在过去十年中，美国处方类阿片类镇痛药的滥用现象急剧增加。一些政府和监管机构特别指出，互联网已成为这些药物的一个重要来源，这在很大程度上可能是滥用现象激增的原因。我们研究了这种说法是否正确。
我们通过标准化问卷，询问了1116名因滥用处方药而入院治疗的患者他们获取药物的来源。我们还试图从随机抽取的提供此类销售的互联网网站样本中购买附表II和III类药物。
经销商、朋友或亲戚以及医生处方被列为药物来源的频率相同（约50%-65%），盗窃和伪造远远落后，占20%。在所有回复者中，提及互联网的不到6%。由于这些数据表明要么无法获取，要么我们的样本尚未意识到互联网是一个潜在来源，我们试图从列出此类销售的网站中随机抽取10%的样本购买附表II和III类阿片类药物以及非附表类阿片类药物曲马多。我们未能成功购买到一种附表类阿片类镇痛药，但发现曲马多作为一种非附表类药物可以自由获取。
关于互联网已成为附表类处方阿片类镇痛药非法流通的危险新途径这一说法似乎没有实证依据，且在很大程度上是不正确的。
