AMARILLO, Texas (KAMR/KCIT) — Almost one-half of the U.S. population take a prescription medication, and studies have shown prescription drugs purchased online are becoming an increased danger due to its counterfeit nature.

According to Texas Tech University Health Science Center (TTUHSC), in 2018 there were 5.8 billion prescriptions filled nationwide, with prescription drugs purchased online or from social media expected to increase from 2020 through 2026, eventually producing around $146 billion in revenues for online pharmacies.

The question remains, are online drugs a safe, less expensive option to those purchased from a local pharmacy? According to pharmacist and toxicology expert Charles Seifert, Pharm.D., from TTUHSC, “maybe, maybe not.”

“If you’re not ordering from a legitimate pharmacy in the United States, you can get anything you want online,” Seifert said. “You can order from China and the U.S. Postal Service will deliver it right to your front door, but you never know what’s in that product, per se. That’s where these counterfeit drugs are coming in [from]. People order certain things online thinking they’re safe, but the look-alikes are so similar that you can’t tell the difference.”

Seifert added that safety is the main priority and therefore individuals must verify that the pharmacy and pharmacist is licensed.

“In Texas, you can verify those licenses at the Texas State Board of Pharmacy to make sure you’re not walking in off the street into something that’s not a pharmacy,” Seifert said. “Even those online pharmacies that are in the United States and are registered with the State Board of Pharmacy are on that website. However, international pharmacies such as Canadian and Mexican pharmacies are not registered in the state of Texas.”

Online pharmacies in countries like Canada and Mexico have similar laws to the U.S., which requires pharmacies to be registered with the government and are subject to same laws, regulations and standards. However, Seifert explained, that medications sold by online pharmacies in Canada may have been manufactured somewhere else and counterfeit purchasing is still possible.

In Mexico, the laws are more eased, which increases the danger of purchasing prescription drugs online. According to TTUHSC, drug names in Mexico may be different from those in the U.S. For example, Zithromax, a common antibiotic, is sold under as many as 14 different names in Mexico.

“In Mexico, the pharmacies are really not registered with the government at all, so there’s no way to double check the Mexican pharmacies,” Seifert pointed out. “You essentially can walk in off the street and get anything you want in the Mexican pharmacy without a prescription. And a lot of those products are good, but it’s very hard to verify those. There’s also increased potential for name confusion in a Mexican farmacia.”

According to TTUHSC, verification is increasingly important in Mexico because drug cartels are part of the counterfeit drug business.

Seifert added, the U.S. Drug Enforcement Agency (DEA) sent out a bulletin for its “One Pill Can Kill” campaign in its “fight against mass-produced counterfeit pills that are falsely advertised to the American public as being legitimate.”

“What the DEA is talking about is a lot of the prescription painkillers, like oxycodone, for example,” Seifert explained. “Usually it’s the drug cartels in Mexico that are creating exactly the same look-alike tablet, but it has other substances in it. And the big one is a very dangerous opioid called fentanyl.”

Seifert explained that Fentanyl is used for different reasons and can become extremely dangerous if the wrong dose is administered.

In addition, drug doses may vary if purchased online. For example, a 10-miligram dose of morphine is basically the same to a 100-microgram dose of fentanyl, yet many of these counterfeit painkillers contain as much as two milligrams of fentanyl, according to Seifert.

“That’s 2,000 micrograms, and it’s very deadly and dangerous,” Seifert warned. “And it’s not only fentanyl, but other things like crystal meth, or methamphetamine are also in some of these counterfeit products. So you may think you know what you’re getting, but you don’t.”

Seifert further explained that drug manufacturers use a National Drug Code (NDC) so the FDA can identify the drugs. Each NDC has three-segment numbers, which the FDA publishes the updated numbers in its daily NDC directory, including the manufacturer, lot number, and expiration date. Seifert said that this is standard practice to make sure the drugs purchased are safe to consume.

“Most of the pharmacies in the U.S. go through a wholesaler, and there are two or three really good wholesalers in the country that most pharmacies use,” Seifert said. “That wholesaler actually contracts with the drug manufacturer for large quantities of drugs, and they have internal processes to maintain what I would call almost a chain of command or a chain of evidence as to where the drug was manufactured so they can trace it back.”

“If someone suspects that they have received one of these counterfeit pills that the DEA is talking about, they should probably take that to their local law enforcement,” he suggested.

Seifert said that the FDA website lists all registered online U.S. pharmacies and provides tips on spotting false online pharmacies, many located outside the U.S.

“If the pharmacy, online or not, is selling prescription drugs then it has to have a prescription from a legitimate practitioner in the United States,” Seifert said. “If they don’t require a prescription, that should be a big red flag that something’s wrong.”

“If you have older people who may be in the house, their eyesight may not be as good or their thinking may not be as clear, so try to have somebody else review their medications with them and maybe help organize their medications,” Seifert recommended. “If there is something that’s changed with your medication’s appearance, make sure you call the pharmacy and find out because pharmacies make mistakes, too. If you just blindly take drugs, it can have serious consequences.”

Click here to view the FDA website and learn more about safely purchasing prescription drugs online.