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I told them, honestly, that I had none. They asked me about other drug activity on campus. They wanted me to give up other dealers to try to help myself. How did you get into this situation?
So, I used alcohol and marijuana as a crutch to escape my unhappiness. It all started when a girl in one of my classes asked to buy an Adderall here or there to help her study for exams. I realized I had an easy source of money right there in my pocket.
It only ramped up after winter break when she left the school. She came to me, and said her boyfriend who went to school about an hour away would like to buy from me. He started to drive out once a month, and my Adderall began to go from the pharmacy to his hands — I was the conveyer.
Copper : Did you feel like you were dealing drugs, or realize the serious risk of what was going on? With Adderall, there is a flippant attitude.
I have an exam. Everyone laughs and jokes about it. It was not a devious plan. It was a slow progression that felt rather innocent, and all of the sudden there are 15 policemen ransacking my room. Could you tell us what happened from there? Joe : After the two detectives interviewed me, and asked questions they would ask a serious drug dealer, reality — and fear — set in.
I was so terrified of what they would say that, when the police finally gave me my one phone call, I hung up after two rings. It was silly because, once they finally got involved, all they wanted to do was help me. The police informed me I was being charged with two felony counts of trafficking amphetamines, which carried mandatory minimums of 1 to 7 years each, meaning, if I was convicted of both my sentence would be a minimum mandatory of 2 to 14 years. I was fully booked, deloused, given a jumpsuit, and put back in holding before I given a second chance to call my parents.
They found a bail bondsman who secured my release, and 12 hours after being taken off campus in a police car, he took me back to my dorm room that had been completely destroyed. In the next couple days and weeks all I had was terror and loneliness. Joe : The boyfriend I was selling to was pulled over after leaving my campus with the Adderall he had bought from me, and a plethora of other illicit substances.
There was no arguing that I was not guilty. I dropped out of school and hired a lawyer. His strategy was to argue that I was a good kid who was caught up in bad circumstances. Three weeks after my arrest, I started the process of conveying this to the judge by enrolling in a wilderness therapy program for drug and alcohol. I spent the next three and a half months in intensive talk therapy and outdoor activities with minimal contact with or support from my family and friends.
After the program, my lawyer recommended I go to a sober house for seven months. There, I was drug tested three times a week, breathalyzed on demand, and subjected to very strict house rules including therapy and AA meeting requirements.
His first deal took place in Gelman Library out in the open at a table, where his friend sat bleary-eyed over her work. The junior empathized with her and handed over a single Adderall pill, hoping to help her out.
Later in the semester, she approached him again for Adderall with that same exhausted stare. This time he debated selling to her, but again acted as a guardian angel providing the focus-enhancing drug free of charge. He said he felt uncomfortable dealing but continued to sell to this one student about five times over the spring semester of his sophomore year, going to different spots on campus to accommodate her. Experts said the unprescribed use of drugs like Adderall is a dangerous practice because it can give false confidence and result in negative health effects, like increased heart rate, headache or loss of appetite.
He continued selling into college to cover the cost of student loans, knowing he wanted to get rid of the debt before graduation. Adderall made up for a small percentage of his profits, but he said he could make more money selling other drugs.
Although he has ceased dealing drugs completely after three years of selling, the senior often kept dealer-client relationships at a business level, meeting people outside his off-campus apartment rather than inviting them upstairs. He also said he marked up prices if he knew the students were wealthy or in a fraternity.
But he said the demanding standards of success at GW are what drove students to seek out his services. This article appeared in the January 22, issue of the Hatchet. The safety characteristics of all online pharmacies selling Adderall are described in Table 1. Overall, the locations listed on rogue and unclassified online pharmacy websites were not consistent with the locations of their servers as determined by www.
Server locations and the respective website-listed locations of online pharmacies in our sample are depicted in Figure 3. Rogue online pharmacy server locations seldom matched those claimed on the website. The marketing characteristics of all online pharmacies selling Adderall are described in Table 2. Marketing characteristics stratified by rogue, unclassified, and legitimate pharmacies.
For rogue and unclassified online pharmacies, the cost per tablet of 30 mg Adderall IR and cost per capsule of 30 mg Adderall XR at quantities of 60, 90, , , and tablets or capsules are displayed in Figure 4. The single legitimate website www. Drug warnings and precautions, drug information, and the price for Adderall could not be observed on this site because consumers were unable to advance without a member identification and prescription.
The marketing characteristics of the legitimate website did not place an emphasis on price there were no listed price or bulk discounts but did promote accessibility with a phone number listed and an offer to speak with an associate.
We found that most online pharmacies selling Adderall were rogue or unclassified by LegitScript. Of 62 online pharmacies claiming to sell Adderall, only 1 was a legitimate seller. By not requiring a prescription, rogue pharmacies allow the purchase of medications that could be abused, enabling the ill-advised practice of Adderall use without concurrent therapeutic monitoring. With high doses and repeated use of Adderall, the development of psychological amphetamine dependence and adverse events such as weight loss, psychosis, seizures, and cardiovascular events can occur.
Those with a valid prescription might receive poor quality medication and be harmed by impurities, fail to achieve therapeutic goals, and suffer from a lack of therapeutic monitoring. Those without a valid prescription, who might be more inclined to abuse Adderall and take more than the necessary dose, are predisposed to the same known risks as those with a prescription, in addition to the potential for an increased frequency of dose-dependent adverse effects.
Concerns related to the purchase of Adderall from rogue online pharmacies are amplified by the marketing characteristics that these pharmacies employ. As evinced in these pharmacies not placing quantity limits on the amount of Adderall for purchase, rogue online pharmacies intend to sell as much of these products as possible. The sale of Adderall is achieved through varied sales arguments—the appeal to cost-savings, constant customer support, and privacy—that are perhaps the most important for consumers who intend to purchase controlled substances without a prescription.
Rogue online pharmacies appeal to discrete package delivery, protection of patient information, and the use of de-identified forms of payments involving cryptocurrency.
These sales arguments, which are designed to lure consumers into purchasing more medications, run counter to reasonable patient care and sensible legislation that aims to protect the public from drugs with abuse and misuse potential. Previous studies comparing prescription drug prices between online and brick-and-mortar pharmacies have had mixed results depending primarily on the drug studied, with several finding lower costs online.
Compared with prices listed on GoodRx, a popular coupon site for patients purchasing medications without insurance, rogue online pharmacy prices, including shipping costs for Adderall IR and Adderall XR, were nearly 5-fold more expensive per unit.
The steep price differential is suggestive of the illegal nature of Adderall purchase without a prescription online. Simply from a cost standpoint, patients with a valid prescription have little incentive to purchase Adderall from a rogue online pharmacy. This result supports existing literature that among online pharmacies there is a price markup for the purchase of medications without a prescription.
Our research showed, however, that rogue online pharmacies often inauthentically claimed registration. Rogue online pharmacies are creative in their methods to bolster reputability. Although there have been numerous efforts to control the groundswell of rogue online pharmacies, our results suggest that these efforts have not been altogether successful. Operation Pangea, a cooperative effort led by Interpol in conjunction with FDA and DOJ, has led to the removal of thousands of illegitimate online pharmacies.
LegitScript reported helping to close 6, rogue pharmacies in alone. However, illegitimate online pharmacies are challenging to control because they regularly re-emerge. Although the overall Web traffic to rogue online pharmacies in our results was relatively low Figure 2 , this could be suggestive of the methods that rogue online pharmacies use to avoid detection, regularly closing and opening new websites under unique URLs.
These results demonstrate that search engines are not effectively screening for, and removing, rogue online pharmacies from their search results at present. In the absence of efficient methods to regulate and remove rogue online pharmacies, it is imperative that search engines acknowledge the pervasiveness of rogue online pharmacies within their search results and take additional measures of control.
Search engines should help lead the effort to create a safer online pharmacy landscape through the generation of search algorithms that select for legitimate online pharmacies. There were several limitations to our study. We limited our screening to websites owing to feasibility. Given this limitation, numerous online pharmacies remained undetected.
This limited screening yielded only 1 legitimate pharmacy, precluding an in-depth analysis comparing the characteristics of rogue pharmacies with those of legitimate pharmacies. However, we believe that our methodology accurately replicates the behavior of a typical U. Although we were able to assess how many unique visits each online pharmacy received from www.
We did not attempt to purchase Adderall from any of the included online pharmacies. It is therefore unclear whether an order placed with an online pharmacy included in this sample would have resulted in the delivery of Adderall. Without purchasing the product, we also could not test the quality of the medication. However, we believe that the purchase of prescription drugs from rogue online pharmacies is in itself ethically tenuous. Although we believe that our results are generally applicable to the online pharmacy landscape, given the transient nature of online pharmacies, our results—in terms of particular sites analyzed—are a slice in time, analyzing the sites listed on 4 search engines in the United States from December to February Our study also failed to capture the prevalence of Adderall advertising on social media platforms, which is an emerging market for the advertising and person-to-person sale of controlled substances.
Finally, data collection for our study was conducted before the novel coronavirus disease COVID pandemic, which saw an increase in rogue online pharmacies peddling no-prescription medications, particularly for treatment of COVID Adderall, a controlled substance with high potential for abuse, is readily accessible online without a prescription.
While doing little to ensure patient safety, rogue online pharmacies treat patients as consumers with aggressive marketing tactics. In addition to concerted law enforcement and regulatory efforts to remove these websites, common search engines should make efforts to better select for legitimate online pharmacies, deterring the illegal purchase of Adderall and improving the safety of consumers in the online pharmacy marketplace.
In the meantime, organizations should continue to offer and support efforts to warn consumers of the dangers of illegitimate online pharmacies.
Stephen F. Disclosure: The authors declare no relevant conflicts of interest or financial relationships. National Center for Biotechnology Information , U. J Am Pharm Assoc Published online Sep 7. Author information Article notes Copyright and License information Disclaimer. Received Apr 15; Accepted Jul Published by Elsevier Inc. All rights reserved. Elsevier hereby grants permission to make all its COVIDrelated research that is available on the COVID resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source.
Abstract Objectives Adderall amphetamine-dextroamphetamine is a controlled substance with harmful adverse effects if abused or misused. Design Cross-sectional study. Outcome measures Online pharmacies were categorized as rogue, unclassified, or legitimate on the basis of LegitScript classifications. Results Of the 62 online pharmacies found to sell Adderall, 61 were rogue or unclassified. Conclusion Rogue online pharmacies are pervasive in search engine results, enabling the illicit purchase of Adderall without a prescription.
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