Those Online Pharmacies!

There is a myth that the United States is always somehow better. It is a variation on the old "streets paved with gold" lure to encourage people to live and work there. The natural corollary is that what happens in other countries is always suspect. As it affects online pharmacies, the myth is usually spread by the US pharmaceutical companies in their fight for price controls. It supplements the covert refusal to supply some overseas wholesalers on the ground that they export to the US.

The usual argument as frequently applied to Canadian online pharmacies is as follows:

• almost all online pharmacies are based outside the US;

• all the normal regulatory safeguards that protect Americans are missing — you cannot be sure you are getting the right drugs, none of the prescriptions are written by doctors who meet the patients, etc.;

• so all online pharmacies are a "bad thing".

It is against this background that I noticed a story from Pittsburgh. On Monday, a physician pleaded guilty for conspiring with a US-based online pharmacy to prescribe Xanax and other medications for no legitimate medical reason. He had simply written out 28,000 prescriptions, which would supply more than a million doses of Xanax. The man frankly admitted that to selling any medication regardless of medical need to any online customer.

So we do have evidence of something done well in the United States. There is a regime of supervision and regulation for online pharmacies based in the US and it does seem to work. Or at least, with the prodding and support of the pharmaceutical companies, more effort is made to enforce the regulation of online pharmacies.

I suspect it is like the Recording Industry Association of America (RIAA) that has made itself so popular by pursuing the downloaders of music. Except that this is not just about the profits of the local manufacturers. There is a legitimate reason for controlling the supply of a medication like Xanax. Xanax can be habit-forming. As one of the benzodiazepines, it is highly effective over short periods of time to relieve the symptoms of anxiety and panic disorders. We could rehearse the debate over whether to use "addiction" and "dependence" but that would get us nowhere. Whatever words you use, it is undeniable that if you take Xanax for too long or at too high a dose, you will experience withdrawal symptoms if you stop suddenly.

Thus, as with all the benzodiazepine group, there are advantages and disadvantages to taking Xanax. In an ideal world, you would discuss these issues with your regular doctor who would write out a prescription. That would be the best way for the first prescription. But for all the repeat prescriptions you need (and it does not matter whether it is medically necessary for you to continue taking Xanax or you have become dependent), the question of price cannot be ignored. When you have had all the advice you need and the internet will supply you with genuine Xanax at a heavily discounted price, what possible reason is there for continuing to support the profits of the US manufacturer? This is, after all, how market economies are supposed to work. Competition benefits the consumer because it drives down the price.

Do the foreign online pharmacies face similar regulations? Yes. Every country regulates the supply of potentially dangerous medications. So the next time you need to fill a prescription for Xanax or any other medication you need to keep you healthy (or at least prevent you from becoming more ill) pick a reputable pharmacy. If it sells genuine Xanax at a discounted price, act rationally in a capitalist system and buy your Xanax online. Making sure, of course, that your state has not placed controls on drug imports. Some US states protect local manufacturers by outlawing all interstate movements of medications and will seize your package as it enters the borders.