Go E-Mail the Doctor

Online Pharmacies Offer Relief to the Uninsured, Vulnerable, and Desperate

Ops also do a large trade in benzodiazepine tranquilizers such as Xanax, Ativan, Klonopin, and Valium, which can be difficult to obtain from a physician on a regular basis—2 mg "sticks" or diskettes of Xanax meet with special hostility from doctors. Other items for sale include muscle relaxants like Soma and Flexeril, potency or hair-loss remedies for the easily embarrassed, and antidepressants like Prozac and related SSRI medications. Pressed on doctors by drug salesmen who emphasize that they're not controlled substances, they are now shoved down patients' throats as a cure-all for anything from low-grade depression to post-traumatic stress.

Ops can function out of office suites or people's bedrooms. Two very visible and overpriced Florida ops, buymeds.com and tropicalrx.com, shared the same e-mailing list for potential customers. But customers got sick of Pharmanet, the garage pharmacy used by Buymeds. One never knew if the medicines had been sitting in the Miami sun, were old to begin with, or were exposed to heat in transit. With any op there are the usual e-commerce hassles—nondelivery, shorted quantities, credit card overbillings—but many of these seem to be solved quickly as with any other business.

Two of the better ops, norcoworldwide.com and aaamedsworldwide.com, are located near each other in north-central Florida. After an online form listing physical complaints is filled out, a phone consultation is scheduled via e-mail. This basically consists of a few questions, not as coldly put as might appear. "What are you taking now? We offer those in 30, 60, and 90 quantity per month, which would you like? Do you know they're addictive? You're not getting them from anyone else, are you?" Click. The consultation costs $120, but medications are reasonably priced: at Norco, 90 tablets of Lortab 10 and Xanax 2 mg are $82 and $77, respectively. With the consultation good for two refills, prescription prices, apart from the overnight shipping ($28), are only slightly steeper than at many chain drugstores.

illustration: Insu Lee

International ops (IOPs) present something of a legal risk, especially on quantities of three months or over, which the DEA can construe as enough for resale. Individuals who have ordered from IOPs have received what's known as a "love letter" from the DEA reporting that a package has been seized. If the recipient ignores it, likely nothing will happen. But challenge of the seizure notice sets the stage for legal repercussions from the DEA, and nobody wants that. Some IOPs are quite respectable and deliver slowly but surely, for instance www.pharma24.cc, located in Gibraltar. Under cold and cough remedies, Gibraltar features Perduretas Codeina retard 50 mg, which provides instant pain release when bitten into and chewed. Gibraltar also features one of Europe's most popular pain relievers, Contugesic 60, a time-released codeine derivative, dihydrocodeine. Invented around 1900 for upper respiratory infections and neuralgia, dihydrocodeine is described as a speedier version of codeine, and can offer up to 10 hours of pain relief.

The most offbeat of the IOPs is a secretive individual in the United Kingdom known as the Bioman, who makes no pretense of being a doctor or pharmacist. He goes so far as to offer free samples of Peduretas Codeina, Spanish Ambien, Contugesic 60, Aldonto (Spanish time-release tramadol), and an array of antidepressants, actually fronting samples before payment. Then he sends 20 tablets, all in the original blister packs in a discreet envelope. If you like the 20, you send $20 cash and he'll send 40 more pills. He'll continue doing it in quantities of 60 for three months at a time. The Bioman knowingly never sends enough pills to be construed as for resale.

Surprisingly, there is less overprescribing with ops than with unscrupulous Dr. Feelgoods who give patients enormous prescriptions before either cutting them off abruptly or passing them on to the rehabs they collude with. The limit on ops is usually 90 tablets, and if you use an op that shares the same mail-order pharmacy as your last op before the 25-day legal limit, your order will be bounced. In addition, it becomes cost-prohibitive to go to too many ops. Since ops are cheaper, safer, and easier to use than street-corner dealers, they avoid all Medicaid fraud or drug dealing criminality, and provide a legitimate prescription bottle if a drug test becomes necessary. It's less than a shock to learn that many of the same doctors' names turn up on bottles for different ops; some of the more courteous and obliging have earned word-of-mouth fame. The ops have put a great many street dealers out of business. In the long run, you're paying $1.25 to $2.50 for a pill a dealer would price at $5 to $6, without risk of arrest, burn, or no-show.

It's a free country, and that extends to choosing what medical technique is best for you, be it holistic, acupuncture, or pharmaceutical. The ops are performing a necessary service. Perhaps they're the first step toward the British system, in which many typical minor narcotic remedies are available over the counter and heroin is a legal drug for those who decide to live out their lives on it. Ops have gotten health care for the uninsured. They've cut into the business of the kind of callous doctor who'll tell someone to take Advil for a broken rib. They've even reduced street-corner drug dealing. Whatever the shady accusations, the bottom line is that ops have assuaged people's nerves and eased their pain in a war-torn, depressed America.

Names have been changed to protect anonymity.

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