Online drug sellers making opioid epidemic worse

The National Association of Boards of Pharmacy’s (NABP) Internet Drug Outlet Identification Program Progress for State and Federal Regulators provides an update on the internet drug buying landscape and how the online sale of counterfeit medications is exacerbating the opioid epidemic in the United States.

In a recent study, NABP evaluated 100 websites selling medications to patients in the US, and all of them were found to be operating illegally.  The study found:

  • 54% of the sites were selling controlled substances (CS).  This is a substantial jump from the 13% of all sites NABP has reviewed and listed as “Not Recommended” in the past nine years that were selling CS.
  • 98% of the sites do not require a valid prescription.
  • 76% of the sites offered foreign or non-Food and Drug Administration-approved drugs.
  • 40% of the sites were selling CS, including opioids frequently linked to fentanyl-related overdoses.  The most common CS being offered with no prescription was Xanax, a drug who counterfeit could contain fentanyl.

More than 63,600 Americans died from drug overdoses in 2016, according to the Centers for Disease Control and Prevention.  Sixty-six percent of those deaths were caused by opioids, including fentanyl, a drug that is 50 times stronger than heroin and more potent than morphine.

Opioid painkillers have been linked to the largest number of overdose deaths compared to all other illicit drug classes each year since 2001.  These numbers help illustrate the gravity of the opioid problem in America, a situation made worse by the availability of these drugs illegally online.  Restricting illegal online drug sellers from appearing in search results would limit public exposure to counterfeit and potentially dangerous medication, a solution that NABP supports.

Consumers who buy medicines from NABP-verified websites can be confident they are buying medicine from trustworthy, legitimate pharmacies.  An easy way to know that a website has been verified by NABP is to look for the pharmacy domain at the end of the web address.  A list of safe online pharmacies and related resources can be found on the Buying Safely page of

Read the full report and learn more about online counterfeit drug sales and their impact on the opioid epidemic in America by visiting the Program and Committee Reports page in the Publication and Reports section of

NABP is the independent international and impartial Association that assists its state member board and jurisdictions for the purpose of protecting the public health.