Study shows unwanted e-mail puts meds only a few clicks away

University of Toronto researcherssaythey were able to purchase products through junk e-mails forwhat looked like brand-name erectile dysfunction medications, anti-anxiety drugs and obesity supplements with relative ease — though what exactly is in the bubble packs is still being tested.

'You have no way of knowing where these companies are located, where they get their drugs, what is in their drugs, or how to reach them if there is a problem.' —Health Canada

But Dr. Alejandro Jadad, a professor of medicine at the University of Toronto and founder of the Centre for Global eHealth Innovation at Toronto's University Health Network, warned the business is a shady one. An address used to purchase medication one week can be a dead end the next, leaving buyers with no recourse if the drugs turn out to be bogus or past their expiry date.

"These could be fake. These could be real. These could be adulterated. We don't know," Jadad said of the products he and fellow researcher Peter Gernburd managed to purchase. "So 'User beware' big time here."

The researchers are in the process of having the products analyzed by a laboratory. Health Canada would not offer comment Monday on Jadad's study, which was published Tuesday in the journal Public Library of Science Medicine.

Instead, a spokesman pointed to cautions posted on the department's website, statements warning that people put their health at serious risk when they buy drugs online.

"You have no way of knowing where these companies are located, where they get their drugs, what is in their drugs, or how to reach them if there is a problem," the department says in a fact sheet posted on its website.

"If you order from these sites, you may get counterfeit drugs with no active ingredients, drugs with the wrong ingredients, drugs with dangerous additives, or drugs past their expiry date. Even if these drugs do not harm you directly or immediately, your condition may get worse without effective treatment."

Spam sent from U.S., China, Congo

Jadad, who describes himself as a public advocate,was inspired to explore the business of spam-generated drug sales because of the volume of the unwanted e-mail he was getting.

A check of the medical literature produced little on the subject. So he and Gernburd set up three e-mail accounts and monitored the number and types of spam messages they received.

In one month — November 2006 — the accounts received 4,153 messages what qualified as spam, 82 per cent of the total e-mail traffic. Health-related spam made up 32 per cent of the total.

As far as the researchers could tell, most was from abroad — the United States, China and Congo. Only 58 per cent of the active links in the spam e-mails were still viable a week later and only a quarter of the links still worked at the end of the month.

Jadad's wife had secured a special credit card with a low credit limit and Jadad and Gernburd tried to order 27 items using it. Only nine orders went through. Five were for prescription drugs (erectile dysfunction drugs and anti-anxiety medications) and four were for natural health products (weight management and penile enlargement).

The only charges made against the credit card were for items that were actually delivered, Jadad said. But whether the products are the real thing remains to be seen. He wouldn't say whether the drugs were expired or more expensive than they would have been in a local pharmacy, saying that analysis will be in a future instalment of this work.

"The fact at the end of the day is … there are enough people who are willing to look at those messages and consider the products and make an order. And that is what keeps this going," said Jadad, a professor of medicine at the University of Toronto and founder of the Centre for Global eHealth Innovation at Toronto's University Health Network.

"If people didn't respond, we wouldn't have spam. And the fact that spam is growing so much is a reflection of the fact that the spammers are making a lot of money out of it."