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Many prescribed drugs are freely available for purchase on the web without a legitimate prescription from a physician.

This study focused on the motivations for using no-prescription online pharmacies (NPOPs) to get prescribed drugs instead of using the normal doctor-patient-pharmacy model. We also studied whether users of NPOP-purchased drugs had poorer health outcomes than those that obtain an equivalent drug through legitimate health care channels.

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We selected tramadol 100mg as a representative drug to affect our objective because it’s widely prescribed as an unscheduled opioid analgesic and should easily be purchased from NPOPs. Using program marketing (SEM), we placed advertisements on search result pages stemming from the keyword “tramadol” and related terms and phrases. Participants, who either used the traditional doctor-patient-pharmacy model to urge tramadol (traditional users, n=349) or purchased it on the web without a prescription from their local doctor (ie, nontraditional users, n=96), were then asked to finish a web survey.

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