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Facebook as a source of access to medicines

Buying Ecstasy Poznan

Official websites use. Share sensitive information only on official, secure websites. Competing Interests: The authors have declared that no competing interests exist. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hence, we aimed to verify if Facebook might be considered as a source of access to medicines. We also intended to identify prescription Rx and over the counter OTC medicines if available on that platform. The study was conducted from January to July We investigated offers of pharmaceuticals posted on Facebook individual posts and communities between and Medicines were divided into Rx and OTC brands and in accordance with their possible therapeutic use. We verified whether the medicines were for sale, to exchange, or available for free. Out of offers, In 47 We also found clear candidates for misuse. Facebook provides the possibility of uncontrolled access to medicines. The majority of offers concerned Rx brands, including opioids and benzodiazepines. Medicines offered on Facebook were mainly accessible for free. The scope and the number of medications offered on Facebook should make this issue a hazardous phenomenon. The Internet was designed to be unstoppable, and essentially it is \[ 1 \]. It contributes, among others, to the enormous development and popularity of online communities, networks, and social media like Facebook or Twitter. These services have become the primary source of general information, especially for teenagers and young adults \[ 2 , 3 \], including information on health and medicines \[ 2 , 3 \]. Nevertheless, medicines are not the same commodities like clothes or office supplies, for instance \[ 4 \]. Despite many indisputable benefits related to pharmacotherapy, medications might be harmful when not used correctly \[ 5 \]. Hence, most of them require a prescription or advice from trained medical professionals or pharmacists before they can be taken \[ 4 \]. This contributes to the significant scope of falsified medicines available on the Internet \[ 6 — 8 \]. Considering that drug misuse has become a global public health and economic issue \[ 7 , 9 , 10 \], local and international agencies should focus on decreasing the risks of buying medicines over the Internet platforms \[ 11 \] or social networking services which like Facebook do not have a medicines license. Despite the swift growth of the trade of several goods on Facebook it is, to our knowledge, the first study evaluating Facebook as a platform allowing access to medicines. Besides, the European Commission has imposed a common logo on these registered retailers \[ 12 \]. Facebook facilitates sharing information, messages, and the exchange of goods \[ 14 \]. The variety of features that serve different purposes for the user also provide health education \[ 14 , 15 \]. Therefore social media platforms have increasingly enabled drug manufacturers to engage with patients and healthcare providers \[ 15 \]. Simultaneously, however, social media are being redesigned to improve their commercial services, which allow for selling or exchanging commodities, including medicines. Our study aimed to verify if Facebook might be considered as a source of access to medicines. We also intended to evaluate the scope of that phenomenon and to identify prescription Rx and over the counter OTC medicines, if available. The study was conducted from January to July and both data collection and analysis complied with conditions for the source of the data. Being in crisis, some started their activity with digital currency exchange platforms, betting, playing in the stock exchange, or online trade. Hence, it is conceivable that medicines could have been used for that purpose, and people used social media sites like Facebook for such trade. We investigated, written in Polish, offers of pharmaceuticals posted on Facebook individual posts and communities from to Out of trade offers found in that period, 13 were from , 23 concerned , concerned , and concerned We examined these offers to verify if medicines were for sale, to exchange for other goods, or available for free. We used our private accounts to mine the data, joining open and, if accepted by the moderator, closed groups or societies on Facebook like e. We have investigated posts only from private accounts excluding shops, retail points, or anonymous offers. If an offer of medicines trade was found, we saved just information in the excel sheet about the medicine and expected payment form. No personal data was collected so as not to contravene the data protection or the GDPR \[ 16 \]. We have not contacted tenderers to be not accused of having personal data in the contact box. In case of screenshots Figs 1 — 3 confirming, in our opinion, the most important examples of medicines traded on Facebook, we anonymized all posts permanently removing or hiding personal information. For that purpose, we used Corel Photo-Paint 9. Besides, we collected data only for scientific purposes. In the case of screenshots and figures, these were similar but not identical partial screenshot with concealed parts of the picture to the original image and, therefore, only for illustrative purposes. Moreover, we obtained the confirmation from the Bioethics Committee that the study is not a medical experiment and, according to the Polish law and GCP regulations, does not require approval of the Bioethics Committee at Poznan University of Medical Sciences. Source: Facebook. The URL address was not collected and is not reported to avoid the possible traceability of the Facebook user and to not to contravene the data protection or the GDPR. The presented figure is similar but not identical partial screenshot with concealed parts of the picture to the original image and is therefore only for illustrative purposes. Because of the scope of investigated medicines and the fact that the majority of the offers concerned Rx brands, we decided to present medications categorized in the following groups: antibiotics, anticancer medicines, anticoagulants, antidiabetics, anti-asthma medications, antihistamines, antipsychotic medicines, cardiovascular medicines, hormones, and painkillers. In our opinion there were substances which might be categorized in several groups like novel oral anticoagulants NOACs in cardiovascular medicines or anticoagulants. Nonetheless, these medicines like rivaroxaban, dabigatran, apixaban were classified into the cardiovascular medicines category. Anticoagulants, however, were dedicated to substances like enoxaparin, for instance. We decided to classify neuroleptics, antidepressants, and benzodiazepines as antipsychotic medicines. The use of brand names is strongly limited to avoid any accusations of advertising, although the names are sometimes presented to ensure text clarity. Out of offers of medicines posted on Facebook, We present the results with percentages in square brackets. In most cases, these are part of all analyzed offers. If the result constitutes the percentage of cases in the separated group, it is always indicated in the text. We believe that the results presented in that way will contribute to the clearness of this chapter. Out of 26 6. The one offer 0. For antibiotics e. There were 17 4. One 0. It contains, however, naltrexone and bupropion, which are individually used in the treatment of alcoholism and depression, respectively \[ 17 \]. With reference to the medicines groups, results are also presented in Table 1 , which was created to provide transparency for those who prefer tabulated data. We present only these groups of medicines where the exact retail price was indicated. For instance, out of 19 offers in the group of antibiotics there were 15 Considering painkillers including opioids , out of 19 in that group there were 17 The structure of offers related to opioids, benzodiazepines, and anti-cancer medicines is presented in Table 2. We showed these relatively small groups of studied medicines separately, because of their therapeutic significance and risk of a recreational use. Among goods expected for exchange, the most popular was coffee, followed by sweets and a smile. Besides, the smile was clearly indicated as an expected commodity. The type of goods may result from the characteristics of market places like Facebook or similar platforms, where people frequently offer goods within local societies in exchange for something symbolic. The structure of goods expected by the bidders is presented in Fig 4. In the group of posts offered for exchange, we found, e. However, in 29 cases, the payment method was to be negotiated. It concerned, e. Hence the usage should be controlled by professional medical staff instead of self-treatment. Nevertheless, the brand mentioned above is not reimbursed in Poland. Thus the price may vary between pharmacies and as presented in the study, the medicine might be cheaper buying it in the regular pharmacy than on Facebook. Among the offered medicines, there were also medicines requiring special storage conditions like filgrastim or insulins. Nevertheless, posts and the content of the offers did not confirm suitable storage and further transportation. The analysis revealed that Facebook might be a source of uncontrolled access to several medications. Out of investigated offers, the majority Cardiovascular medicines were most frequently Importantly, we also found offers of medicines that might be misused. There were, among others, 7 1. Most of the investigated medicines were available for free. The severity of medicines offered on Facebook makes this most popular networking platform an important medicines trade source. Free and uncontrolled access to medicines might be related to possible misuse of prescription drugs, which became a hazardous phenomenon worldwide \[ 3 , 9 , 19 , 20 \]. It is in line with our study, where most investigated posts considered Rx brands. Thus the development of that market may significantly jeopardize public health and boosts related costs \[ 20 , 21 \]. In , approximately 18 million people misused prescription medicines. It mainly concerned adolescents and young adults \[ 9 \]. Worldwide, opioids remain the most frequently misused prescription drugs. In the United States, the number of people who misused these medicines in was 2 million. It contributes to the huge economic burden of that issue \[ 20 — 22 \], and e. It is estimated that in the USA, 36 million Americans have bought medicines online, including lifestyle and lifesaving drugs, without a valid prescription \[ 7 \]. Facebook might be a source of these medicines too. In our study we revealed posts offering cardiovascular medicines, antibiotics, and antidiabetics, for example. In the case of antibiotics, there were offers for doxycycline. As a relatively cheap and easily accessible medicine, doxycycline was frequently used in the first days of the symptoms of a SARS-CoV-2 infection, especially at the beginning of the pandemic \[ 27 \]. However, it could be a more developed phenomenon than presented in this study. It might result from the underestimated number of SARS-CoV-2 infections related to limited test availability in the first months of the pandemic and then hidden cases which are frequently not reported in official statistics \[ 29 , 30 \]. We also found offers e. People build up a tolerance to these medicines very quickly, and often escalate their dosage to get a similar state. Therefore, the overdose risk is vast \[ 4 \], and uncontrolled access, and misuse of these medicines may contribute to dire consequences to patients and society \[ 4 , 23 , 31 \]. Besides, the same or very similar risks are related to the other medicines. Likewise, it should be an issue for all market stakeholders, including politicians and marketing authorisation holders. We found, in our study, several offers of neuroleptics and hormones likewise. The importance of using medicines from legitimate supply chains also confirms the example from the Democratic Republic of Congo. Still, when tested, the pills were found to contain haloperidol \[ 32 \]. The trade on Facebook does not protect potential users from such dangers. In the hormones group, we mainly found contraceptives, but there were offers for clomifene and letrozole. These might be used for anabolic purposes or to counter the side effects of anabolic steroid abuse \[ 33 , 34 \]. Still, their misuse should not be downplayed because it is also a developing problem and a serious global public health challenge \[ 9 , 10 , 35 \]. In supra-therapeutic doses, substances like dextromethorphan or pseudoephedrine can elicit psychoactive effects such as euphoric or dissociating \[ 9 , 10 \]. Although pharmaceutical law in Poland was amended to reduce recreational use of OTC medicines, access to medications containing substances mentioned above is still relatively free \[ 10 \]. It may explain why these and other OTC medicines were not frequently offered on Facebook. For many people, the Internet, including social media, became a primary and trustworthy source of health information \[ 2 , 36 \]. Nevertheless, such trust might be dangerous. It raises e. Moreover, Coloma et al. Besides, Coloma et al. It confirms the potential risks of improper storage and transportation like in the case of found insulins or filgrastim, which require cool storage conditions. It, and the study as a whole, also demonstrates some failures of the falsified medicines directive, which applies to legitimate medicines providers instead of illegal points of frequently substandard medicines turnover \[ 39 , 41 \]. The globalization of several markets and COVID pandemic lead to the very fast growth of e-commerce. It also concerns the pharmaceutical market with easy purchase and delivery of medicines via the Internet \[ 42 \]. Despite worldwide warnings related to the dangers of buying pharmaceuticals online, patients increasingly turn to online retailers to reduce out-of-pocket costs and to avoid queues as well as coverage-based limitations \[ 6 \]. For these reasons, people look for the best retail offers, and therefore drugs are increasingly bought from informal pharmacies or websites that look legitimate, but in fact, are falsified \[ 3 , 6 , 7 , 32 , 39 , 41 , 42 \]. The simultaneous development of medicines trade on Facebook and other Internet channels makes uncontrolled access to medicines, misuse of drugs, and their inappropriate supply an urgent issue requiring the engagement of healthcare decision-makers, politicians, and all stakeholders of the pharmaceutical market. Moreover, there is a lack of not only societal but also school education concerning risks of misuse of medicines and their access through illegitimate sources like Facebook. This social media is one of the most popular platforms among teenagers, and the uncontrolled access to several medicines from Facebook only adds to the scale of the problem. The study has some limitations. Namely we did not attempt to buy the investigated medicines to evaluate bargaining possibilities or to ask about storage conditions for example. It could be interesting to check these medicines, every tenth for instance, in a laboratory to evaluate if the medicines were fake. It could be valuable to analyse not only Facebook, but also several auction sites, where medicines might be offered too. Nevertheless, this might be a topic for future research in the field. It would also be worth considering the potential advantages of the medicines market on Facebook and related networking platforms. These may provide an unrestrained chance to find a medicine that is not commonly accessible, for example, due to drug shortages. The majority of offers concerned several Rx brands, including opioids and benzodiazepines. Medications offered on Facebook were mainly available for free, resulting in open access to many substances for end-users at any age. There are no guarantees of proper storage conditions, supply chain, or drug origin. The scope and the number of medicines offered on Facebook should make this issue a hazardous phenomenon. Safeguarding the pharmaceutical market and society in the age of globalization represents an urgent challenge for politicians, researchers, and all market stakeholders. Further studies are needed to aggregate data in the field and to extend the conclusions. This section collects any data citations, data availability statements, or supplementary materials included in this article. As a library, NLM provides access to scientific literature. PLoS One. Conceptualization, Formal analysis, Investigation, Methodology, Project administration, Resources, Supervision, Visualization, Writing — original draft. Find articles by Tomasz Zaprutko. Find articles by Dorota Kopciuch. Find articles by Anna Paczkowska. Find articles by Julia Cynar. Find articles by Katarzyna Niewczas. Find articles by Aleksandra Stolecka. Find articles by Maria Sygit. Find articles by Piotr Ratajczak. Find articles by Krzysztof Kus. Anna Paczkowska : Data curation, Resources. Julia Cynar : Investigation, Resources. Katarzyna Niewczas : Investigation, Resources. Piotr Ratajczak : Data curation, Resources. Selcen Ozturkcan : Editor. Received Jan 24; Accepted Sep 13; Collection date Open in a new tab. There were no offers for the exchange within these groups of medicines. Similar articles. Add to Collections. Create a new collection. Add to an existing collection. Choose a collection Unable to load your collection due to an error Please try again. Add Cancel.

Buying Ecstasy Poznan