How can I buy cocaine online in Hungary

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How can I buy cocaine online in Hungary

Consumption of the drug has rapidly increased across the continent in recent years, leaving a trail of devastation. Over the past 10 years, Europe has developed a serious cocaine problem. The drug, originating in the jungles of South America, is being transported, sold and consumed across the European continent in record amounts. The increasing demand from users — and the huge profits to be made in this booming marketplace — is reshaping the international drug-trafficking trade on both sides of the Atlantic and its widespread availability is leaving a trail of addiction, organised crime and human rights abuses in its wake. Cocaine is a highly addictive stimulant made from the leaves of the coca plant, native to Andean countries in South America, especially Colombia, Peru and Bolivia. Usually manufactured in makeshift labs located deep in the rainforest, cocaine is often cut with a variety of substances before it is sold and then distributed as a white, crystalline powder that can be snorted or injected. The most recent UNODC report into the global cocaine trade found that the UK has the second highest rate of cocaine use in the world, with one in 40 British adults 2. According to UN analysis, is seen as a pivotal moment in the expansion of the cocaine markets in western and central Europe, with data pointing to a much wider supply and consumption of the drug after , borne out by increased levels of cocaine being found in wastewater across the continent. According to the European Drug report, cocaine residues in wastewater have increased in two thirds of European cities over the past two years. Over the past five years, record amounts of cocaine have been seized by the authorities across Europe. More than tonnes of cocaine were seized by EU member states in , the biggest volume of the drug ever confiscated by the authorities. Cocaine reaches Europe through a variety of routes, either by sea from ports in Ecuador and other countries, or travelling across the continent to Venezuela, where it then moves through the Caribbean or west Africa — which, data suggests, has picked up substantially as a transit zone — and then by sea or land to ports or across borders into Europe. The busy container shipping route between Ecuador and ports in Europe is being used to transit huge amounts of drugs into Europe. In August , 9. Belgium, the Netherlands and Spain report the highest numbers of cocaine seizures in Europe, mostly through their seaports. According to the EMCDDA , the illicit processing of cocaine products now also takes place in several EU member states, with 39 cocaine laboratories reported to have been dismantled in , compared with 34 in The bloodshed, chaos and human rights abuses that have historically come hand in hand with the cocaine trade are playing out on both sides of the Atlantic. The infiltration of international trafficking networks into Ecuador is causing community violence, gun crime and political instability. In countries along the supply chain, an influx of arms, drug traffickers and cocaine money are swamping once-peaceful cities with violence and crime; corrupting political institutions and law enforcement in countries such as Venezuela ; creating a generation of child addicts; and leading to a surge in violent crime in Caribbean transit points such as Trinidad and Tobago. Europol and the EMCDDA recently released a report in which they said that drug trafficking was leading to unprecedented levels of child exploitation, gun violence and crime. Cocaine, often considered a recreational or party drug, is also highly addictive. With purity levels rising and widespread availability of the drug — boosted by sales on social media platforms and the use of encrypted messaging services — the health and social consequences for users, their families and communities is also proving devastating. In , cocaine was the second-most frequently reported drug used by people admitted for drug use in hospital emergency departments across Europe. Data also suggests the drug was involved in about a fifth of overdose deaths in Have you or your community been affected by the issues raised in this story? Please share your story if you are 18 or over, anonymously if you wish. For more information please see our terms of service and privacy policy. In the UK, Action on Addiction is available on This article is more than 4 months old. What is cocaine and how is it made? How much cocaine is coming to Europe? How is cocaine reaching Europe? How much does cocaine cost? Explore more on these topics Drugs Bloodlines Drugs trade explainers. Reuse this content. More on this story. Over 40kg of cocaine found in banana deliveries to French supermarkets. Drug smugglers targeting Oslo as gateway into Europe. Manchester graduate who sold Viagra-style drugs online is jailed. Europol smashes Balkan cartel shipping drugs from South America. Most viewed.

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How can I buy cocaine online in Hungary

Official websites use. Share sensitive information only on official, secure websites. Arianna Giorgetti , University of Bologna, Italy. The use, distribution or reproduction in other forums is permitted, provided the original author s and the copyright owner s are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Methods: Relevant databases were searched to retrieve studies published from to A narrative synthesis was employed. Results: Seventeen studies were included. The analysis of these studies revealed 7 themes that represent the reasons that lead people to buy prescription medicines via the Internet. Discussion: This study provides a comprehensive review of the breadth of reasons that drive people to buy prescription medicines via the Internet. Identifying those reasons could provide the basis for regulators to design evidence-based awareness campaigns to minimise the purchase of prescription medicines via the Internet. Furthermore, future research directions have been provided in this review to build upon the existing knowledge and address the research gaps in this area. Keywords: prescription medicines, online pharmacy, theoretical domains framework, COM-B model, narrative synthesis, a systematic review, internet. Online sales of medicines have shown tremendous growth in recent years Fittler et al. Evidently, studies conducted in various countries including the United States, Europe, and the Middle East have found that the number of people purchasing medicines on the Internet has increased in recent years Bowman et al. One of these studies, conducted in Hungary, revealed a surprising tenfold increase in online medicine purchases from to Fittler et al. People can purchase a wide range of medicines from the internet ranging from over-the-counter medicines not needing a prescription to medicines that are prescribed by an authorised prescriber i. Some consumers turn to the internet today to self-medicating and buy prescription medicines without having a valid prescription and without any input from healthcare providers. This is possible if consumers decided to purchase medicines from the illegal sellers of medicines operating on the internet. The internet provides a platform that hosts both legal and illegal sellers of medicines. Legal online sellers of medicines are those who comply with safe pharmacy practices, and the laws and regulations of the country where the online seller operates Mackey and Nayyar, Conversely, illegal online sellers of medicines are those who violate pharmacy regulations and laws. A common practice of illegal sellers of medicines is offering the purchase of prescription medicines without any input from a healthcare provider, which includes not having a valid prescription Mackey and Nayyar, Several studies have provided evidence of the availability of different types of prescription medicines on the internet and the easy accessibility to those medicines without the need for prescriptions Boyd et al. For example, researchers from Europe have explored the online availability of several active ingredients including controlled medicines. They found that controlled medicines such as tramadol are widely available on the Internet and easily accessible to people without the need for a prescription Fittler et al. Likewise, a recent study conducted in the United States explored the online availability and accessibility of imatinib anticancer medication and found that those medicines are widely available online and could be obtained without any involvement of healthcare providers Sun et al. Laws regulating the sales of medicines over the Internet vary from one country to another. Internationally, there are shortages of effective global regulations and laws that control and regulate online pharmacies Fittler. Thus, prescription medicines can be sold on the Internet by anyone in those countries Hock et al. These shortages in international laws as well as the rapid development of technology have facilitated the expansion of illegal online pharmacies Mackey and Nayyar, This uncontrolled proliferation of illegal online pharmacies may bring a lot of risks to people e. The supply chain of prescription medicines over the Internet is complex and hard to track, which makes it impossible to keep the Internet free of illegal websites selling medicines Fittler et al. From another angle, one possible solution could come from focusing on the potential consumers themselves Fittler et al. Several public awareness campaigns have warned people about the danger of purchasing prescription medicines from the internet and about how to safely purchase medicines online e. According to a recent study, out of a sample size of 1, individuals, Furthermore, according to an estimate by the United Kingdom government, 1 in 10 people bought fake medical products online in MHRA, The reasons behind this behaviour are not well understood and need further investigation. Previous systematic review studies in this field have explored the characteristics of the websites that sell medicines, the quality of pharmaceutical products purchased online, and the number of consumers who are purchasing medicines on the internet and their characteristics Orizio et al. However, none of these systematic reviews investigated the available evidence on the reasons that drive people to purchase prescription medicines via the Internet. In light of the above, this systematic review aims to explore the prevalence of people purchasing prescription medicines from the Internet and to provide an overarching understanding of the reasons that could drive people to make this purchase. Additionally, this review provides directions for future research. To achieve the research objective, a narrative synthesis approach was undertaken. The Capability, Opportunity, Motivation- Behaviour model and the Theoretical Domains Framework were used to develop the coding of themes. The main aim of this study was to determine the breadth of reasons why people buy prescription medicines on the Internet. A narrative synthesis was employed because of the heterogenicity of methodologies between the included studies Harden et al. A narrative synthesis is an approach in which different types of studies quantitative, qualitative, and mix-methods were arranged into more homogenous groups Barnett-Page and Thomas, This model helps researchers to understand why people behave in a specific way. According to the COM-B model Figure 1 , a particular behaviour will occur only when an individual concerned has the capability psychological or physical capability and the opportunity physical and social environment to engage in the behaviour and is more motivated reflective and automatic mechanisms to enact that behaviour than any other behaviours Michie et al. Capability is an attribute of the consumer that together with the opportunity facilitates the behaviour. Motivation is a sum of mental processes that energised consumers to make a specific behaviour. It could be reflective which represents the conscious thought processes e. Finally, the opportunity is an external environmental and social factor that together with capability facilitates the behaviour. The TDF is a theoretical framework synthesised from 33 behavioural theories and grouping the constructs from these theories into domains Michie et al. The TDF provided a comprehensive and theory-informed approach to identifying the predictors of behaviour Atkins et al. Moreover, the TDF provides a theoretical lens through which to view the cognitive, affective emotional , environmental and social influences on behaviour Atkins et al. Appendix 1 illustrates the TDF domains and their definitions. Both PD and NP are experienced research-active academics. The search was carried out using multiple relevant databases i. The search was carried out using search terms related to the research topic i. The search was limited to articles published from the beginning of January to the end of December Studies were included if they were primary research articles qualitative, quantitative, and mixed methods studies , published in the English language, focused on the consumer perspective, and focused on prescription medicines. Studies that focused on illegal drugs e. First, HM imported all records into the EndNote referencing management software to exclude any duplicates. Then, HM screened the titles to double-check and exclude any duplicates that EndNote may have missed. Additionally, the references and citations of the included articles were screened in order to retrieve articles that might have been missed in the database searches. Any inter-rater disagreement in the screening process was resolved through discussion. Each step in the selection process was verified by PD and NP. As the included articles used qualitative, quantitative, or mixed methods approaches, three methodological quality assessment tools were employed. The CASP qualitative checklist aims to assess various elements of qualitative research studies, including research aims, appropriate methodology, research design and strategy, methods of data collection and communication between researchers and participants, ethical considerations, the rigor of data analysis, and the clarity and value of study findings. The tool consists of a point checklist that requires a yes , no , or do not know. The AXIS tool has been designed to assess the quality of observational cross-sectional studies. The MMAT allows the appraisal of the methodological quality of empirical studies including mixed methods studies. HM assessed all the articles qualitative, quantitative, and mixed methods studies whilst NP independently assessed the qualitative and mixed methods studies, and AR independently assessed the quantitative studies. Any inter-rater disagreement was resolved through discussion. Relevant data were extracted from the selected studies which included: general information i. For the qualitative studies and the qualitative part of the mixed methods studies, the thematic meta-synthesis proposed by Thomas and Harden was employed. Then all participant quotes provided within the original studies were analysed and coded. For each article, the codes were organised and categorised to form initial themes i. Then the summaries of the descriptive themes of all articles were analysed iteratively and categorised to develop higher-level themes i. The TDF was acting as a framework to develop the coding of themes. For the quantitative studies and the quantitative part of the mixed methods studies, meta-analysis was not undertaken as the included studies were not sufficiently homogeneous in terms of the participants involved and the outcomes Haidich, Instead, findings relevant to the current study aims have been extracted and summarised. To integrate the findings from the analysis of all the studies qualitative and quantitative findings , all the findings have been combined in an overarching conceptual model which has been developed using the frameworks of the COM-B model and the TDF. This model represents the reasons that could drive people to buy prescription medicines online. The initial search yielded articles, of which were identified as duplicates. The titles and abstracts of the remaining papers were reviewed, of which were excluded because they did not meet the inclusion criteria. The full texts of the remaining 42 articles were reviewed, from which 29 articles were excluded. Hand-searching the citations and references of the remaining 13 articles yielded 4 more articles that met the current study inclusion criteria. In total, a sum of 17 articles was included in this study for the narrative synthesis Figure 3. The quality assessment showed that the qualitative studies and the mixed method study were all high quality. Of the 12 quantitative studies, 4 were scored as high quality, while 8 scored as medium quality. One-third of the quantitative studies only used descriptive statistics 4QN, 7QN, 8QN, 10QN by summarising and describing the data obtained from a sample of respondents. Appendices 2, 3, and 4 illustrate the detailed quality appraisal process. None of the articles were excluded based on the quality assessment stage. Table 1 illustrates the characteristics of the included studies. The thematic analysis of the qualitative studies and the qualitative part of the mixed methods study revealed seven high-construct analytical themes Figure 4. The TDF were used as conceptual lenses that guided the formation of the analytical themes. By applying this framework, we systematically identified and linked the factors to specific analytical themes, enabling a deeper understanding of the complex interplay between individual, social, and environmental factors driving consumers to purchase medicines on the internet. One of the analytical themes was the perceived benefits that consumers might expect if they select to purchase prescription medicines online. For example, a US-based, year-old woman with three children discussed how the purchase was convenient and comfortable:. It would have been a much easier process, doing it at home, in the comfort of my own home. If they could have mailed me those pills, I could have done the abortion safely at home. Some participants discussed how people could save time when they select sourcing medicines from the internet by avoiding long waiting times to obtain appointments to see a doctor, as exemplified in the following quote:. For one participant who has purchased abortion medicines, the privacy of the online purchase was mentioned as a factor influencing their decision:. For sure, it would definitely be the way to go if it was an option. Finally, low prices of medicines available online were seen as a big advantage as illustrated in the following quote:. Regarding the risks of purchasing medicines online, participants pointed out several safety concerns. Some participants mentioned the possibility of purchasing and consuming fake medicines. For example,:. Another health-related risk perceived by the participants was the risks associated with the absence of healthcare professional oversight. One of the participants discussed how pregnant women could struggle with selecting a suitable and safe medicine if they decided to buy medicines online without involving the healthcare professional:. Another risk perceived by some participants was the risk of financial scams and fraud when purchasing medicines using the Internet, as illustrated in the following quote:. They all want to make a profit, too. Additionally, there was a view that medicines available online could be of inferior quality. This quote illustrates this risk:. People who are desperately struggling with the treatment of their illness could attempt to obtain prescription medicines online, as exemplified in the following quote:. The fear could also play a role. Participants in one of the included studies have expressed their fear of purchasing medicines from the internet without involving their doctors, as illustrated in the following quote:. When pregnant, I am generally a little more cautious anyway. The next analytical theme revealed was the facilitators of the purchasing of prescription medicines from the Internet. For example, the ease of use of the website Websites usability where consumers could purchase prescription medicines with just a few steps and would remember passwords and payment card details for the next purchases:. If there is difficult signing in, remembering passwords, looking for payment cards etc. Another facilitator that was offered by the online sellers was online access to prescription medicines. The following example illustrates this point from the perspective of a pregnant woman based in the United States who has chosen to purchase abortion pills prescription medicine that requires a prescription and medical supervision from the internet because of the accessibility to these medicines without a prescription:. Social media platforms were discussed by participants in some of the studies as a factor that could facilitate the online purchase of prescription medicines. For example, Instagram was found to facilitate communication and connection between buyers and sellers as shown in this example:. Furthermore, social media platforms hosted different support groups which could provide advice on what medication was helpful:. The barriers to purchasing medicines online have been classified into barriers that either prevent people from buying medicines from a specific website Website-specific barrier or barriers from the internet in general regardless of which website they could select General barrier Almomani et al. Website-specific barriers include the payment method suitability and security. Absent of a suitable payment option could delay the purchase, as exemplified here:. So, I just started thinking they were sketchy as hell. Another website-specific barrier was website security. For example, the absence of a secure payment method was highlighted as a factor that could hinder the online purchase:. I know there is a backup if something goes wrong and also its PayPal which has my information and not the actual website. General barriers included the financial capability of the consumer, as shown in the following example:. One of the studies found that more internet-confident consumers who had the knowledge and experience computer and internet literacy were more likely to purchase prescription medication online:. Some participants discussed the difficulties in recognising legal online sellers from illegal ones. The following example illustrates this point from the perspective of one participant who express scepticism against the logo used to distinguish legal sellers from illegal ones:. For example, some consumers trust websites they are already familiar with. I would be swayed by any negative reviews to avoid purchasing. The following example illustrates this point:. These factors were family and friends, peers with similar experiences, and healthcare providers doctors or pharmacists. The following quotes illustrate these factors:. But as others have said, if it was more common practice among people I know, then I would not be so wary of it. This trust is important in determining the source of purchase of medicines making online purchase from unknown sources less likely. This theme includes any environmental condition that discourages or encourages the behaviour of purchasing prescription medicines via the Internet. One of the environmental conditions that could trigger people to buy medicines online is the difficulty to access the clinics which could be financial or logistical difficulties. The following quote is the perspective of a year-old woman who turned to obtain abortion pills online because she could not afford the abortion clinic fees. It was going to have to come out of my rent money. So, for me, it was a matter of having to decide: Pay my rent or pay for the abortion…. Another condition that could encourage people to buy prescription medicines online is the restricted options available in local market sectors where few alternatives are available. One more encouraging condition was the marketing used by the online sellers of medicines. Online sellers of medicines were trying to persuade consumers to make the purchase by providing an environment and services that make the purchase easier for consumers such as advertising or influencer marketing as exemplified here:. The findings of the quantitative studies that are relevant to the current study aim were extracted and summarised in Appendix 5. Twelve cross-sectional survey studies in addition to the quantitative part of the mixed-method study were explored. These studies included data from a total of 6, participants living in different countries. Several types of prescription medicines were purchased e. To integrate the findings from the qualitative and quantitative studies, the findings have been categorised against the COM-B model. Using Figure 2 , six of the analytical themes knowledge, emotions, behavioural regulations, beliefs about consequences, social factors, and environmental factors were mapped directly against the COM-B model. The last analytical theme i. Thus, increasing consumers control over the behaviour. This dual placement offering a comprehensive understanding of how trust influences cognitive appraisal and self-regulation, thus shaping the behaviour. Figure 5 highlights the superordinate themes revealed from the analysis, however, within these themes, a breadth of specific details has also been produced. Table 2 illustrates these superordinate themes and their compositions, as well as the source in which each of these themes was cited. The overarching table which includes the themes identified from the synthesis and their compositions. Despite the abundance of public awareness campaigns that warn consumers about purchasing prescription medicines on the Internet ASOP, , the evidence explored in the current study found that people are buying medicines from the Internet and put themselves at risks associated with this purchase. Of the 12 quantitative studies explored, 11 studies provided the number of consumers who purchased medicines using the Internet. The current review study summarised what consumers perceived about the benefits and the risks associated with purchasing prescription medicines from the Internet. Consumers might be enticed by several benefits of the purchase e. However, many risks were also associated with the purchase e. Before making the purchase, consumers try to evaluate what they perceive about the consequences of the purchase. This evaluation process is a complex cognitive process in which consumers take into consideration what they perceive about the positive and negative outcomes of the purchase, so if the positive outcomes benefits outweigh the negative ones risks , then there might be a preference to make the purchase. Additionally, the probability of making the purchase could be increased when consumers have inadequate knowledge about the risks associated with the purchase. The cognitive process discussed above i. The evidence explored in this review found that desperation could drive consumers to behave without conscious thought, meaning that when desperate buyers, who are struggling with obtaining prescription medicines for a serious medical condition, find the medicines available online, then the purchase could be more likely to occur even if the buyers were aware of the risks of the purchase. So, when the healthcare provider refuses to prescribe a specific medications to the patient who think that this medication is useful to them, then patients might seek for alternatives including the internet Cicero and Ellis, , thus, putting the patient at risk of end up buying fake medicines which are widely available on the internet Almomani et al. On the other hand, healthcare providers could play a beneficial role by educating patients to about the risks of purchasing prescription medicines from the internet and how to purchase medicines safely Bowman et al. The current study also summarised the facilitators and barriers to purchasing prescription medicines online. Consumers could face barriers that might delay or prevent purchasing medicines from the internet such as the complex instruction for using some prescription medicines, however, social media platforms could facilitate the purchase and help consumers overcome this barrier as these platforms host different support groups which could provide assist consumers by providing them with the information about how to use these prescription medicines. Additionally, the social media platforms such as Facebook, Twitter, and Instagram and encrypted messaging applications such as WhatsApp or Telegram can play a role as a private communication channel between the buyers and sellers of prescription medicines. The messaging applications could offer the option of end-to-end encryption to protect user privacy. End-to-end encryption is a type of encryption that is adopted by some messaging applications to ensures that only both parties the sender and the receiver of a message can read the message contents Kulshrestha and Mayer, Thus, these applications offer a private and secure means of communication between buyers and sellers, which could help alleviate concerns about the potential risks of engaging in this illegal behaviour. Another facilitator offered by the online sellers of medicines highlighted in this review was the accessibility to prescription medicines without the need for a prescription. Several previous studies have found that many prescription medicines available on the internet and easily accessible for anyone without requiring a prescription include high-risk controlled medicines and antibiotics Boyd et al. The current study findings are in line with these studies, as this practice offering prescription medicines requiring a prescription have facilitated the purchase and made it easier for consumer to control the purchase, thus, consumers can purchase different types of prescription medicines including controlled medicines and antibiotics easily and without limits. This is problematic as the easy access to controlled medicines could increase the possibility of abusing the medicines. Moreover, buying antibiotics online without medical oversight could increase antimicrobial resistance Boyd et al. One important environmental condition highlighted in this review is the impact of the medicine shortages on purchasing prescription medicines from the Internet. Medicine shortages can be caused by many reasons including the sudden increase in demand for a specific medication, supply side problems manufacturing obstacles such as the shortages of the raw material , pandemics such as the Coronavirus disease COVID , political events such as the Brexit , or government policies such as the price controls which make it unprofitable for pharmaceutical companies to manufacture certain products Iyengar et al. Medicines shortages can frustrate consumers as they might struggle to obtain the medicines they need, which could create a sense of desperation for consumers, which in turn could encourage them to seek alternative sources including the Internet to obtain their needs. This is problematic as previous studies have shown that medicines in shortage are widely available online without requiring a prescription or healthcare provider involvement. For example, a study conducted in Europe found that anticancer drugs affected by shortages were available and accessible online without medical prescription. While another study conducted in the United States found that vaccines in shortage are widely available and easily accessible on the Internet Liang and Mackey, ; Fittler et al. Thus, this availability and easy accessibility of prescription medicines on the internet could encourage desperate consumers to make the purchase. Moreover, this finding is in line with a recent study that analysed the news media coverage of the problem of purchasing prescription medicines on the internet Almomani et al. Some of the participants in the studies included in this review trusted websites they had previously purchased from without facing any problems, while others judged whether a website was trustable or not by relying on other customer reviews. This is in line with the findings from a review study that found that pregnant women were influenced by customer reviews Little et al. We found that consumer behaviour of purchasing prescription medicines from the internet is a complex and multi-dimensional phenomenon that is influenced by a range of internal and external factors. This complexity arises from the multiple factors that interfere with the purchasing decision including the cognitive process, affective process, social influencing factors, external environmental factors, and economic factors. However, other factors including emotions could bias consumer judgments and behaviour, which in turn increases the complexity of understanding the decision. The overarching interpretation of the consumers behaviour of purchasing prescription medicines from the internet provided by the current theory-based systematic review enables a deeper understanding of this complex behaviour and decision-making process, thus, this review provides the basis for policymakers and regulators to take effective actions that can protect consumers from the risks of such purchase. This study is the first systematic review that looks solely at the consumers behaviour of purchasing prescription medicines via the Internet. This review provided an overarching view of the breadth of reasons that lead people to buy prescription medicines from the internet. This review provides diversified views about the research topic as the included studies were conducted in different countries and the participants were from diverse cultures, sex, and age groups. Furthermore, the studies included in this review used different methodologies qualitative, quantitative, and mixed methods , thus, providing stronger evidence and more confidence in the review findings. In addition, this review was guided by the COM-B model and the TDF theories, and these behavioural theories were validated by research in different contexts, thus, increasing the validity and credibility of the research findings. One limitation of this study is that the non-English language articles were excluded which might affect the generalisability of the study. Another limitation is that the heterogeneity among the quantitative studies precluded a meta-analysis, therefore, the method we employed to synthesize their findings could not generate effect size estimates, thus, it cannot assess the magnitude of the purported relationship between the independent variables factors that influence buying behaviour on the dependent variable buying prescription medicines online. Several awareness campaigns have been run to warn consumers about the risks of purchasing prescription medicines from the Internet ASOP, However, our systematic review founds that people still obtain their medicines from the internet and put themselves at risk associated with this purchase. For example, tailored messages focusing on the high costs incurred if failure of treatment occurs, due to the use of ineffective medicines, can be developed to target consumers seeking cost saving options, while other messages focusing on the health risks caused by possible drug-drug interactions or the risks of fake medicines can be developed to target individuals with chronic medical conditions. Based on our findings, one of the factors that could play a role in increasing the purchase of prescription medicines from the Internet is the long waiting times that patients have to wait in order to receive their treatment. This is a long-standing problem and difficult to solve. As patients continue to face long waiting times for medical consultations, their tendency to resort to medicine purchases through the internet may further escalate. Thus, a holistic approach is needed to effectively resolve this problem by involving healthcare system improvements, policy interventions, technology, and innovative solutions to ensure timely access to quality healthcare for all people. To address this problem, healthcare process improvement is needed by assessing and evaluating the processes to identify any areas that may be causing delays in order to eliminate unnecessary stages and increase the efficiency of the process. For example, regulators in healthcare sectors could check if the healthcare providers and administrators handle the high workload efficiently, if not, then provide suitable training. In the case that staff shortages are the problem, then increasing the capacity could be the solution by hiring more medical staff, and in case this is not applicable, then regulators and policymakers could increase the number of authorised prescribers people authorised to prescribe the prescription medicines by authorising pharmacists to prescribe prescription medicines for certain conditions or in certain situations. The current study found that different Internet platforms including social media, search engines, encrypted messaging applications, and customer review websites have facilitated the purchase of prescription medicines from the internet. Moreover, the pharmaceutical companies could also incur financial losses caused by the drop in sales. Therefore, given the serious patient safety concerns associated with this purchase, policymakers and regulators must hold a higher level of accountability and responsibility to these platforms to prevent such activity. However, to the end of , there are shortages in studies conducted in several countries in Europe such as Germany, Spain, France and the United Kingdom. Whereas in Asia, only 4 studies Given the limited research that analyse the consumer behaviour of purchasing prescription medicines from the internet in several countries, such as Australia, Canada, United Kingdom, China, South America, Africa, and several other countries. Future studies are needed to address this gap and provide a more comprehensive understanding of this phenomenon from a global perspective. The population of half of the qualitative studies included in this review was pregnant women, which in turn, could limit the generalisability of the findings. Thus, further qualitative studies that explore populations other than pregnant women could help in covering this gap. This systematic review has identified the breadth of reasons that drive people to purchase prescription medicines via the internet, meaning that the current study identified what needs to be changed in order to design interventions to minimise the purchase of prescription medicines from the internet. Thus, the current study findings could provide the basis for future researchers to conduct intervention studies that aim to promote positive changes in behaviour and develop behavioural intervention techniques in order to minimise the purchase of prescription medicines from the internet, thus protecting consumers from the risks of the purchase including the risks fake medicines. The behaviour of purchasing prescription medicines from the internet is complex and not straightforward to understand. However, underpinning the research using validated behavioural theories could help in understanding complex human behaviour as theories enable researchers to look at data from different angles within which to conduct the analysis and defined which key variables influence a phenomenon of interest Reeves et al. Growing evidence supports the use of theory when understanding behaviour as theories could provide tentative explanations for why and under what circumstances behaviours occur Alhusein et al. The majority of the studies explored in this review did not adopt any particular theoretical frameworks. Only 2 articles Thus, further studies, which use behavioural theories to interpret the consumer behaviour of purchasing prescription medicines from the Internet, will need to be undertaken. As shown in Table 1 , only a few studies to date employed qualitative methods including individual interviews, focus groups, ethnography, and qualitative questionnaires. Qualitative research generates rich data and enables a deeper understanding of this phenomenon Bell et al. Future studies which use qualitative research methods on the current phenomenon in different research contexts are therefore recommended. This systematic review of qualitative and quantitative studies explored the existing knowledge about consumers behaviour of purchasing prescription medicines online. Implications to policymakers were provided. Furthermore, research gaps were identified, and future research opportunities were discussed. The behaviour of purchasing prescription medicines from the internet is complex as many factors could affect consumers decision to make the online purchase of prescription medicines. The current theory-based study helps resolve this complexity as this study explored those factors and provided an overarching understanding of the reasons that could encourage consumers to purchase medicines from the internet. Identifying those factors could enable the development of evidence-based public awareness campaigns to protect consumers from these purchase risks. HA: conceived and designed the study, developed the search strategy, conducted the literature search, screened articles for eligibility, extracted data from selected studies, performed the quality assessment of included studies, analyzed the data, and drafted the manuscript. AR: independently screened articles for eligibility, resolved discrepancies in article selection, and contributed to the quality assessment of included studies. NP: provided expertise and guidance in the methodology, reviewed and refined the search strategy, critically assessed the quality of included studies, and critically revised the manuscript. PD: supervised the overall process of the study, provided guidance on the methodology and data synthesis, reviewed and approved the search strategy, contributed to the quality assessment of included studies, and reviewed the data extraction process. All authors contributed to the article and approved the submitted version. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. 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. Front Pharmacol. Find articles by Hamzeh Almomani. Find articles by Amna Raza. Find articles by Nilesh Patel. Find articles by Parastou Donyai. Received Jun 13; Accepted Aug 15; Collection date Open in a new tab. Reasons why people purchase prescription medicines on the internet. Viagra, birth control bills, antibiotics, narcotics, refill medication for chronic conditions, herbal medicine, supplements, and cosmetics Jairoun et al. Analgesics, Antihistamines, Anti-cough medicine, dietary supplements Moureaud et al. Prescription medicines Abanmy 17 2. Click here for additional data file. 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. Demant et al. Little et al. Lundin and Liu Aiken et al. Alwhaibi et al. Jairoun et al. Moureaud et al. Ashames et al. Fittler et al. Koenraadt and Van de Ven Abanmy Assi et al. Cicero and Ellis Svorc Bowman et al. Viagra, birth control bills, antibiotics, narcotics, refill medication for chronic conditions, herbal medicine, supplements, and cosmetics. Analgesics, Antihistamines, Anti-cough medicine, dietary supplements.

How can I buy cocaine online in Hungary