By Gilbert M. Gaul and Mary Pat Flaherty, Washington Post Staff Writers


LAS VEGAS -- In July 2001, regulators at the Nevada State Board of Pharmacy noticed something unusual among the reams of data that flow into the busy agency each day. Buried along with the other numbers was a report from a small Internet pharmacy that had filled 1,105 prescriptions for painkillers and other dangerous drugs that month.


The same tiny pharmacy had dispensed just 17 prescriptions in the prior six months.


Virtually overnight, prescriptiononline.com had become one of the largest distributors of controlled substances in Nevada. Over the next year, the online pharmacy shipped nearly 5 million doses of highly addictive drugs to customers scattered across the country. By the time regulators shut the Las Vegas firm in January, prescriptiononline.com accounted for 10 percent of all hydrocodone sold in Nevada, regulators said.


It turned out that the booming business was owned by a 23-year-old former restaurant hostess. But it was run by her father, who had been convicted of a felony in 1992.


"For any single pharmacy to account for 10 percent of any drug is incredible," said Louis Ling, general counsel to the Nevada pharmacy board. "The fact that it was a highly addictive painkiller and an Internet site run by a convicted felon was even more troubling. This was unlike anything we had ever seen."


With little notice or meaningful oversight, the Internet has become a pipeline for narcotics and other deadly drugs. Customers can pick from a vast array of painkillers, antidepressants, stimulants and steroids with few controls and virtually no medical monitoring.


There are dozens of legitimate online drugstores and mail-order pharmacies. Unlike rogue sites, they require customers to mail in prescriptions from their doctors. Typically, the legitimate sites offer a full range of medications, with painkillers accounting for less than 20 percent of their business.


In contrast, a majority of the rogue sites' sales are for hydrocodone, Xanax, Valium and a few other addictive drugs. Many work with middlemen who set up the sites' customers with doctors who are veritable script-writing machines. Some of those doctors have financial problems and histories of substance abuse or medical incompetence, records show.


The online merchants now feed a sprawling shadow market for prescription drugs, frustrating medical leaders alarmed by the threat to public health and investigators hard-pressed to keep up with nimble Web sites that can open and close at a moment's notice.


"It's like rabbits," said Wayne A. Michaels, a senior investigator for the Drug Enforcement Administration. "Every day, there are more of them. They're up, they're down, they're foreign, they're domestic."


The agency recently created a six-person task force solely to track the online trade in narcotics. But officials acknowledged the effort is a form of "triage" amid an escalating crisis. "We're afraid it's going to overwhelm us, once we've identified all these sites," said Elizabeth A. Willis, chief of the DEA's drug operations section.


The multimillion-dollar industry has appeared overnight, pumping millions of pills into some of America's smallest and most economically distressed communities.


The Washington Post obtained and analyzed a Nevada pharmacy board database of 30,000 orders filled by prescriptiononline.com. The analysis found that four of every 10 pills poured into four southern states with widely documented prescription-abuse problems. A disproportionate share of those drugs went to customers in small towns.


Some small Tennessee towns received 50 times more painkillers per capita than large cities, the analysis found. For example, Church Hill got 1,013 pills for every 1,000 residents; Nashville, just 26. Bristol got 1,584; Memphis, 14.


"It's a no-brainer why you see high volumes in these little places," said Tammy Meade, a narcotics prosecutor in Nashville. "Users and people who want to get their hands on enough to distribute can't doctor shop in places like that. And if they use the Internet, someone like me . . . is going to have a tougher time finding out."


Stretching from Florida to California, the Internet pipeline has left a trail of deaths, overdoses, addictions and emotionally devastated families.





"It absolutely blew my mind that you could get these drugs online," said Sue R. Townsend, the coroner in Aiken County, S.C. Her son Douglas, 30, died after driving his car into a fence in September 2001. His family said he had taken a generic form of the tranquilizer Xanax, which they said he had purchased from myprivatedoc.com, a now-defunct Web site in Mesa, Ariz. Townsend's family sued the Web site, the pharmacy and the Arizona doctor who wrote the prescription, accusing them of selling the drug without a proper medical consultation. The case was recently settled with no admission of liability.

"Losing Doug has broken our hearts," Sue Townsend said, fighting back tears. "He had a young wife and a baby boy who will never know his daddy. Somehow we have to tell how dangerous this is, because it's happening all over."

In a typical purchase from a rogue site, a customer logs on and orders hydrocodone (generic Vicodin and Lortab). The Web site steers him to a middleman, often another Web site, which arranges a telephone consultation with a doctor. The customer and the doctor talk briefly, after which the doctor writes the prescription and sends it electronically to the Internet pharmacy. The pharmacy ships 60 pills to the customer by overnight mail. Total cost: $290. The pharmacy pockets $190 for the hydrocodone and the doctor and the middleman split the remaining $100 as a consultation fee. There are no face-to-face meetings, lab tests, X-rays or follow-ups.

There are dozens of Web sites selling narcotics in the United States, with scores more operating offshore. Federal prosecutors have shut Web sites, filed indictments and won guilty pleas from several owners. But it often takes years to prove a case. In the meantime, the pills move.

For each site closed, "two or three more open," said Jennifer Bolen, a former federal prosecutor in Knoxville, Tenn. "It is so easy for them to close down a site one day and open a new one the next."

For the DEA, an agency already responsible for everything from drug cartels to street drugs, trying to police the growing number of online pharmacies "is like trying to work every corner drug dealer," said Laura M. Nagel, the agency's deputy assistant administrator. "We can't do it all."

When prosecutors shut the Internet pharmacy operations at thepillbox.com in San Antonio, much of the business shifted to prescriptiononline.com in Las Vegas, records show. When that site was closed two years later, Nevada regulators suspect the business shifted yet again -- this time to Florida.

Some Web sites have dozens or even hundreds of affiliate sites. Others are designed to appear as though they are headquartered in the United States when they are really offshore, in such places as Namibia, Thailand and Sri Lanka. The growing numbers of foreign online pharmacies operate with near impunity. The Food and Drug Administration (news - web sites)'s strongest recourse is to send a warning letter, which usually is ignored.

"As an investigator, it's incredibly frustrating," said Robert J. West, a special agent with the FDA's Office of Criminal Investigations. "All we can do is bang away and try to draw attention to what these guys are doing. Right now, I don't think people have any idea how widespread or dangerous this is."

Little Regulation
States regulate pharmacies, creating widely different rules governing Internet sites. Under-staffed pharmacy boards barely have time to inspect brick-and-mortar pharmacies, let alone virtual ones. Many online pharmacies have ignored state efforts to register them. Only one state -- California -- has a full-time agent investigating doctors writing prescriptions for Internet pharmacies.

The lax oversight comes amid Congress's inability to pass legislation requiring even minimal disclosure by Internet pharmacies.

In 1999, then-Rep. Ron Klink (D-Pa.) issued a warning at a committee hearing: "I am concerned a 'Wild West' world is unfolding before us, where many consumers are accessing potentially dangerous drugs with little or no practical guidance. Yet because it is e-commerce, there is a mentality: It must be progress."

In 2000, the FDA, the General Accounting Office (news - web sites) and several House members urged that online pharmacies be required to disclose their owners, locations, doctors, affiliated pharmacies and telephone numbers. But Congress never followed through. Nearly four years later, there is still no disclosure requirement.

"Getting a bill regulating the Internet is about as hard as it gets," said William K. Hubbard, the FDA's senior associate commissioner. "You have all of these people worrying about stifling this wonderful thing . . . and they don't want the bad Feds in there."

A Post reporter sent e-mail asking for identifying information to 15 online pharmacies specializing in painkillers. Only one responded. It declined to say who owns the site or where it is located. One online pharmacy included a telephone number for customer service that linked to a freight forwarding company in Miami. When a reporter called, a secretary said that it moved shipments for a customer in Costa Rica.

In late 1999, the National Association of Boards of Pharmacy instituted a voluntary system for certifying online pharmacies, including inspections and disclosure. But of the hundreds of Internet pharmacies now operating, only a "dozen or so" signed up, said Carmen Catizone, the board's executive director. Most of those are large, legitimate sites, such as drugstore.com.

One pharmacy that received certification was prescriptiononline.com. "I can't explain what happened there," Catizone said. "I know we certified it originally, and then later on we got some complaints, and we suspended their certification. Obviously, if we knew then what we do now, we never would have certified them."

Easy Licenses
Regulators in Nevada faced a similar situation in April 1999 when Terri Suarez applied for a license to operate an online pharmacy called prescriptiononline.com.

No one at the Nevada State Board of Pharmacy had ever heard of Suarez. She was not a pharmacist. She was not even from Nevada. She was based in Louisiana. But all Suarez had to do to get a license was show that she had a corporation.

"At that time, our whole application was essentially a page and a half," said Ling, the board's counsel. "It was essentially nothing. I don't even think she had to prove she had a business license."

Her application was approved.

Nevada regulators did not know that Suarez operated a closed-door pharmacy in Jefferson, La., called Pharmaceuticals Southwest Inc. On paper, the tiny company was set up to sell discounted drugs to nursing homes. But when an inspector showed up in November 1999, there were no drugs to be found.

"It was definitely a front," Carlos M. Finalet III of the Louisiana Board of Pharmacy said later. "It had no stock. The pharmacist sat there reading a book."

Suarez denied buying any drugs, even when she was confronted with invoices bearing her signature, according to a complaint that the Louisiana board filed against Suarez's company. The board determined that Suarez had indeed purchased drugs -- $1.2 million worth in two months from Bindley Western Industries Inc. But inspectors could not find them.

Based on Suarez's "complete disregard for pharmacy laws," the board revoked the company's license and fined it $100,000. But the board has been unable to collect, and Finalet said Suarez's whereabouts are unknown .

Nevada regulators did not know about Suarez's troubles when her name resurfaced in March 2001. That month, they received notice that she had sold her interest in prescriptiononline.com to Melissa Cosenza, 23.

The regulators blanched. Cosenza's father is Michael R. Cosenza, who has a long history of working at the margins of drug distribution in Nevada and elsewhere.

"We knew immediately that he was using her as a front," Ling said. "What we didn't know was what he was up to."

At a hearing, Melissa Cosenza confirmed that her father was going to be a consultant to prescriptiononline.com. "She had supposedly bought the company for $50,000, payable at $5,000 a year," Ling recalled. "Who buys a pharmacy for $50,000? It sounded as hokey as could be. We started asking her questions. It was pretty obvious she didn't know anything about the business."

In April 2001, Melissa Cosenza submitted an application for a license, stating that she owned all of the company's stock. She gave a home address near San Diego. Under work history, she listed jobs as a restaurant hostess and salon receptionist.

Nevertheless, she qualified for a license. "I suppose it looks pretty embarrassing but really there wasn't much we could do," Ling said. Under the board's existing rules, "I really can't deny someone a license just because they come from a family and I know they are going to do something bad as soon as I give them a license."

Nor was there much the board could do about Michael Cosenza, 60, whose consulting business Med-Pharm Inc. would be running prescriptiononline.com.

Cosenza had pleaded guilty to grand theft in 1992 in Inyo County, Calif., for stealing more than $100,000 from a health care construction project, court records show. He later was incarcerated in 2000 for six months on a charge related to the earlier case. In October of that year, he had that case dismissed and expunged from his record.

"There was no way Michael as a convicted felon could qualify for a license," Ling said. "But under the law at the time, we didn't have the ability to take action against a pharmacy based on who was employed. It's probably still unclear today if we could stop him from operating the company."

It was not the first time Cosenza had worked around his past.

In April 1997, the California Board of Pharmacy said that Cosenza was operating two closed-door pharmacies licensed under the name of his wife, Barbara Jackson Cosenza. According to the board's official accusation, the two pharmacies were supposed to purchase prescription drugs at a discount and sell them to nursing homes.

"In reality, both pharmacies were actually wholesale businesses in which hundreds of thousands of dollars of dangerous drugs were . . . sold to other wholesale companies," the state board alleged. "Some of these drug shipments were delivered to the San Diego office of a courier and picked up by non-licensed agents. . . . Upon occasion, these dangerous drugs stayed with the courier for days without proper storage or supervision by a registered pharmacist."

According to the accusation, Michael Cosenza had held himself out as the owner of the two pharmacies "and conducted business transactions on behalf of both pharmacies." The California regulators said he did not qualify for a license because of his 1992 felony conviction. In December 1998, Cosenza's wife agreed to surrender the two licenses.

In January 2002, Barnes Wholesale Drugs Inc., a California drug distributor, sued Cosenza. The wholesaler charged that it was owed $529,000 for drugs purchased by an Oregon company called Pharmaceuticals Northwest Inc. The firm was run by Cosenza's stepfather, George Kemmler, 74, a retired snack food deliveryman with diabetes and "blindness in one eye." Barnes alleged that Cosenza paid Kemmler $1,500 a month to act as a straw man. Kemmler declined to comment for this article.

Barnes also alleged that the company was diverting drugs meant for nursing homes to another wholesaler in Las Vegas.

In a deposition, Cosenza denied any role in the diversion. He settled the lawsuit in 2002 by agreeing to pay Barnes $514,000. But he fell behind on the payments, and a judgment was entered against him for $658,000.

Cosenza and his daughter declined to be interviewed for this article. In a court filing in 2003, his lawyer said that prescriptiononline.com was a legitimate pharmacy that complied with all of Nevada's laws and regulations.

Booming Business
With Michael Cosenza behind it, prescriptiononline.com's business surged. Between July and December 2001, the online pharmacy filled 18,499 prescriptions, compared with just 17 in the prior six months. Nearly all were for controlled substances.

"Normally, with any retail pharmacy, you would expect 15 to 20 percent of the sales to be painkillers," Ling said. "Prescriptiononline turned that upside-down. They reversed the model."

Located in a small business park in northwest Las Vegas, prescriptiononline.com did not employ its own physicians. Unlike some other sites, it relied on doctors to steer business its way. All of those physicians were in other states and were associated with middlemen who arranged brief telephone conversations with patients in return for a fee. Two of the doctors -- Jon S. Opsahl and William Dale from California -- quickly became the two most prolific prescription writers in Nevada, regulators said.

In March 2002, Ling told prescriptiononline.com's attorney that he was concerned about the volume of controlled substances. Sherwood N. Cook wrote back that prescriptiononline.com believed that its product mix was consistent with that of other Internet pharmacies, and that "a majority of the drugs filled by Internet and mail-order pharmacies are controlled substances."

One of prescriptiononline.com's customers was Nancy Harler, a former nurse, of Columbia, S.C. She had been getting her painkillers from thepillbox.com. But after that site's legal problems arose, prescriptiononline.com began filling her orders for hydrocodone.

Harler said she had started ordering hydrocodone online for migraines and arthritis in February 2000. In all, she estimated that she spent $10,000 and used more than 1,500 pills. "It just got to the point where I was no longer in control and knew I needed help," she said.

Harler is now undergoing methadone treatment for her addiction, which she said was fed by the online pharmacies. "If you ask them anything about the money, they say we'll be glad to pull the plug. They know they have addicts on the line," she said.

Most of prescriptiononline.com's customers sought painkillers. The Post's analysis showed nearly 90 percent of the orders were for controlled substances, including hydrocodone and the generic equivalents of Valium and Xanax.

For years, hydrocodone has been one of the most used and abused drugs, according to the DEA. Sales have soared, and so have thefts of the drug and hydrocodone-related emergency room admissions.

The street value of hydrocodone is also climbing, said Tony King, the agent in charge of the DEA's Louisville office. A single generic tablet that costs an online pharmacy 15 cents may be sold to Internet customers for $1.50. On the street, that same tablet may go for "$3 to $5," King said. Overall sales of hydrocodone in Kentucky have doubled in the past four years, to 120 million tablets.

The surge began a few years back, when doctors alarmed by OxyContin abuse began switching patients to hydrocodone, King said. "But hydrocodone is equally dangerous," he said. "It's kind of like: Do you use a .38- or .40-caliber gun to shoot yourself?"

A breakdown of prescriptiononline.com's sales by Zip code revealed that four of every 10 pills flowed into Alabama, Tennessee, Louisiana and Kentucky. Those four states routinely rank among the top five nationally in the per-capita use of hydrocodone and Xanax, according to law enforcement data.

The pills poured into small towns. In Hope, Ky., with a population of 152, customers bought 7,910 pills -- an average of 52 pills for each resident. In Gunlock, Ky., population 430, customers bought 2,910 pills, about seven per person. By contrast, in Louisville, Kentucky's biggest city with a population of 206,239, customers bought 5,810 pills, about 0.03 per person.

In some cases, these orders went to multiple customers listed at the same address. For example, over five months 2,030 pills were shipped to five customers at one home in Baileyton, Ala. More than 80 percent were hydrocodone.

In an interview, Opsahl, the California physician who wrote the prescriptions, said he was aware that customers occasionally listed the same address, but not to the extent detailed in The Post analysis. "I didn't have that data at the time," he said, calling the information "very disturbing. You've presented some information that certainly gives me some pause how this whole system can be blatantly abused and easily abused."

Still, Opsahl maintained that most Internet patients have legitimate needs.

That view is not shared by Mike Vories, a physician who runs a pain management clinic in Hazzard, Ky.

"How in the world does an Internet Web site have any control over whether that controlled substance is going to a patient with a legitimate complaint?" he wondered. "Really, come on. Let's call this for what it is. A few maybe are legitimate and have pain. For the majority, it is a source of income."

Long Investigation
Alarmed by prescriptiononline.com's sales of controlled substances, Nevada regulators alerted the Las Vegas office of the DEA in the summer of 2001. Ling hoped for quick action. But the investigation stretched over months.

In the fall of 2001, DEA agents made undercover purchases from the Web site. In March 2002, DEA agents searched prescriptiononline.com's small office and seized business records. But the agents allowed the company to remain in business.

It would be 10 months before the DEA took away prescriptiononline.com's license to sell narcotics, declaring it "an imminent danger to the public health and safety" and seizing 21 boxes of drugs worth $143,000. By then, the company had moved about 1.8 million more doses of dangerous drugs.

When the DEA acted, the pharmacy board formally accused prescriptiononline.com of more than two dozen violations, including dispensing dangerous drugs where there was no valid physician-patient relationship.

On Jan. 22, Michael Cosenza and prescriptiononline.com agreed to relinquish the company's license and pay $200,000 in fines. The deal prohibited Cosenza or any member of his family from applying for a pharmacy license in Nevada for two years.

Melissa Cosenza did not attend the hearing.


Link to this article

OH MY GOD!!! Is this for real? What a biased article, that categorizes all OP's as "illicit". Now to me "illicit" implies something dirty, sordid or illegal. I don't think that there is anything wrong with using a licenced US OP for getting pain meds that my doctor will not give me. Just because certain people have used poor judgement and have overdone it and wound up dead or horriblly addicted, shouldn't mean that all OP's should be shut down. Now have heard some pretty bad rumors on another site about a certain doctor that works for many US OP's. A post stated that he didn't even have a licence and now the OP's he was affiliated with are being investigated. Its a shame. I couldn't beleive it when the article stated that the majority of people who use OP's use it for a source of drugs to sell on the street. In reality, yes this probably happens, but I think a majority of people who use Op's are legitimate pain patients. There are lots of reasons why someone would use an OP instead of go the traditional way of finding a doctor and then being sent to a pain clinic. For one, there are millions out there who do not have health insurance and cannnot afford to go to a doctor and risk being handed Vioxx samples after shelling out thousands of dollars in medical costs. Some of us have doctors and documented painful conditions which our physcians refuse to treat in the manner which works best for us. Face it: Narcotics work very well in treating pain. Yes they are addicting and can provide some euphoric effects, but they help us live normal lives. Yes I wish I didn't have this disease and didn't have to take this medication. I would do anything to be free of this and to have my life back. So would most of us out there with chronic pain. Why can't the press and the government stop worrying about us like we are little children who must be constantly watched and monitored. We can't be trusted to take matters into our own hands and decide which medicine works best for our pain and order it by ourselves, from a doctor who has some compassion. Yeah, a few people have died, some get addicted and go out of control and some order pills from Op's to sell on the streets. The media needs to know that WE the Suffering are OP's main customer base.

This article and a few others which I have read on another, similar site scare the crap out of me. I have a refill coming up with EPHY and I hope I get it. They are one of the OP's with problems. This does not look good at all for OP's.

Sarah

"How in the world does an Internet Web site have any control over whether that controlled substance is going to a patient with a legitimate complaint?" he wondered. "Really, come on. Let's call this for what it is. A few maybe are legitimate and have pain. For the majority, it is a source of income."

I hate to tell you this but almost all the OP's operating on the web are illegle. I just read the information off the DEA's web-site it self. I breaks down to 4 or 5 qualifications for an internet pharmacy to be legal.
1. The have to get legit medical records from you directly relating to the condition for which your attempting to get meds for.
2. They have to have to varify those records with your doctor, surgeon etc, by phoning or fax for varification.
If the records can not be varified or they are two old your required to take a physical. i.e. port-a-med.
3 Now a reputible doctor has to review all your information and call you for a consultation and having reviewed all your info, reviewed the test results or port-med results and discuessing with you your condition, He can legally and with the DEA's blessing prescribe to any medication he thinks will help you with your condition.

The big kicker in all this is that you the patient and the doctor have to have a tradition doctor-patient relationship. This doesn't mean he has to see you or you have to visit his office, but he does have to have more then some 30 questionaire that you just did 5 minutes before he's talks to you or worse yet the OP's that just take the form info and claim one of their doctors review it.

Keeping in mind I would say that 95% of the OP's I have see are running illeagly.
Of course I just did a consult with Madison and while it was expensive as hell and took almost a month to get my meds, I honestly believe they meet and exceed all of the criteria set down by the DEA for operating over the internet. Hell during my consultation the doctor was going over my blood work and making suggestion. I built more repore with him over the phone in 15 minuites then I have at the last local internal medician doctors I have go to.
It's just my thinking but I think you'll see a lot of OP's close up shop in the comming months with electins next year.I think however the smart ones will be around. just my opinions however
Shawn
PS the DEA said that regardless of any conditions, ordering medications for oversea's is against the law no if, ands or buts.

I agree, I think that the days are numbered for OP's in the US. I have met all of the requirements that you stated above, had medical records, a current physical report and labs sent over. The doctor reviewed them and prescribed my meds. Yes, I was surprised at how easy it was, and I know it must be a great thing for addicts and dealers. But there should be a way to weed those people out, instead of making those of us with real pain or medical problems suffer.
I hate the fact that as usual, a few stupid people went ahead and screwed it up for the rest of us. I also have heard that Dr. Dominuque was operating without a licence, and I know he operated out of a lot of different OPs, and that surely brought some heat on them. But if we have the medical records or even have to have a port-a-medic visit, I think they should be allowed to stay in business.

It seems to me that the DEA should have bigger fish to fry than worrying about OP's. The media has also not helped, by calling all OP's illicit, suggesting that they are doing something wrong. I think that without OP's, a lot of people would be dead right now, with doctors scared to properly medicate them. I know that personally OPs have saved my butt several times, and right now, since I lost my job and health insurance, I will have to rely on them unless my doctor and I can work out a deal.

I just hate it when I see news stories about "prescription drug abuse" and how it is an epidemic among americans. I also think that the system is so hypocritical. Rush Limbaugh got busted with Oxy, and no charges are filed. Courtney Love gets caught with them and she goes to jail and has her kids taken away. I have seem articles that imply that you can buy things like Oxycontin on the internet from OP's, and we all know that you can't. (at least not from any sites on here) We need to get a message out that OP's are not doing anything wrong, and that it is a legitimate way of practicing medicine and helping people get the medications they need.

Sarah

Yes, I agree. Sheesh....I think some politicians and doctors want EVERYTHING to require an office visit and RX...including vitamins!!

The site I get my Tramadol from does NOT handle narcotics, stimulants or any controlled substance I know this cuts out those with legitimate need...but it also cuts out pill-heads, junkies, dealers, etc. (The site also keeps a list of those who committed credit card fraud,and those who ordered drugs using different names for themselves, so they could obtain large quantities. etc. OPs can be victims too)!

I agree with the newspaper article that what is going on with all these OPs makes no sense. Do people need benzos to deal with pain? I recently read in our local paper that the use of illegal drugs is way down but the illegal use of prescription narcotic drugs is way up. So obviously the new culprit for LE is the internet and its use for the illegal procurement of prescription drugs.

Realistically, I'm sure many people like me chance upon this site just to read what people do and what people are willing to pay to get benzos to deal with their anxieties. I see very few posts in support of a good antidepressant rather than all these tranquilizers. Is it because a good antidepressant does not give instant relief like the good old addictive benzos?

For people who are in genuine pain or really sick without good medical care, then it's obviously a different situation and I don't know the answer to that. But perhaps the internet can help people like that find a good real doctor online, someone who could help and that arrangements could be made to see that professional in person and get a good program for pain care. Faxing records to a doctor who has never seen the patient really does not make any sense to me, really.

YOu know what pus- I have had anxiety problems since I was 4 years old. I would rip and bite my toenails until they bled. I see a neurologist monthly for my disorder, and yes I have been, and did see a psychiatrist for 8 years, both agree - I will never be able to get by- just day to day- let alone some god awlful situation- without nerve medication. PERIOD. I have had so many different antidepressants that I should have been a medical study myself! FOr you to say that these BENZOS just give instant relief! I guess you have never dealt with someone with VERY real panic attacks, Like having to pull the car off of the interstate because you cannot feel your legs, and you might wreck the car: PLUNGING INTO FOUR CARS IN THE LANE BESIDE YOU....IF THEY dont pull over...well I guess you would just say 'HUM i guess she just needs some antidepressants, and all would be fine" Not to mention that antidepressants can make you feel like you live in a fog and will fall asleep at any given moment- HUH - makes me think - some people do need them and may have for many years before they were actually diagnosed and were prescibed them. Its NOT always a quick fix. I am so sick of people saying crap like this--not until they have actually Lived a day in MY (or someone else who suffers) body.

Monday,

35 yrs, yep 35 yrs I've been taking benzo's, started out on the original benzo librium.
I would say most of the early benzo's were either very weak or I had a very high tolerance,
it proved to be the latter.

As the King of Rock&Roll allegedly said one time I shall also utter
"I need'em man, I need'em"

I have had a general anxiety disorder or PTSD which ever came first I don't know ,
Panic Disorder and PTSD have pretty much the same symptoms.

Quite frankly I could care less what anti- med stinkers
say about the use and or abuse of these life saving medications.

Thats right I sed LIfe saving! ain't it cool! me asserting myself! lol
I was in a assertivness training group once so that explains it you'all!

How many poor folks caught up in a seemingly no-win anxiety disorder crisis would have
suicided if it weren't for benzo's or anti-psychotics. For me meds rule! talk therapy?
yeah it helps too. But w/o meds I wouldn't be here I'm pretty darn sure of that..

Down off soap-box mode back in a state of normalcy <g>

Al

Monday & Al, I couldn't agree more. I can't figure out why some people get so upset over OTHER people's use of certain medications. I guess it is the same thought process as being intolerant of other's religion, politics, etc. In other words, it's the old "I feel like I have the right to make YOUR business MY business."

As far as anti-depressants go, my experience with the supposed wonder drugs, SSRIs, was a nightmare far worse than the problems I originally sought help for. I will never take another anti-depressant as long as I live. Frankly, because of my reaction to Paxil, I am lucky to be alive today. Monday, I can totally relate to the legs going numb while driving scenario, legs and arms in my case. Almost nothing is more frightening. In my case, this could have been a reaction to SSRIs as well as panic. I will never know for sure.

At any rate, it never ceases to amaze me that not only do we have to deal with unsympathetic, ignorant doctors, but we have to have the general public telling us what THEY think is best for us. It's pathetic. And for the record, I do not take Benzos of any kind, but I recognize their value for other people. And Al, congratulations on your self-assertion. You "done" good!

Lindsay

I respect your decision to take meds from OPs. THe problem is that online doctors don't give you the required blood, liver and kidney tests which are so necessary when people take any kind of medicine for extended periods. If they require that you do take the necessary follow up blood work to ensure you are not becoming toxic, then ok I'm wrong I apologize.

I'm not judging you. You're the only who can judge yourself. But if you have a family and children especially, you owe it to them to keep yourself healthy and sane, and not cause undue fear and uncertainty by doing things that may be cause for concern or may hurt your family which I'm sure you would not wish to do.

As for the King himself, dear Elvis, I'm sure none of you wish to end up the way Elvis did. That's a tragic example of what abuse of prescription drugs can do. Look at what he did to himself, his body, his mind, and look at the people in his life he did hurt, especially his daughter Lisa Marie, who never recovered from what had happened to her father. I'm glad you brought that up.

I would never, never do something that would cause concern to my children. I set the example, I am a mother, it's my duty and the most important one I have in my life.

isnt the name of this board PHARMACY WATCHERS?

glad you joined our board so you can "respect our decision to take meds from OP's"

Repost, but revelant you your story..
I grew up in the 60's and 70's when no one knew much about them, much less treat them.
I spent thousands of dollars in talk therapy and took powerful drugs that are now only used for psycotic people, and years of my social life due to these things.
Valium and Alcohol helped some, but created a dependence on them.
Thank God they can now be treated successfully without heavy duty psycotrophic drugs.
One doc on the early 70's put me a a drug called Stelazine, A powerful anti-psycotic just because of the panic attacks.
later, they discovered that these drugs, as well as being poison, made the panic disorder worse.
I'd kill myself and burn in hell forever if I had to endure them again without the ability to take meds like Paxil or The newer benzos.
Luckily I 80% grew out of them by my mid-late 20's.
Like migraines, you don't have a clue as to how debilitating these things can be unless tou have personally experienced them.
For someone who has them regularly and doesn't respond to anything but Xanax or Klonopin, dependence/addiction is only a small concern.

One of the main things that many members here have in common is the desire to take more responsibility for their own medical choices - typically after having been diagnosed with a legitimate condition that traditionally would have been treated with pain meds or benzos. But people like you -- members of "Drs. are Gods so they must be right" club, don't seem to understand that most drs. these days have been put in the impossible position of having to choose between keeping their licenses or prescribing what they'd really like to or what would be most effective for the patient.



The climate in the medical industry has changed, with drs. and patients both ending up screwed. Many people here had no problem being treated adequately (or at least somewhat adequately) a decade ago for the same conditions. But with the DEA making it harder than ever to prescribe these "risky" medications, most drs. choose not to take the risk, and I can't say I blame them.



If you really had a good understanding of the people here and what many of us have been through, you'd understand what it is to search repeatedly for a doctor to actually give you an accurate diagnosis, finally find a treatment that helps this condition only to have it ripped out from under you as soon as you feel you're finally starting to live a productive life.



I started to say, I don't know why you think SSRI's and other antidepressants meds are "the" answer for anxiety and panic disorders, but I do know why. You're buying hook, line and sinker into the messages the pharmaceutical firms (one of which employs you, I believe) put out in 24/7 ads, promising to help these conditions with a simple antidepressant med. I'm one of the many people who has tried nearly every antidepressant out there and have either gotten no relief (best case scenario) or horrible, life-altering side effects (more common in my case). I count myself lucky to have finally found a combination of natural supplements that have started to lift the fog of depression that's been hanging around my head for years, but I know that many people can't find the same relief with supplements.



There are many people on this board who have conditions that were diagnosed years, even decades ago, and have tried the full array of treatments that are available. Once they've found something that actually minimizes their symptoms enough to let them be functional, productive members of society, why would they want to stop? You want them to see another dr. to try yet another treatment? Well, besides the extra time and expense, people no longer have to rely solely on drs. to advise them as to their treatment options. The internet has made it possible for these sufferers to educate themselves about their conditions and treatment options. This certainly doesn't take the place of a medical degree, but I know I've personally had several encounters with drs. regarding treatment of illnesses in which I was aware of several other treatment options the dr. had never heard of. If I waited for most mainstream drs. to investigate natural supplements to the same extent I have, I'd still be living in that fog, waiting for one of them to finally discover what's been available at my local healthfood store for decades.



If this post is harsh, well, I don't care. I just don't understand people who join a group, full well knowing what the focus of the group is, and then condemning the focus of the group. Would you join a fishing club and then start criticizing the hobby of fishing? Well, why do that here?



PW doesn't aggressively recruit new members through spam or pop-up ads or anything of that nature, because the board isn't trying to push its views on anyone else. You came here of your own free will and joined based on the same. If you don't like people who've decided to make some of their medical decisions based on their personal experiences rather than relying on a dr. to prescribe what's easy or "popular" right now, then I guess I have to wonder why you're wasting your time here.

Poussette,
Interesting name . You have joined PW uhhh and for what reason? I'm a nosey old coot ain't I?
But I don't understand your post. This is website is the last time I looked, a OP group
where folks who wish purchase from OP's . Are you a minister?
regards,
Al

D.J Screw also died the same way(on the toliet) - he was the best and all of us in Screwstone, Texas miss him and thank him for everything he gave us. We miss and love you Robert Earl Davis, Jr. - aka the King and pioneer of our slowed down swangin and bangin now spread from h-town to el valle y san antonio y dallas y otros lugares del mundo.