Physician Sounds Alarm On Illegal Drugs Sold On Amazon

Jul 4, 2014
Originally published on June 5, 2014 1:19 pm

Amazon, the world’s largest online retailer, is known for selling everything from books and music to diapers and groceries. And illegal pharmaceuticals.

Physician and journalist Dr. Ford Vox says Amazon sells a number of dangerous steroids, muscle relaxants and prescription antibiotics, delivered right to your door without a prescription.

There has been little reaction from the U.S. Food and Drug Administration or U.S. Customs and Border Protection, as many of the shipments come from sellers abroad.

Now, some lawmakers and companies are trying change that. Vox has been writing about this and joins Here & Now’s Robin Young to discuss the issue.


  • Ford Vox, physician at the Shepherd Center, which specializes in spinal cord injury and traumatic brain injury rehabilitation and research. He’s also journalist. He tweets @fordvox.
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Amazon sells everything from books to groceries and illegal pharmaceuticals. According to our next guest, Amazon sells a number of dangerous medications. Now Amazon hasn't yet responded to our request for a comment, but their policy says that if products are found to be illegal, the company will withhold payments to sellers. Dr. Vox is also journalist. Let's learn more he joins us now. Welcome.

DR. FORD VOX: Robin, thanks for having me on.

YOUNG: And you sacrificed your wife at the beginning of this article because you got involved in this when she had some slight acne and she got what?

VOX: Well, she does have an inglorious lead in the story. She was looking for different products on Amazon. She ended up being connected with a product that she didn't know she was obtaining kind of illicitly. When this product arrived - a prescription antibiotic called clindamycin - she brought it to my attention because she thought it did look a bit unusual.

YOUNG: Well, it was mailed from a third party in Thailand. Of course, you can't know that when you're ordering it. It arrives. And she asks you, what were your concerns about clindamycin.

VOX: Well, you know, my interest was really raised at that point. Clindamycin is an antibiotic that we don't use lightly in the hospital. Now this preparation of clindamycin that she received is actually topical - a little bit less dangerous. But still, it is a medication that we know can result in really dangerous or deadly diarrheal infections - an infection called C. diff. And some people, they react so severely to the medication it can cause a severe skin reaction called Stevens-Johnson syndrome.

YOUNG: Well, so you start digging deeper now that you see this. And first of all, this clindamycin came in the packaging that said, gift on it. So obviously someone was trying to sneak it into the - into the country. And when you started digging deeper, you discovered that Amazon is continuing to sell dangerous steroids and stimulants that had been banned in sports. Tell us a little bit more about this rabbit hole you went down.

VOX: I did start - I was curious and started to query with a few other compounds. And I found actually a potential drug of abuse on there called methyl carbinol that can kind of give a mild high. That's something that can actually even be deadly in combination with alcohol. I did more digging. And that led me to the surprising finding of Amazon's kind of behavior in the past of removing things and then having them come back on the site.

YOUNG: Well, for instance the FDA fined the website $7 million in 2012 for selling band anabolic steroids. We remember reporting on that story. You found the Amazon sold some of the same steroids.

VOX: Truly remarkable. For at least two years prior to the FDA coming down hard on, Amazon was selling similar substances. Then after that fine came down, Amazon was actually selling some of the same drugs at the same time. One of the sources that I have in the story, Oliver Catlin with the Banned Substances Control Group, had actually taken it upon himself to record screenshots because he himself was dumbfounded at what Amazon was doing. He also was able to document how Amazon would take these substances down and then they would come back up again.

YOUNG: Well, then why hasn't Amazon been the recipient of a very strong letter that the FDA can send out? It's a - you call it an untitled letter or a public warning letter to Amazon's CEO, Jeff Bezos. Why hasn't that happened?

VOX: Well, I talked to a former FDA attorney who of course reiterated the fact that I think we're all somewhat aware - our federal government is stretched. They are certainly often looking out for kind of the most egregious situations. However, I would call this pretty egregious and also something that's rather low hanging fruit.

YOUNG: What about other federal groups? Why can't Customs and Border Protection block some of this?

VOX: Customs and Border Protection does have a strong role to play really on the ground, in shipping centers. And they will act at the bidding of other agencies like DEA and FDA, who are responsible for doing the investigations and kind of deciding where CBP is going to act.

YOUNG: Meantime you write about companies that have banded together - the Center for Safe Internet Pharmacies represents Google, UPS, Visa - companies that seem to understand their platforms can be used for illegal pharmaceuticals. What are they trying to do?

VOX: They actually go out there and, you know, cancel payment - they try to figure out when people are, for example, using Visa's systems to operate an illegal drug market. And they tried to cancel those payers and transactions out. They shut down websites that are selling these drugs. And the Center for Safe Online Pharmacies does invite Amazon to join them. And I think that they should.

YOUNG: Well, Amazon hasn't joined. And you talked to their PR manager. What do they say about - I mean, how does it work? Does Amazon - isn't there someone, at some point along the way who knows - hey this is an illegal substance from Thailand that's being sold on our website? Isn't there somebody assigned to everything that's on there?

VOX: You know, part of kind of understanding Amazon - it was one of the first successful companies. It started, you know, back in 1994. The idea was to literally sell anything that ships. But they have very much developed a platform that is kind of robot powered - both in terms of actual little robots in the warehouses but also online. It's very much automated, automatic. So, for example, I'm asking direct questions of Amazon. Hey, do you look at each individual product? They're not answering those particular direct questions. You can put two and two together in terms of talking with people or looking at what people are writing or complaining about in terms of selling on Amazon - to what level Amazon is actually supervising that. So for example, just this Sunday, I saw that kind of in the background on Amazon's seller forum on their website, someone had received a letter - one of the sellers on Amazon - telling them that we are suspending your account for selling illegal drugs on our website. And the seller was kind of complaining about the fact that they sell over 500,000 different products on Amazon and about 70,000 of those products were perhaps in a gray area. I'm somewhat dumbfounded here by these numbers. And it was evident that the seller and himself does not know, for example, whether a particular product is legal or not that he is selling. And he's now going through one by one of his products. You know, we're having to read between the lines here 'cause Amazon is not answering these questions directly. But I do not think that an actual human at Amazon is reviewing each of the products that are for sale to Amazon consumers and that is incredibly concerning.

YOUNG: Yeah. Well, meanwhile I feel a little bit badly that we've just alerted people to that fact. But as you point out, you know, anybody can go online and try to find anything. But meanwhile, Rhode Island's Democratic Senator Sheldon Whitehouse and Utah's Republican Senator Orrin Hatch have introduced the Designer Anabolic Steroid Control Act of 2014. It would make it easier for the Drug Enforcement Agency to categorize something as a controlled substance. But is - do you see anything happening to limit some of these illegal drug sales on Amazon?

VOX: Well, if the Designer Anabolic Steroid Control Act were to pass, that would give the DEA kind of more teeth. Part of the problem with Amazon in particular is it is the ideal market. As soon as you develop any new, potentially dangerous compound and you want to call it a supplement or some type of food like additive or product, you can go on there and sell it to the consumer. And only after we learn that these products are dangerous, that they've injured people, or only after regulators get wind of them can they then go back in a long process that's expensive - we don't have many resources for - try and control that substance and get it off of the market. So what the Senators would like to do is for the agency to be more proactive - take a look at the products that are coming out and go, hey is this suspicious or not? Is this something we need to look into more before American consumers have access to it and potentially injure themselves with it? And go ahead and schedule that substance temporarily as a controlled compound while they work that out.

YOUNG: Ford Vox is a journalist. He's also a doctor based at the Shepherd Center in Atlanta. They specialize in spinal cord and brain injuries. He joins us from WABE in Atlanta. Dr. Vox, thanks so much.

VOX: I appreciate the opportunity to talk to you today. Thank you. Transcript provided by NPR, Copyright NPR.