News Releases

Results of the First Study To Establish A Link Between
Twitter and Illegal Online Pharmacies Published In JMIR

San Diego, CA (December 16, 2015) – The results of a new study published today in logo_ghpithe Journal of Medical Internet Research (JMIR) found illegal online pharmacies are using Twitter to promote prescription drug abuse of controlled substances. The paper, Establishing a Link Between Prescription Drug Abuse and Illicit Online Pharmacies: Analysis of Twitter Data, was co-authored by Timothy Mackey, MAS, PhD, Director of the Global Health Policy Institute (GHPi) at UC San Diego, Takeo Katsuki, PhD and Raphael Cuomo, MPH, with support from the Alliance for Safe Online Pharmacies (ASOP Global).

“This study is the first to establish an empirical link between Twitter content and illicit online pharmacies who promote the illegal sale of drugs that have significant abuse potential,” explained Dr. Mackey. “Our results are concerning, as the study found over 45,000 tweets that promoted drug abuse even though we only looked at a two week period of Tweets.”

According to the U.S. Department of Health and Human Services (HHS) and National Institute on Drug Abuse (NIDA), young adults are the biggest abusers of prescription opioid pain relievers, ADHD stimulants, and anti-anxiety drugs.

“Non-medical use of prescription medications is a national epidemic,” Dr. Mackey said. “However, until now little was known about the association between the promotion of drug abuse behavior and access via Twitter, which is currently used by a third of all teens and young adults.  This study is a crucial first step in examining this unregulated channel of risk.”

In order to better assess drug abuse behavior through Twitter, the study conducted surveillance and content analysis of over two million tweets using the Twitter public streaming application programming interface and used assisted machine learning. Tweets were analyzed to determine if they discussed drug abuse issues, whether they favorably promoted drug abuse behavior, and were also examined to see if they directly enabled the illegal access to controlled substances by online pharmacies.

Dr. Mackey said the study findings are extremely troubling. “When we examined links included in a subset of the Tweets that discussed drug abuse, we discovered that more than three-quarters (76%) of these Tweets included a link to an online marketing affiliate that advertising the sale of the controlled substance Valium, a tranquilizer that is commonly abused,” he said. “This marketing website had a hyperlink prominently displayed on its landing page that sent users to an illegal online pharmacy that offered the sale of several other controlled substances without a prescription, a direct violation of Federal law under the Ryan Haight Act.”

“Additional research is clearly needed to further identify the potentially dangerous link between Twitter content and drug abuse, as well as to help inform future technology-based tools, online health promotion activities, and public policy to combat drug abuse online and ensure that our youth and adolescents are protected from this harmful behavior and access,” Dr. Mackey added.


“Of the 35,000-50,000 active online drug sellers, more than 96 percent do not comply with U.S. laws and 50 percent of medicines sold online are fake or counterfeit,” explained ASOP Global Executive Director Libby Baney. “Buying prescription drugs from illegal online pharmacies also endangers consumers’ financial information and puts consumers at risk of identity theft,” she added.

Counterfeit products sold by illegal online drug sellers often are manufactured in unsafe conditions; contain little or no active ingredients; and/or contain dangerous substances including floor wax, mercury, concrete, chalk, boric acid, road tar, paint, anti-freeze and other poisons. “This means that consumers are just a click away from buying products that may cause harm, treatment failure or even death,” Baney said.

To stay safe, ASOP Global recommends consumers avoid “pharmacy” websites that: (1) do not require a valid prescription; (2) sell prescription medications merely by completing an online questionnaire; (3) send unsolicited emails offering ‘too good to be true’ drug prices; (4) ship prescription drugs worldwide; (5) do not have a licensed pharmacist available for consultation; (6) do not have a physical street address; and (7) are located outside the U.S. or are not licensed in the U.S. by a state agency.

“Consumers should visit the Verified Internet Pharmacy Practice Sites (VIPPS) program; LegitScript, the leading source of Internet pharmacy verification globally; or contact their state board of pharmacy to determine whether an online pharmacy is legitimate,” Baney advised. “They also can trust websites that end in the .pharmacy top-level domain (e.g. since only legitimate Internet pharmacies and pharmacy-related websites will qualify for .pharmacy domains, giving consumers a way to distinguish safe and legal online pharmacies and resources from rogue sites.”



Headquartered in San Diego, CA, the mission of the Global Health Policy Institute (GHPi) is to address important and underserved issues in global health, engage a broad array of stakeholders in problem solving and consensus building, and lead in the development of evidence-based policymaking.



Headquartered in Washington, D.C., the Alliance for Safe Online Pharmacies (ASOP Global) is a 501(c)(4) social welfare organization dedicated to combating illegal online drug sellers and making the Internet safe for consumers worldwide.



Caren Kagan Evans
301-467-6337 (cell)

Jayme Soulati
937-232-2529 (cell)