Ever wonder what would happen if you actually opened that e-mail titled "Vi@GRa, LeVitr@ with the LOWEST prices!" and ordered up some pills?
Researchers at the University of Toronto-based Centre for Global eHealth Innovation recently took on the task, sifting through more than 4,000 spam e-mails and placing 27 orders in an attempt to gauge how easy it is for Canadians to buy prescription drugs online.
The study leaders, Alejandro Jadad and Peter Gernburd, received one product for every three orders they placed.
"We were very surprised to find you could get so much from these spammers. Canadians have to be wary of this," Dr. Jadad said.
The study was published yesterday in the online journal PLoS Medicine.
For between $64 and $140, the researchers acquired pills claiming to be an array of drugs popular with online buyers, including the erectile dysfunction drug Cialis, the painkiller Tramadol, the anti-anxiety drug Xanax, the anti-obesity drug Meridia and the tranquillizer Valium.
They also took delivery of three substances purporting to be the natural remedies Anatrim, Hoodia and ManXL, a herbal concoction for penile enlargement.
While the researchers obtained nine products in all, they won't know what they actually received until the end of the year, when chemical tests are finished.
"This is the big caveat right now," said Dr. Jadad, Canada Research Chair in eHealth Innovation. "We don't know if the Cialis we got is really the product sold by Lilly."
Last year, a 58-year-old Vancouver Island woman died after taking what she thought was a generic form of the sleeping pill Ambien purchased from an online pharmacy.
A coroner found that her liver had been contaminated with aluminum, arsenic and several other metals. The coroner said it was the first death attributable to counterfeit drugs purchased online.
"There are all kinds of nightmare examples out there," said Neil Schwartzman, chairman of the Canadian division of the Coalition Against Unsolicited Commercial E-mail, a volunteer consumer group pushing for legal remedies against spam.
"It might be funny if you're just trying to get an erection, but if you're trying to fix a heart problem it can be deadly," he said.
A report by a federal spam task force, completed two years ago, recommended tougher anti-spam laws but no new legislation has been introduced.
"Our number one recommendation to consumers was not to click on spam," said Michael Geist who sat on the task force and is Canada Research Chair in Internet and E-commerce Law. "The risks of purchasing from spam are too significant to ignore."
The study revealed several other insights into spam. When the researchers set up three dummy e-mail accounts to catch spam, they found that one-third of it shilled erectile-dysfunction drugs, painkillers and other health-related medication.
And contrary to popular notions, few of those health-related e-mails were generated within Canadian borders. During a single one-week period, nearly three-quarters of the health spam they collected came from the United States. Much of the rest originated in China (16 per cent) and the Democratic Republic of Congo (5 per cent).
Just 2 per cent of the spam tracked by the researchers came from Canada.
"Canada has this reputation for being a hotbed of online pharmacies," Dr. Jadad said. "Given our reputation, we expected Canada to be sending more of these."
For the remaining two-thirds of orders for which the researchers didn't receive any pills, Dr. Jadad had expected to find evidence of credit-card fraud - spammers trying to steal money or an identity. He found no evidence of either.
"It was a credit card registered to a consulting company of mine [that researchers used]," Dr. Jadad said. "So that was relief."
The researchers took a number of risks in ordering from potentially dubious sources. For one, they were never entirely sure whether ordering prescription drugs from spammers might be breaking the law. For another, they weren't sure how to pitch the study to university administrators without sounding too lurid.
"Imagine talking to university administration and telling them about why you need to buy penis-enlargement pills," Dr. Jadad said. "Every step of the process was quite scary for us."
Even if the researchers had encountered online scams, they weren't sure where they'd report them.
"We contacted a number of different law-enforcement agencies during the study," Dr. Jadad said. "None of them seemed to know whose jurisdiction this was."
