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We wanted to determine if it was possible to obtain antibiotics without a prescription and how people do it.
In the United States, there are 4 ways to obtain antibiotics without a prescription: buy them in a pet store, drive down to Mexico, buy them in an ethnic market/convenience store or buy them on the internet.
Any pharmacist will tell you:
(A) Fish diseases are treated with human antibiotics.
(B) You don't need a prescription to purchase antibiotics for fish.
We visited 6 pet stores in the New York City Area - 2 national chains, a regional chain and 3 independently owned pet shops.
Both national chain pet stores we visited had antibiotics for sale. Most of the formulations were available as liquid gel drops or powders that are difficult for people to take. However we were able to obtain tablets of triple sulfa (a cocktail of 3 broad spectrum sulfa antibiotics) and tetracycline tablets on the websites of these chains.
The regional chain pet store and all three mom and pop pet stores sold tetracycline, erythromycin and ampicillin in tablet and capsule form.
On the internet, it was easy to find amoxicillin, ampicillin, tetracycline, cephalexin, metronidazole and erythromycin for sale without a prescription by searching Google for the term "fish antibiotics".
It is a bad idea for people to take veterinary medicines but chemically the drugs are the same as what you find in a human pharmacy.
According to anecdotal reports the fact that one can obtain antibiotics in this manner is common knowledge among branches of the armed forces.
Importing non-prescription antibiotics over the internet into the United States is a low priority for the authorities compared to narcotics and controlled substances. When was the last time you read about someone being arrested for importing Cipro or Augmentin into the USA?
Here's how it works: As long as the pharmacy is located in a country that does not require a doctor's prescription for a drug, they are happy to sell you whatever you need (other than controlled substances) without a prescription. You are breaking the law, but the authorities are not able to keep up with every single package entering the United States from overseas.
Many ethnic grocery/convenience stores such as bodegas (small grocery/convenience stores found in Latino neighborhoods), sell antibiotics.
Since I live in New York City, we conducted our experiment in Washington Heights, a vibrant immigrant community with a large native Spanish speaking ex-pat population.
Our undercover investigator went into several bodegas and explained that she had a sore throat and needed antibiotics. Two out of seven stores had antibiotics for sale.
One store had "Gimalxina", a brand name for amoxicillin. She bought 20 capsules for $10.00. Another store had generic ampicillin and tetracycline for $0.60 per pill. They also had other medicines for sale (such as diuretics and birth control pills but that's another story).
People who buy medicine from ethnic markets are typically poor and originate from cultures where buying antibiotics over-the-counter is the norm.
A 2002 NY Times article indicated that Chinese and Russian immigrants easily purchase antibiotics and other prescription drugs in small markets.
Selling prescription medicines to Americans is a huge industry in Mexico. The main shopping streets in border towns such as Tijuana and Nagales are lined with pharmacies.
We took a bus from downtown San Diego across the border to Tijuana, Mexico. There, we were able to buy 14 tablets of brand-name Cipro 500 mg (ciprofloxacin) for $35.00 US. 96 capsules of Amoxicillin 500mg went for $18.95. Levaquin was harder to find but we were able to buy 15 tablets of the generic for about $25.00.
South of the border you can walk into any drugstore and buy antibiotics over-the-counter. It's just like buying Tylenol or Advil. No prescriptions are needed and nobody asks any questions. So, if you live within driving distance of the Mexican border (like in San Diego, or El Paso) this is a piece of cake.
Why do people feel they need antibiotics
without a prescription?
Why not do what everyone else does - go to the doctor, get a prescription and take it to the drugstore?
There are many reasons people don't want to obtain antibiotics the traditional way:
Persistent Infections - such as urinary tract infections. You feel burning discomfort down there with an urgency to urinate and you know right away what you have because you get it all the time. It is a pain in the neck having to run to the doctor for an expensive examination when you know what you have and what you need.
Skin Conditions - People who suffer from acne or rosacea often take antibiotics propholactically to prevent flare-ups. They prefer to buy a large quantity of medicine for a cheap price rather than visiting dermatologist every time they need a refill.
Poverty, Lack of Insurance, Cultural Norms - many people (such as undocumented immigrants) work for small businesses. They get zero benefits. They can't afford the doctor and they cant afford American drug prices. Often, they come from cultures where prescriptions are not required for antibiotics.
Why Is Buying Prescription Drugs Without A Prescription Dangerous? If you get your antibiotics without going to a doctor and getting a prescription, you can get yourself in trouble:
Antibiotics are not a cure-all. They are only effective to against bacterial illnesses. They are not effective against viral illnesses.
Antibiotics are designed to combat specific ailments. For instance, penicillins (a family of drugs with names ending in "-cillin" such as penicillin, amoxicillin, ampicillin) are effective against streptococcal infections, syphilis, and Lyme disease but for community-acquired pneumonia, bacterial diarrhea, mycoplasmal infections or gonorrhea you would be better off using a quinolone (a family of drugs with names ending in "-oxacin such as levofloxacin (Levaquin) or Ciprofloxacin (Cipro).
A doctor is an expert in knowing which antibiotic to use for specific ailments. If an untrained person uses the wrong antibiotic his condition may get worse and he may wind up in the hospital.
Antibiotics can cause side effects. If you take an antibiotic that you are allergic to you could develop an anaphylactic reaction, go into shock and die. Other antibiotic side effects include nausea and diarrhea, abdominal pain, liver toxicity, brain and kidney damage or even pseudomembranous colitis.
Interactions (Drug, Food, Alcohol)
Certain antibiotics should not be mixed with other drugs, foods or alcohol. Mixing cephlosporins (such as cephalexin) with alcohol could cause nausea or abdominal cramps. Drinking grapefruit juice with erythromycins or taking erythromycin with theophylline (a drug used for respiratory ailments) can cause fatal heart arythmias. There are many other interactions that doctors know about but you don't.
No-prescription antibiotics are likely to be misused leading to drug resistance. Drug resistant germs are difficult to treat and have spread into the community wreaking havoc on our healthcare institutions.
Buying antibiotics without a doctor's prescription is easy. The drugs are inexpensive. This is a potentially dangerous practice but it is unlikely to stop because it is a low priority for law enforcement institutions.
Appendix; Internet Resources:
No Prescription for Antibiotics? No Problem
[NY Times; November 12, 2002; HOWARD MARKEL]
New England Journal Of Medicine
Obtaining Antibiotics without a Prescription
N Engl J Med. 2002 Jul 18;347(3):223.
Rev Saude Publica
Adverse events to antibiotics in inpatients of a university hospital
Rev Saude Publica. 2007 Nov 5
Some New York City stores are selling antibiotics illegally over the counter
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This Page Last Updated: 4/17/2014