Characteristics of Online Pharmacies Selling Adderall (Amphetamine/Dextroamphetamine)

Abstract Background Adderall (amphetamine/dextroamphetamine) is a controlled substance with harmful adverse effects if abused or misused. Accessibility of Adderall from online pharmacies has not been documented. Objectives Assess the availability of Adderall from common search engines, and evaluate the safety and marketing characteristics of online pharmacies selling Adderall. Methods From December 2019 to February 2020, the phrase ‘buy Adderall online' was queried in four search engines. The first 100 results of Google and Bing, and the first 50 results of Yahoo and DuckDuckGo were screened. Online pharmacies that claimed to sell Adderall, had unique uniform resource locations (URLs), were active, free-access, and in English language were included. Online pharmacies were categorized as rogue, unclassified, or legitimate based on LegitScript classifications. Safety, marketing characteristics, and costs were collected. Results Of 62 online pharmacies found to sell Adderall, 61 were rogue or unclassified. Across all rogue and unclassified online pharmacies, prescriptions were not required (100%), pharmacist services were not offered (100%), and quantity limits were not placed on the number of Adderall purchases (100%). Rogue and unclassified online pharmacies appealed to cost, claiming price discounts (61%), providing bulk discounts (67%), and offering coupon codes (70%). Contrary to these claims, cheaper prices were available from GoodRx than from rogue and unclassified online pharmacies across all formulations and strengths of Adderall. Rogue and unclassified online pharmacies promoted and enabled illicit purchase of Adderall, appealing to privacy (74%), offering purchase through cryptocurrency (74%), and claiming registration or accreditation of their sites (33%). Conclusion Rogue online pharmacies are pervasive in search engine results, enabling the illicit purchase of Adderall without a prescription. Consumers are at risk of purchasing Adderall, a medication of high abuse potential, from unsafe sources. Law enforcement, regulatory agencies, and search engines should work to further protect consumers from unregistered online pharmacies selling Adderall.