Streets of London: Bypassing Prescriptions Online

The virtually no-questions-asked availability of the controversial smoking cessation drug Zyban (buproprion hydrochloride) on some British websites is causing consternation among the relevant UK authorities. There have been several news items here recently highlighting how easy it is to purchase Zyban, Viagra and ‘fat-busting’ drugs through sites run by shrewd operators exploiting the loopholes in Britain's outdated medicine laws. For brevity's sake, I'll disregard the myriad of issues surrounding regulating Internet content.

It's not that there aren't legit, conscientiously run on-line pharmacies. However British law requires a prescription, which should follow a consultation. Websites advertising and selling Zyban in bulk offer a 'consultation and prescription' but this is likely to involve the potential customer simply ticking a series of boxes, answering questions about their susceptibility to seizures, kidney troubles or other conditions, then, hey presto, an instant prescription before they enter their credit card details. There's not necessarily any follow up and, unsurprisingly, the risks aren't adequately explained on websites offering Zyban Now, Stop Smoking Now! at high prices. Incidentally, maybe high prices are the most serious disincentive to people buying treatments through these sites on an even larger scale. One site advertises Zyban at £159 for a month's supply. You can get it on the National Health Service, but GPs only prescribe it for pretty serious cases.

Let's get one thing straight: I'm not attacking Zyban per se. This non-nicotine pill has probably helped hundreds of thousands of people quit smoking, saving many lives otherwise lost through cancer and heart disease. It's been more successful than patches, inhalers and gum. However, maybe it needs to be further refined and, from a fairness point of view, one of the preconditions for a successful market economy is consumer choice based on substantive freely available information. These websites certainly aren't providing that.

Some Canadian research I've come across underscores the relative riskiness of taking Zyban. Between its introduction into Canada in August 1998 and August 1999 there were 356 reported adverse reactions to Zyban, about 50 of them involving convulsions. Sure, smoking was then killing Canadians at an annual rate of 40 000. Moreover, the 356’s out of about 630 500 prescriptions, that’s a tiny fraction(one-twentieth of one percent), but some medical experts say relatively speaking it's way too high. Moreover, London's Guardian newspaper reported recently that Zyban should be used under a doctor's supervision with 'motivational support' and side effects include anxiety, insomnia, agitation, sweating and fever. That’s quite a list to contend with.

Very importantly, with any drug people should know what they're taking. Zyban was derived from an anti-depressant and it has the same calming quality. Be under no illusion, Zyban lowers your stress levels so that you don't need ciggies, or feel you don't need them. It works indirectly. By the way, as a former moderate cigarette smoker I’m strongly opposed to smoking to deal with stress. Having a smoke to calm your nerves is like drinking Coca-Cola to quench your thirst. The 'hit' has a momentarily calming effect when you're under pressure but in the medium, let alone long term smoking contributes to much greater stress.

Anyway, I digress. It's dodgy and some Zyban vendors sell their consumers short by failing to inform them that smoking is often symptomatic of larger stress management issues, somewhat paradoxically particularly if Zyban seems to help them. GPs are the best people to consult first regarding dealing with stress and depression. Regular exercise and better diet can apparently work wonders for many people. A holistic approach is required, not a quick fix.

Smokers aiming to quit who want to use Zyban or other ingested smoking cessation aids should be aware of the likely high costs and the associated health risks that may be understated by Internet vendors looking for a quick buck. Brits have been advised by the authorities to use on-line pharmacies that insist on a real prescription being sent to them. They would be well advised to visit their GPs and have your susceptibility to seizures or any other potential risks properly assessed. And, have a check up for stress while they're at it. Last but not least, it pays to keep in mind that giving up through sheer will power, cold turkey, is often cheaper, easier and much more personally satisfying than people realise. Life as a non-smoker's considerably less stressful too.

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