Inside the Underground Trade of Prescription Drugs

Flashpoint analysts have observed a thriving prescription drug trade on both the surface web and the Deep & Dark Web (DDW), with vendors advertising everything from high-risk, controlled substances such as Xanax and OxyContin to more benign medications, such as inhalers and eye drops.

Surface-Web Pharmacies

Surface-web pharmacies are online stores that sell a variety of prescription drugs. Some are run by legitimate pharmacists based outside of the U.S., offering cheaper, generic medications to consumers in countries where healthcare is more expensive. However, Flashpoint analysts have also uncovered multiple surface-web pharmacies offering drugs with high risk for addiction or abuse, such as tramadol, Valium, and various sleep aids. While many online pharmacies recommend following a doctor’s advice, no prescription is required to purchase drugs from these vendors.

Among prescription-drug vendors on the surface web, certain pharmacies have become especially prominent, including one that is operated by the owner of a pharmacy in India. Fully licensed to operate in India, this particular vendor claims to buy the drugs they sell from the same manufacturers that supply billion-dollar pharmaceutical companies. This vendor also claims that most of their clients are based in the U.S., the U.K., and Australia.

Prescription Drug Vendors on the DDW

Many surface-web pharmacies also maintain a presence on the DDW. Flashpoint analysts assess with a moderate degree of confidence that persistent law enforcement takedowns of surface-web pharmacies are contributing to the increased presence of prescription drug vendors on the DDW, since operating on the DDW protects the anonymity of vendors and their clients.

In addition to operating on large cybercriminal marketplaces, many DDW vendors also sell their products on specialized drug marketplaces. The use of Bitcoin and other cryptocurrencies helps obfuscate transactions carried out in these spaces, subverting law enforcement efforts to track funds exchanged between actors engaging in illicit drug trade.

Origins of DDW Prescription Drugs

The origins of prescription drugs for sale on underground marketplaces are not fully known. Flashpoint analysts assess with a moderate degree of confidence that a portion of DDW drug vendors manufacture and sell their own imitation versions of popular prescription drugs. Flashpoint analysts observed DDW actors exchanging drug manufacturing guides, as well as instructional videos showing the production of prescription drugs such as Xanax. Equipment for manufacturing drugs—such as scales, vials, flasks, powder grinders, and pill presses—is also available on the DDW.

Flashpoint analysts also believe some of the drugs sold on the DDW are diverted from legitimate pharmaceutical supply chains by malicious, financially motivated insiders. Many DDW consumers prefer these diverted drugs over those manufactured by DDW drug vendors, because they feel they can better trust the quality of the product.

Harm Reduction

As a result of the high risks associated with the unregulated sale of controlled substances, a significant harm reduction subculture exists within the drug-trading communities of the DDW. One of the most prolific members of this community is a Spanish doctor who has answered questions across various underground communities regarding how to safely use controlled substances and illegal drugs. Flashpoint analysts have not identified any DDW activity by this doctor since 2015, but he continues his harm-reduction advocacy by testing substances purchased from the DDW to assess their purity in hopes of making the space safer.

Assessment

Drugs constitute a large part of the underground economy, and Flashpoint analysts assess with a high degree of confidence that the illicit sale of prescription drugs on the DDW will continue. However, it is possible the sale of certain substances will decline if subjected to increased law enforcement pressure. For example, through 2016 and 2017, Flashpoint discovered that surface-web pharmacies were gradually ceasing to offer fentanyl on their platforms, likely due to an increased number of reported deaths by caused by fentanyl overdoses and the resulting increase in law enforcement scrutiny.

Law enforcement officials have also been cracking down on the sale of certain high-risk substances on the DDW. The U.S. Department of Justice cited the sale of fentanyl and heroin among reasons for carrying out the seizure and takedown of the AlphaBay Market—formerly the largest marketplace on the DDW—on July 5, 2017. In fact, the official statement announcing the AlphaBay takedown opens with the following subheading:

‘Dark Net’ Site Was Major Source of Fentanyl and Heroin, Linked to Overdose Deaths, and Used By Hundreds of Thousands of People to Buy and Sell Illegal Goods and Services Anonymously over the Internet

The sale of more benign prescription drugs, such as inhalers, is also likely to continue proliferating on the DDW. Flashpoint analysts assess with a low degree of confidence that the appeal of generic medications available on the DDW may increase if individuals perceive that legal methods of obtaining such medications are increasingly inaccessible or unaffordable.

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