In March 2004, The British Medical Journal reported on the International Narcotics Control Board statement on the sale of drugs over the Internet. They highlight popular drugs such as sildenafil (viagra) and fluoxetine (Prozac) - who hasn't received email about these substances!? It is interesting that some of these drugs are associated with so-called 'lifestyle' enhancements. While the lack of regulation over online drugs is significant, I wonder how much of their concern is about how these drugs reflect a shift in the way people use and perceive medicine. One of the difficulties facing the medical profession is how to curb the tide on lifestyle medicine. There seem to be a number of legal and moral questions arising from the development of online pharmacies and, even if the current regulations offer a structure through which action could be taken against a dodgy company, we need to take into account how online pharmacies are different social spaces, compared with high-street retail outlets. For example, how does a physician take a history of their patient through the Internet? What relationship between the physician and patient is possible?

There also seem to be difficult boundary issues facing regulation. Even if the legal issues are similar to the importation of substances from one place to another, the manner in which people transcend these boundaries is radically different - it is much easier to click on a website of a company in a country far away, than it is to go there or connnect with a supplier in that country.