Dark-web dealers are quitting Class As to push a new kind of stash – prescription medications – and young British men are among their primary targets. With online anonymity making transactions easier than ever, can the problem be untangled? MH reports fro
It’s a muggy morning, and Men’s Health has a front-row seat at the denouement of a high-level drugs investigation. An exhaustive, long-term probe into a thriving organised crime network has led a group of government agents and regional police to a Premier Inn car park in Sheffield*. Here, they conduct the final briefing before the climactic drugs bust.
Heavy clouds threaten rain as the team weaves through traffic to the raid site. Several unmarked vehicles surround an ordinary-looking building – thought to be the gang’s base of operations – on an unremarkable main road. Pedestrians amble past, oblivious to what will soon take place. Inside, the perps go about their business as the team, coiled like a spring, waits for the signal.
Radios crack. Vans disgorge officers, who sprint across the busy streets and unceremoniously smash doors off their hinges. In one of the remaining cars, a few officers wait in silence. Then, a phone rings. “They’ve hit the jackpot,” an analyst says, ending the call. “No money. Just product. Lots of product. Let’s get in there.”
Meticulously organised on plastic shelves are countless drugs, now being packed into evidence bags. But there’s no ecstasy or coke here, and the government agents methodically sorting through their haul with black-gloved hands aren’t ordinary narcs: they belong to neither the National Crime Agency nor CID. They aren’t spooks or undercover operatives. They’re medicine regulators, more interested in codeine than cocaine. The sophisticated criminals taken down today fall under their jurisdiction.
Like many drug dealers today, this gang chose not to sell Class As but medications. They were illegally peddling erectile dysfunction (ED) pills, hair-loss tablets, steroids and cancer drugs – and it is the responsibility of the Medicines and Healthcare Products Regulatory Agency (MHRA) to stop them reaching your doorstep.
We have entered a new era of crime, but most people – including many government ministers and some police officers – have yet to notice. Today, almost half of all UK crimes are committed online. Drug dealers, in particular, are adopting cuttingedge digital tech at such a pace that law enforcement is struggling to keep up. The product is changing, too. In the past five years, the MHRA has seized almost £50m worth of ED drugs; meanwhile, millions of mental health drugs have entered the UK black market. And that’s just scratching the surface. “There’s a shift happening,” says Kate Mcmahon, the analyst from the car. “Organised criminals are moving prescription meds.” It’s a risk-reward thing: instead of 40 years in jail, they’re looking at just a few years and a possible fine.
Gangs have also cottoned on to our seemingly ever-increasing appetite for self-medication. The shift in methodology is, in part, a case of supply adjusting to meet demand: people are willing to go to extreme lengths to buy off-the-books meds, which means there’s easy money to be made. “Class A drugs might be what people talk about, but this is really affecting people’s lives,” says Mcmahon.
The illegal distribution of medications is primarily a dot-com problem. Almost any prescription drug can be delivered to your door via a website designed to look like that of a legitimate pharmacy, or through the “dark web” – encrypted, unindexed sites that exist beyond the reach of search engines. What you buy here lands through your letter box with all the expediency of an Amazon Prime delivery. And forget the stereotypes of nerds and hackers inputting neon-green code on a black screen (though those people love the dark web, too). More ordinary British men are using it than anyone had previously imagined.
Grasping in the Dark
Until relatively recently, drugs couldn’t reach the end user without some palmto-palm action. Thanks to the back alleys of the internet, however, you can now bypass risky contact altogether. And it seems that we are taking full advantage of this: according to the 2018 Global Drug Survey, the UK is the world’s third-biggest purchaser of narcotics on the dark web. So alarming is this trend that the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) has published a report specifically tackling the issue. “It seems likely that online markets could disrupt drug dealing in the same way that ebay, Amazon and Paypal have revolutionised the retail experience,” says Alexis Goosdeel, the EMCDDA’S director.
Adam Winstock, psychiatrist and founder of the Global Drug Survey, explains that it’s countries such as the UK with strict drug laws and a proliferation of CCTV that tend to have the most people scoring online. Dark-web marketplaces are set up to shroud transactions, wiping delivery addresses immediately after dispatch. “Identifying who the users and sellers are is challenging,” says MHRA digital analyst John Hickey. Even determining which dealers are based in the UK can prove incredibly difficult.
“The drugs you buy on the dark web arrive with all the expediency of Amazon Prime”
The MHRA often catches criminals, such as those behind the Sheffield operation, by following the money trail. “It’s how we identify the big players, and it’s often how we prosecute,” says Mcmahon. “We have a team dedicated to fraud and money laundering.” A conviction for financial crimes can lead to longer prison terms than prosecution under the Misuse of Drugs Act. But the rise of cryptocurrencies such as Bitcoin has complicated this, too, making payments untraceable.
Among the most worrying aspects of the dot-com medicines crisis is how many of the users are normal people. Thanks to user-friendly browsers such as Tor, which has millions of active users, the dark web is easily accessible to even the most technophobic 21st-century Luddite. “Five years ago, the great majority of people were very cautious,” says Hickey. “But talking to younger guys now, it’s clear they have no fear of the dark web. Curiosity takes them there. I wouldn’t be surprised if a lot of older guys were on there, too.”
Often, these medicines are imported from parts of Asia, where poorly regulated manufacturers abound. At our borders, the MHRA intercepts everything from sea containers to clothes packed with contraband. The main problem with these unregulated knock-offs is purity: they have been found to contain rat poison, antifreeze and other things you wouldn’t want to swallow. Then there’s the issue of strength. Something as benign as Kamagra – an ED drug – can have such a high level of the base compound that it could damage your heart.
Self-medicating without a doctor’s guidance is, of course, a fool’s game. In a recent high-profile case, several people died after overdosing on fentanyl, a potent synthetic opioid, which they had bought on the dark web. They were customers of a man named Kyle Enos, who had distributed the drug from his flat in Wales, sometimes offering buy-one-get-one-free deals. Enos is now serving an eight-year prison sentence. (Investigators could not prove conclusively that Enos had supplied the specific drugs that killed them.) His wares came from China.
But not everything originates overseas. The UK has a problem that the MHRA classifies as the “diversion of medicines”: a term for when drugs are siphoned from the legal supply chain and sold on. It could be at the manufacturer’s end, in transit, or, as is often the case, from corrupt pharmacists. That may sound like something out of Breaking Bad, but the problem is all too real for regulators. Between 2013 and 2016, £200m worth of medicines disappeared from the supply chain, to be sold on the black market.
Many different drugs are moved, but a popular choice is mental health medicines. “We’re talking about drugs like diazepam [often taken for anxiety] and temazepam [for insomnia],” says Mcmahon. “Packets of diazepam are being sold for £40 or £50. Some of these medicines are highly addictive, which can have catastrophic results. Tackling this is one of our top priorities at the moment.”
The Chill Pills
The misuse of mental health meds is hard to quantify and even harder to instigate action against. The dark web makes tracking sales a Sisyphean task, and bringing meaningful statistics to politicians can be more difficult than rolling boulders up London’s Parliament Hill.
It was for this reason that Cylab, a privacy and security research institute at Carnegie Mellon University in the US, attempted to quantify what it could within the now defunct dark-web marketplace Silk Road (which, before its closure, processed more than $1.2bn in sales). The researchers found that the four most popular sales categories were drug related – nine of the top 10. That Silk Road was ostensibly a drugs marketplace wasn’t surprising. But what was surprising were the types of drugs being bought.
Weed was number one, as you’d expect. At second place were miscellaneous “drugs” – those that the seller hadn’t further classified. Numbers three and four were the real humdingers: “prescription” and “benzos”, respectively, the latter a colloquialism for benzodiazepines: medications such as Valium and other anti-anxiety drugs. These came far above cocaine, at number eight, and MDMA, at number 12.
After Silk Road was dismantled, other dark-web marketplaces were quickly established, with every shop shut down seemingly replaced by another two. Researchers have cast the net wider, and the stats are alarming. The UK, the Oxford Internet Institute found, is second only to the US as a black-market consumer of the anti-anxiety drug Xanax, and more than a fifth of Xanax trades on the dark web are in the UK. Overdoses of the drug can be fatal. While some of its popularity can be attributed to the use of benzos by rappers (the artist Lil Peep died from an overdose of Xanax and fentanyl last year), it is also considered a symptom of an overstressed, anxious populace looking for an escape.
“In just three years, £200m worth of meds entered the UK’S black market”
The US is already treating the spiralling use of illicit mental health drugs as an emergency. Now, many MPS are warning of an emerging crisis in the UK – but we’re already well beyond that stage. We know that 130 million benzo drugs have entered the UK black market since 2014, but the dark web’s secrecy makes the real number hard to pin down. It is doubtless far higher.
Take It Like a Man
It’s unlikely to be a coincidence that all of this comes at a time when reported cases of mental ill health have increased by a third in just four years. Prominent among the rising conditions are three that are intrinsically male: bigorexia (body dysmorphia among men), impotence and performance anxiety. All are perceived to have a pharmaceutical solution.
Body dysmorphia is an all-consuming condition that often results in one untoward purchase or another. Aside from the human appetite for cheats and quick fixes, the boom in steroid use can be linked to industrial decline and the loss of more traditionally “masculine” jobs. “Even when you’ve lost control over aspects of your life, you still have control over your body,” says Jim Mcveigh, director of the Public Health Institute. “These aren’t crazy people taking decisions with no basis in logic. For many, it makes sense in their minds. Until we go behind the headlines to see how intelligent they are and actually try to understand their motivations, we won’t be able to engage with them.”
The Sheffield gang shifted steroids by the bucketload, alongside growth hormone and breast cancer medication, which some men use to cut fat from the pecs area. It’s not by chance that so many are finding these drugs. The fake online pharmacies are designed to play on our biggest insecurities, or, perhaps, our honest motivations.
“Criminals are using analytics to target vulnerable people – those searching for things like ‘lose weight fast’ or ‘cheap diet pills’,” says MHRA spokesperson Joseph Groszewski. “We’re seeing a level of sophistication where they can track your interests, then trick you with legitimate-looking adverts.” Steroids? Add them to your basket. And how about some hair-loss meds with that?
“It’s not uncommon to find steroids being sold on the same websites as, say, ED meds,” says Hickey. “They use functions similar to those you see on Amazon – if you bought this, then you might like this. It’s like an online supermarket for drugs.”
It’s well documented that steroid use can cause erectile problems, and many users take ED pills as part of their stack. Less well known is the extent to which such problems are proliferating among the general population. The MHRA’S £50m haul of ED pills is likely only a fraction of what is being shifted illegally in the UK; the number of drugs that slip through the net is anyone’s guess. And if we know that fake pharmacy users are generally younger than the conventional ED age bracket of 60-plus, then an important question arises: who is taking them?
ED suffered by millennials is woefully underserviced and under-reported, due in no small part to the shame that many feel about their condition. But, according to a study in the Journal of Sexual Medicine, a quarter of new ED patients are under the age of 40. It’s unlikely that there has been a sudden surge of physiological difficulties in men in their teens and twenties – were that the case, we’d be seeing an epidemic of related issues, such as heart disease. Some experts posit instead that the increase is related to a psychogenic disorder called porn-induced erectile dysfunction. The theory – and it remains a theory, as peer-reviewed testing is
pending – is that the volume of (and easy access to) pornography in the digital age is burning us out. There are numbers to back this up: men are visiting porn detox sites such as Reboot Nation and Your Brain on Porn in their hundreds of thousands.
“There are thousands of sites selling ED meds,” says Hickey. “A lot of men are buying them, whether that’s because they’re on other drugs, or they’re too embarrassed to discuss it with their GP.” To combat this, Viagra – which used to require a red-faced chat with a doctor who probably knows your wife and family – can now be bought over the counter. But it still requires speaking to pharmacists, most of whom are female. “I haven’t noticed a drop-off in [illegal] sales because of it,” says Hickey.
It seems that many men are intent on continuing to shop illegally for drugs online, putting their lives at risk. Professor Winstock considers it the natural next step for a society spoiled by convenience and the expectation of a large product range for everything. When it comes to meds, unrealistic ideals are driving us towards these pharmaceutical solutions. Men have unattainably high expectations of themselves and even higher expectations of sex, and it’s getting us down. We need to talk more about body dissatisfaction and our anxieties. We need to start looking at steroid users as people with mental health disorders, treating them with empathy, rather than labelling them
as freaks. It stands to reason that these problems are underpinning many of the unsafe online medicine sales.
Dark-web dealers are becoming ever more dangerous and elusive. Fighting dot-com drug dealers is like battling the Hydra: Silk Road is gone but, since its demise, there has been a threefold increase in the illicit sale of drugs online. The “surface web” is no less elusive. “Websites are wising up to our methods,” Mcmahon says. Criminals are becoming ever more sophisticated, which is a challenge to all law-enforcement agencies – whether they are tackling cyber-fraud or cyber-chemists. “How do you police the internet?”
In Portugal, which decriminalised illegal drugs 17 years ago, just three in every million people die from an overdose, compared to the EU average of 17.3. The dark web’s trade in medications, however, requires a different solution: after all, you can’t decriminalise drugs that are also prescribed legally. Perhaps we should look to the US for pointers. There, some of these medications have been democratised in the private sector, and start-ups are helping to educate people about the issues and allow them to shop safely. Hims, an online company that offers anonymous, doctor-dispensed ED and hair-loss meds, has been such a success that a recent valuation pegged it at $800m. There’s clearly a hunger for simpler, subtler transactions for drugs that many people are too embarrassed to buy openly. Without such a change, men will continue to weigh safety against discretion and make the wrong decision.
The motivations behind the purchases of depression and anxiety meds are less clear, but the problem is indicative of the wider web in which male mental health is entangled. For many men, there are few places to seek help without feeling shame. Anonymity is, perhaps, at the heart of it all – the lack of which is driving men away from the GP’S office and into the hands of online drug dealers. Until we dismantle the needless stigma surrounding mental ill health, anxiety and other particularly male problems, the dark web’s promise of going incognito will continue to lure victims – and the future won’t just be dark online, but in the real world, too.
“The dealers are becoming ever more tech-savvy. Can we police the internet?”