Sir: In his paper on the potential influence of the internet on suicide, Thompson (Reference Thompson1999) considered the availability of dangerous information and the existence of certain sites advocating suicide. Several cases of completed suicide, using methods described on the internet, have been reported since the first such UK report on the subject in 1998 (Haut). We wish to report a case in which the internet's rapidly developing market-place provided the drug employed in a successful suicide.
The patient, a thirty-four year old male, was admitted after an overdose of clomipramine. This had been obtained from an overseas pharmacy, which sold prescription-only drugs on the internet without the need for a prescription. After discharge, the man took a second and fatal overdose of clomipramine that had been obtained, against our advice, from the same source. We were surprised at the ease with which it is possible to obtain a wide range of prescription-only drugs via the internet. One site, for example, offered a list of overseas pharmacies and included advice on how to avoid legal difficulties in obtaining drugs from them.
The sale of prescription drugs in the UK is controlled by the Medicines Act, but the purchase of such drugs from overseas pharmacies seems to fall into a legal grey area. All that UK authorities can currently do is stop such medications at customs control. It has recently been reported in the press that the Medicines Control Agency and the National Criminal Intelligence Service are starting to work with other countries to develop international standards to control the sale of drugs on the internet.
The internet can provide both the information and the physical means enabling people to commit suicide. We are used to considering our clients' use of illegal substances or legally obtained prescription drugs, but increasingly we may need to be aware of their use of illegally obtained prescription drugs.
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