Correspondence

Web Sites with Misinformation about Illicit Drugs

N Engl J Med 2001; 345:469-471August 9, 2001

Article

To the Editor:

As part of our research on the relation between the Internet and substance abuse, we have identified several Web sites that promulgate information about illicit drugs. These “partisan” Web sites are easily identified by common search engines if one uses the names of illicit substances as search terms.1 With some pages viewed more than 160,000 times per day, partisan sites appear to be effective in reaching adolescents and young adults. In a recent study, 24 percent of college students used the Internet to obtain information on illicit substances, and 27 percent of Internet-using college students reported that Internet use increased the likelihood that they would use drugs.2

The popularity of partisan Web sites may arise from their plausible descriptions of the preparation, dose, administration, and psychoactive effects of drugs (Table 1Table 1Features of Partisan Web Sites as of May 24, 2001.). Partisan sites also offer recommendations for management of the adverse effects of illicit drugs. As one partisan site says, “it is up to the drug user to stay out of [the physician's] hands.”11 To evaluate the quality of such information, we conducted a survey of seven partisan Web sites. With high interobserver reliability (kappa=0.81) between experts unaware of the source of the information, we found that every partisan site made potentially harmful recommendations for the management of the adverse effects of illicit drugs. Information from partisan sites has been linked to adverse outcomes: some partisan sites have described their own role in the deaths of drug users and some have been implicated in poisoning from 1,4-butanediol.12,13

Unfortunately, Internet-based efforts to prevent drug use may not deflect visitors from partisan Web sites. We performed five separate searches using identical key words (“GHB” [γ-hydroxybutyric acid], “ecstasy” [methylenedioxymethamphetamine or MDMA], and “psychedelic mushrooms”) over a period of 10 months. Our first two searches listed 8 partisan and 2 federal antidrug Web sites in the top 10 results. The third search identified nine partisan sites and one federal site, whereas the final two searches identified eight partisan and no federal sites. In all searches, antidrug sites from the federal government failed to appear as often as the partisan sites, which dominate the search results. Moreover, sites of the Federal Website Initiative, part of a billion-dollar multimedia program for the prevention of drug abuse, did not appear in any of the search results. These data suggest that the U.S. government, despite extensive and costly efforts, currently does not provide effective alternative sources of information about drugs on the Web, where partisan sites still get the attention of both search engines and users.

Edward W. Boyer, M.D., Ph.D.
Michael Shannon, M.D., M.P.H.
Patricia L. Hibberd, M.D., Ph.D.
Children's Hospital, Boston, MA 02115
edward.boyer@tch.harvard.edu

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