Unlike legitimate online pharmacies, rogue sites have very little or no medical monitoring, yet consumers can select from a wide selection of painkillers, antidepressants, stimulants, and steroids.

"It's like rabbits," said Wayne A. Michaels, a senior investigator for the Drug Enforcement Administration (DEA). "Every day, there are more of them. They're up, they're down, they're foreign, they're domestic."

In Nevada, for instance, the Nevada State Board of Pharmacy uncovered in a report that a small Internet pharmacy had filled 1,105 prescriptions for painkillers and other dangerous drugs in July 2002. Six months earlier, the same pharmacy had filled only 17 prescriptions.

In just one year, prescriptiononline.com had become one of the largest distributors of controlled substances in the state. Nevada regulators have since shut down the site.

"For any single pharmacy to account for 10 percent of any drug is incredible," said Louis Ling, general counsel to the Nevada pharmacy board. "The fact that it was a highly addictive painkiller and an Internet site run by a convicted felon was even more troubling. This was unlike anything we had ever seen."

Many of the websites work with middlemen who link customers with doctors who write a prescription. Many of these physicians have financial problems or histories of addiction or medical incompetence.

To combat the problem, the DEA recently formed a six-person task force to track online narcotics sales. But Laura M. Nagel, DEA's deputy assistant administrator, said trying to police the increasing number of online pharmacies "is like trying to work every corner drug dealer. We can't do it all."

In addition to the DEA, the Food and Drug Administration (FDA) is concerned about the rapid growth of foreign online pharmacies. However, the agency's strongest enforcement tool is a warning letter.

"As an investigator, it's incredibly frustrating," said Robert J. West, a special agent with the FDA's Office of Criminal Investigations. "All we can do is bang away and try to draw attention to what these guys are doing. Right now, I don't think people have any idea how widespread or dangerous this is."

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