At any given time, between 30,000 and 40,000 illegal online pharmacies hawk substandard prescription drugs to unsuspecting patients. Law enforcement and government agencies have a steep hill to climb in stopping them, but “lock-and-suspend” shows promise. Our newest Rogue Rx Activity Report explores how locking and suspending the domain names of these sites directly impacts patient safety. 

Most illegal online pharmacies belong to organized criminal networks that oversee thousands of related websites. If a few random network sites are taken offline, not much happens because the network has thousands of backups. However, when a significant number of a criminal network’s domain names are locked and suspended, the network can no longer fund its operation, and it collapses.

In 2021, drug overdose killed 107,622 Americans. Authorities tie overdose deaths to illegal online pharmacies.


To demonstrate the impact of lock-and-suspend, we reviewed estimated website traffic of three domain names that were used to illegally sell prescription drugs, including controlled substances. In one case, prior to being locked and suspended, an illegal online pharmacy had between 12,247 and 23,581 monthly visits. Shortly after it was suspended, the visits dropped to zero. 

The site was never reactivated, meaning tens of thousands of future patient encounters did not occur. Website visits translate into patient harm: patients who could be spared from drug overdoses, suboptimal therapies, or identity theft. 

These harms are not theoretical. In 2020, Charlie Ternan fell victim to a #counterfeit pill bought through social media. He thought it was Percocet, a prescription painkiller, to help with back pain. Instead, the tablet was a fake, filled with fentanyl. He was dead within 30 minutes.

His mother, Mary, believes he might still be alive if it weren’t for the criminal networks that peddle these fake medicines on social media and via illegal online pharmacies.

“They’re evil and it’s all about their bottom line, which is the money,” Mary said in this video. They’re just taking all these innocent people, taking their lives.”

Lock-and-suspend, when used at scale, serves as a powerful and unique choke point to stop illegal online pharmacies. We applaud businesses that have taken voluntary action to shut down illegal online pharmacies; however, without government intervention, there is insufficient incentive for the domain name industry to course correct.