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They sent consumers a self-administered electronic questionnaire. One regarded the Internet purchase and injection of gamma-butyrolactone by an year-old woman that led to admission to a pediatric intensive care unit. A year-old man with squamous cell carcinoma of the maxillary sinus, who declined to undergo surgery, radiation, and chemotherapy, decided to treat his cancer using hydralazine sulfate, obtained online; he died from fatal hepatorenal failure, probably caused by the hydralazine sulfate.

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Consumer studies have tried to estimate the number of exposed people and to identify at-risk groups. One of the major risks posed by online pharmacies is drug misuse. This issue leads to the risk of one of the most feared consequences: the possible disruption of the doctor—patient relationship, which has been widely discussed. In the context of the doctor—patient relationship, drugs purchased online can have acute effects, and even chronic and irreversible ones, and nowadays doctors should always investigate the use of nonprescribed substances in their anamnesis.

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Worldwide delivery eliminates national barriers for consumers; but the place of dispatch can be indicative of the place of production, and therefore it could be linked to drug quality. The role of the patient as an active partner in health care, and not just a passive object of diagnostic testing and medical treatment, is widely accepted.

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