NEW DELHI: Artificial intelligence is making it easier for people to buy restricted drugs, from antibiotics to addictive drugs and high-risk psychotropic drugs, raising serious concerns about patient safety, drug misuse and regulatory failures.After being informed by a doctor who said one of his patients was taking antibiotics based on a fake prescription generated by artificial intelligence, TOI launched an investigation to ascertain whether such prescriptions could be convincingly created and used to purchase medicines.We have asked ChatGPT to create AIIMS OPD card using the institution’s logo and names of AIIMS doctors. It refused, saying it “amounted to impersonation and could be used as an official medical document”. ChatGPT proposes alternatives such as unbranded generic government hospital OPD cards, private clinic prescriptions with fictitious details or clearly labeled mock samples. When prompted, it creates a generic government hospital OPD card. However, Grok, another AI platform, produced an old OPD card with the AIIMS logo.Times of India found that images of prescriptions from government and private hospitals could be easily downloaded and edited from the internet, with patients’ names, ages, diagnoses, medications and dates changed. ChatGPT also provides standard government-style prescription formats with dosage and frequency instructions, such as BD or SOS.Therefore, prescriptions can be created with the name of any real or fictitious hospital, making it possible to purchase antibiotics and psychotropic drugs from online platforms or general pharmacies without consulting a doctor. TOI has copies of bills and AI-generated prescriptions that closely resemble real medical documents.The fake prescriptions were used to purchase antibiotics including Norflox 400, Metrogyl 400 and Azithromycin 500, which are restricted medicines, from an online platform. The “Elevate Health Clinic” and “Family Healthcare Clinic” hospitals mentioned on the prescription are fictitious and have no addresses. Still, the pharmacy delivered the medicine. However, an online pharmacy called to verify and refused to fill the prescription.Even more worryingly, Nimesulide 200mg, which was recently banned by the government, is available for purchase on an online platform, indicating that enforcement remains weak even after official banning.Dr. Sunil Rana, deputy director and head of internal medicine (third department) at Asia Hospital, said cases of people using AI-generated prescriptions to buy medicines are emerging. This is especially dangerous with antibiotics, where the wrong drug, dose or duration can lead to antimicrobial resistance. “Increasingly, I’m seeing difficult-to-treat infections due to improper antibiotic administration,” he said, warning that poor prescription verification at some pharmacies increased the risk.Although some drugs are not available on online platforms, The Times of India was able to purchase the highly dependent opioid painkiller tramadol and the psychotropic anti-anxiety drug alprazolam from offline pharmacies, highlighting serious loopholes in drug sales verification. At one store, the seller was hesitant at first but eventually handed over the drugs without a bill, later scrawling details on plain paper after reporters insisted on the documents.Dr Om Prakash, professor at the Institute of Human Behavior and Allied Sciences (IHBAS), said drugs such as alprazolam and tramadol are suitable for short-term use under medical supervision, usually for a few days, to treat acute pain, anxiety or distress. He warned that taking them without medical evaluation could carry a high risk of abuse and dependence with long-term use.In countries such as the United States and Canada, patients do not have direct access to prescriptions. Doctors electronically send prescriptions to pharmacies, which can be filled only after identity verification.According to India’s Drugs Act, Schedule H and Schedule X drugs can be sold only on prescription by a registered medical practitioner. However, weak enforcement and verification by online and offline pharmacies have long subverted the law. The rise of AI-generated prescriptions has now created a new gray area, allowing seemingly legitimate documents to pass review without review.Rajiv Singhal, general secretary of the All India Chemists and Pharmacists Organization, said if the government wants to control antimicrobial resistance and drug abuse, it must take immediate action against platforms or AI tools that enable such practices. “Such activities should be condemned and stopped. Otherwise, it may turn into a serious public health problem with unpredictable consequences,” Singhal said.
