Enter “buy cytotec online cheap” into Google’s search engine and the first four results are sites that illegally offer to ship the abortion pills without a prescription.

Despite the Supreme Court’s ruling last month that gave states the right to ban the procedure, it’s still possible to get abortion medication, even in states where it’s restricted, through telemedicine or by traveling across state lines. But the patchwork of state rules is nonetheless fertile ground for scammers looking to make money off desperate abortion patients who don’t know how to navigate them.

The bad actors pose a public health threat that’s likely to grow now that eight states have banned abortion and another four have restricted it to the first six weeks of pregnancy, public health experts told POLITICO. While patients might get real pills, rogue online pharmacies sometimes sell counterfeit or expired drugs, don’t fill orders, or steal credit card numbers. And the government is ill-positioned to stop them. The FDA, which tracks all drugs going to pharmacies, lacks the subpoena powers that would help reveal who’s behind websites so they can be taken offline.

Google says it’s usually not able to determine when sites are breaking the law, but will remove them from search results when the government asks.

Cytotec, the name-brand version of misoprostol, is an FDA-approved prescription drug for treating stomach ulcers. It is also one of two pills used to end a pregnancy. According to a statement from drugmaker Pfizer, Cytotec is a target for counterfeiters.

Though there are legitimate telemedicine operations and online pharmacies helping connect people online in states that limit abortion, they sometimes have difficulty promoting their services. Illicit pharmacies, meanwhile, are adept at circumventing Google’s rules and rising to the top of search results.

Price is also an issue. Rogue sites are selling Cytotec for roughly $4 per pill, a little under the typical cost per Drugs.com, a New Zealand firm that tracks prices. More than half of abortions in the United States are already induced by medication, according to the Guttmacher Institute, a research group that supports abortion rights. That share will likely rise following the Supreme Court’s decision, providing a huge market to exploit.

Online searches for medication abortion skyrocketed after POLITICO published the Supreme Court draft opinion that preceded the overturning of Roe v. Wade.

What they find is often labyrinthine. Of the roughly 35,000 online pharmacies worldwide, 95 percent operate illegally, according to the National Association of Boards of Pharmacy.

The FDA’s criminal investigators are responsible for going after illegal pharmacies and counterfeit drug operations. It’s a tough assignment. Online, drug dealers can hide their tracks and disappear in an instant. Additionally, the office doesn’t have the necessary enforcement tools to take down sites, especially when dealing with uncooperative domain registrars.

“You could register a domain name anonymously from anywhere in the world and offer pretty much anything you want on it — and good luck trying to shut down that site, because you don’t know who’s operating it,” said Baney of the Alliance for Safe Online Pharmacies.

Full story at Politico.