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Background: Opioids e-commerce represents an important public health issue. While the literature describes this phenomenon in the USA, the studies about this topic are scarce in Europe. This review aims to describe the state of the art of the online opioids commerce and to explore the factors influencing the opioids e-commerce. Methods: Scientific literature available via four bibliographic databases (PubMed, Cochrane Collaboration, ISI Web of knowledge and Scopus) was screened on June 2012. Keywords used were 'Internet and opioids', 'Online and opioids', 'Web and opioids', 'Opioid selling', 'Opioid business', 'Opioid buy', and 'Opioid sale'. After the selection, 31 articles were finally identified as meeting the inclusion criteria. Results: The online market of opioids had experienced a boom thanks to the discount prices, the poor monitoring actions, the quickness and easiness of acquiring of these drugs. Legislation on the sale of drugs online differs among the countries. We found that the opioids e-commerce and its consequences are detailed for the USA context, while there is a lack of knowledge in Europe. Conclusions: Public health impact of online purchase is worthy of consideration and additional research, considering the potential underestimation of the phenomenon. Public health interventions can be indeed hampered by the lack of knowledge of professionals about this topic. [ABSTRACT FROM AUTHOR]