AbstractIntroduction and Aims. Prescription drug misuse and related harms have been increasing considerably over the pastdecade. At the same time, there has also been rapid growth in the use of online and Internet technologies.Thus, it is importantthat we understand the role online and Internet technolog ies play in prescription drug misuse. Design and Methods.Published work addressing the role of technology in prescription drug misuse is explored.Topics include: Internet supply, onlinemonitoring of prescription drug use trends and electronic prescription monitoring. Results. Little is known about the prevalenceof acquiring prescription drugs from online pharmacies. Prescription drugs are easily accessible through vendor websites, and‘rogue’ no-prescription websites have proven difficult to control.There has so far been limited application of real-time monitoringto prevent overuse of prescription medications. Online monitoring of drug use trends may also prove to be a useful and timelysource of information about new methods of ‘off-label’ prescription drug use. Discussion and Conclusions. Technology hasthe potential to play a more prominent role in facilitating drug acquisition, while also enhancing the monitoring and preventionof prescription drug misuse. As technology becomes more ubiquitous in everyday life, the continued investigation of itsrelationship with prescription drug misuse becomes even more important. [Nielsen S, Barratt MJ. Prescription drug misuse:Is technology friend or foe? Drug Alcohol Rev 2009;28:81–86]Key words: prescription drug misuse, drug trend monitoring, online discussion groups, online pharmacies,electronic prescription monitoring, Internet.