Pubdate: Thu, 21 Jul 2005
Source: Daytona Beach News-Journal (FL)
Copyright: 2005 News-Journal Corporation
Contact:  http://www.news-journalonline.com/
Details: http://www.mapinc.org/media/700
Note: gives priority to local writers

DRUG WARS

Online Pharmacies Can Become 'Pill Mills'

When Florida authorities raided a group of Internet-based pharmacies
last week, a ripple of anxiety spread among people who use
no-questions- asked Web sites to order powerful pain-killers and
psychoactive drugs.

By Wednesday, the panic died down and online discussions turned to
more mundane matters -- which pharmacies had the best prices, required
the least documentation, shipped the fastest.

We live in a time when many surf from Web site to Internet forum,
looking for drugs they believe they need to manage pain -- or
medications to which they've become addicted. Online "pill mills" that
cater to these individuals sell drugs on demand, with little
counseling as to side effects. Unlike legitimate online drug-discount
sites that honor valid prescriptions, pill mills charge exorbitant
prices. For example, a hydrocodone prescription that wholesales for $7
might cost $200.

The shadiest sites operate by providing an online "consultation" with
a supposedly licensed doctor, who looks at the answers to a few
questions and then writes a prescription -- usually just what the
"patient," who is never examined in person, has ordered. Many of these
pharmacies operate out of Florida.

The state Department of Health has punished several doctors associated
with prescription sites, including some that did not have a valid
license. The Florida Department of Law Enforcement, the state Attorney
General's Office and the U.S. Drug Enforcement Agency recently
cooperated in a sting that culminated with last week's arrests --
overall, 22 individuals were arrested and more than 650,000 pills were
seized.

But as soon as one operation is busted, another springs up. Law
enforcement can't track down and arrest every online pill mill
operator; there's not enough manpower or time.

One measure that may help is enforcement of "pedigree" laws, which
track the distribution of wholesale drugs from manufacturers to
dispensing pharmacies. Florida has one of the most progressive
pedigree laws in the country. With time, it could help track the flow
of drugs to clusters of illegal online pharmacies.

Another useful prohibition would prevent any Florida-licensed doctor
from prescribing drugs for patients he or she has not seen in person
at least once. That would put a stop to the online consultations that
fuel the most exploitative sites.

One proposed cure, however, would be worse than the disease. Federal
legislation to fund state databases listing every prescription filled
- -- including patient names -- threatens medical privacy. This kind of
database could make the underground pill problem worse by chilling
doctors' willingness to prescribe certain controlled medications. Many
complain that doctors are already unwilling to prescribe effective
painkillers, a claim backed up by University of North Florida
political-science professor Ronald T. Libby, who says the government
is waging an "aggressive, intemperate, unjustified war on pain
doctors," leading many to stop prescribing painkillers like OxyContin
- -- and driving more patients toward unethical pill mills.

Attempts to stop online pill-peddling should be targeted at the
dealers, not customers. Better legislation would help target Web sites
that sell drugs to patients without valid prescriptions and make it
easier to prosecute violators. That's the healthiest approach, and the
one Florida officials should embrace.
- ---
MAP posted-by: Derek