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