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Drugs and the Internet
Robert Penezic
Attorney
Tuesday, October 21, 2003; 1:00 p.m ET
The Internet has become a pipeline for narcotics and other drugs such as painkillers, antidepressants, stimulants and steroids with few controls and virtually no medical monitoring.
Robert Penezic, attorney and former statewide prosecutor in Florida said "Internet pharmacies play a vital role in patients who would otherwise not be able to obtain prescription drugs because they would be cost prohibitive; however, as with many areas of society, criminal activity does exist in the world of Internet pharmacies," in an interview with washingtonpost.com.
Penezic was online Tuesday, Oct. 21 at 1 p.m. ET to discuss the issue of legal and illegal drugs purchased over the Internet.
A transcript follows.
Editor's Note: washingtonpost.com moderators retain editorial control
over Live Online discussions and choose the most relevant questions for guests and hosts; guests and hosts can decline to answer questions.
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Farragut West, Washington, D.C.:
Are there any bills or even ideas in Congress to address the illegal aspects of internet pharmacies? Have other countries had success in preventing abuse over the Internet?
Robert Penezic: First everyone should know that I was formally an Assistant Statewide Prosecutor in the State of Florida. However, now I am in private practice as an Associate with the law firm of Broad and Cassel. Yes there are some ideas currently being discussed in Congress. The committee on Energy & Commerce, Sub-committee on Oversight and Investigation has been addressing this problem. I encourage you to search the internet under Chairman Greenwood of that Committee.
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College Park, Md.:
What a bunch of nonsense! Illegal drugs are, of course, illegal. Period. End of story. If people drive their cars to go buy drugs, do we shut down gas stations? Hardly.
This is simply a scare campaign by the pharmaceutical industry as part of their effort to protect their patent monopoly in the US. Next they'll be saying that people escaping their monopoly pricing are supporting the terrorists....
Robert Penezic: In my view, there is a need for internet pharmacies. They can help people who would otherwise not be able to afford some prescription drugs due to cost attain them. However, as with many aspects of our society, certain criminal elements can invade an otherwise legal and honest business. I think the lesson is we shouldn't throw the baby out with the bathwater.
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Warrenton, Va.:
After reading the articles in the WP, am I to assume that online prescriptions are illegal? These sites have been around for years and because of that, I assumed that ordering diet pills was permitted.
Robert Penezic: Obviously the legality of internet pharmacies is a hot topic. What you must remember is that an internet pharmacy may be subject to state, federal and sometimes international regulations and law. Therefore, a specific sites compliance with applicable law must be addressed on a site by site basis.
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Wheaton, Md.:
Why do so many of these drugs have to be prescription in the first place? There would be far fewer problems here if paitients could simply buy them over-the-counter as needed (under a doctor's advice, of course).
It would also be a lot easier on the insurance companies and help to hold their costs down. And it would drive the Internet markets out of buisness.
Robert Penezic: Prescriptions are required for certain pharmaceuticals to be dispensed to citizens in our society because it is important to have safeguards in place, that would be lost without requiring a prescription.
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Southampton, Pa.:
Three wholesalers supply over 90 percent of pharmaceuticals to dispensing pharmacies, Internet, institutions and retail (excluding 2-3 large chains). What about requiring more due diligence on their part before opening new accounts and shipping products known for abuse?
Robert Penezic: WHen it comes to pharmaceuticals, there are a variety of issues. Although we have a narrow topic for today's discussion. The distribution of pharmaceuticals is an important issue. I think due diligence is important and can definately be improved throughout the industry. In fact, a Florida Statewide Grand Jury mentions due diligence as an important component toward assuring the safety of the nations pharmaceuticals.
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Fairfax, Va.:
If we are to continue to allow on-line pharmacies to exist, as you advocate, how can we create tighter regulations that prevent minors from getting narcotics, prevent multiple prescriptions being sent to one patient/home, etc? How can we reduce the chance of abuse?
Robert Penezic: The first line of defense to address the issues you bring to this discussion lies with the industry. Reputable companies have safeguards in place to help prevent the problems you mention. However, we have to place some responsibility on the person ordering the pharmaceuticals. One solution would be to require a signature for the product at the time of delivery by someone over the age of 18 and that signature must be returned to the appropriate entity.
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Fort Myers, Fla.:
The way I see it, the problem is not the method of delivery. The purity of the prodict delivered is the problem. How can we insure the drugs ordered are what they say and in the dose needed? Do we need some certificate of proof?
Robert Penezic: Ah a question from my hometown! This is a great question. If you have any doubt that the prescriptions that you receive off the internet are anything other than what they purport to be, you should contact your State Dept. of Health in Florida for instance, the Dept. of Health has a fantastic program in place and can assist in insuring the legitimacy of prescription drugs. They can varify that the drug is what it is supposed to be as well as track the drug from its origin to the pharmacy.
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Laurel, Md.:
If Internet pharmacies are shipping to various states, are they then under the jurisdiction of all the states they ship to? Or only the state in which they are licensed and located?
Robert Penezic: Each state has separate statutes, regulations, and rules that may address jurisdiction. So sorry, here comes a lawyer answer, it depends upon each state involved and the precise activity of the internet pharmacy.
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Washington, D.C.:
What is the relationship between the wholesale pharamaceutical industry and the Internet?
Robert Penezic: What you must realize is there exists an entire sub-culture of prescription drug wholesalers throughout the country. For instance, Florida had almost 350 licensed prescription drug wholesalers last year. The way the phamraceutical industry works, is that wholesalers buy and sell prescription drugs like a widget. Therefore, the integrity of our nations prescription drug supply depends in part on the integrity of the prescription drug wholesalers. The way these wholesaler's operate is they buy and sell prescription drugs from other wholesalers and to the nations largest prescription drug distributors. Therefore, the safety of prescription drugs that come from the internet in some cases may depend upon the safety and integrity of every person that handled that prescription drug before it ever reached the internet pharmacy. Many states as well as the federal government are currently looking at ways to effectively regulate prescription drug wholesalers.
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Atlanta, Ga.:
What is the difference between a legitimate on-line pharmacy and an illegitimate on-line pharmacacy -- one that might warrant investigation for criminal activity, seizure of assets, etc.? Thanks.
Robert Penezic: The integrity of the drugs sold i.e. are they what they purport to be? In addition do they comply with all state and federal regulations.
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Washington, D.C.:
I have been following the coverage of the online pharmacies and one obvious answer to me seems to regulate these pharmacies at the national (not state) level. Of course, we still need to deal with international distribution but when you are in N.J. ordering from a Web site in Arizona that gets the drugs from Texas and your prescription comes from a doctor in California, that's a whole can of worms because apparently you can't fully prosecute across state lines or something. Can you clarify this and explain why it is so?
Robert Penezic: Another good question. I think it would be less confusing for everyone if we had a federal law that covered this topic. Otherwise, potentially every state's laws would have to be reviewed in order to determine whether every party involved in a transaction was compliant. As you are probably aware, every state is free for the most part, to establish its own laws in order to protect and safeguard its citizen's best interests.
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Atlanta, Ga.:
Does the patient have any liability in ordering medications online --what about if they come from overseas?
Robert Penezic: As to your first question, potentially yes. It depends upon the drug and the circumstances surrounding the patients request for it. Second, in my opinion, you should use extreme caution in ordering a prescription drug from "overseas". The FDA has strict guidelines in the preparation and quality of prescription drugs that they oversee. Leaving FDA's and/or your state's regulatory channels (in my opinion) is a bad idea.
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Robert Penezic: I believe my time is up. I want to thank everyone who submitted a question. I apologize for not being able to address them all.
Some of your questions were so good, they would require hours to answer properly.
The topics addressed in the series of Washington Post articles are important ones. The area of prescription drugs from the internet as well as other methods of prescription drugs is a fast evolving one.
During this session, I "spoke" of things in general terms. There are specific regulations that may apply in some circumstances, but not all. Many statutes are fact specific. Obviosly, lawyers as well as other affected people (government and industry) may agree or disagree with me in whole or part. Some of your questions have not conrete answers as of todays date. I am sure some of your questions will have to be answered by the Courts.
I hope I was objective and informative.
Thank you for your time.
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