Internet Prescriptions As Public Health Threat

Internet prescription drug overdoses are a threat to public health in the United States. Medical malpractice and product liability suits against the internet pharmacies, physicians who prescribe without a valid physician-patient relationship, and the pharmaceutical companies themselves currently are the only effective means to halt this public health threat.

The Centers for Disease Control last week released data that indicates that “poisoning was second only to motor-vehicle crashes as a cause of death from unintentional injury in the United States.” The report indicated that unintentional drug poisoning deaths increased 68% from 1999 thru 2004. This mortality rate increase was attributed primarily to deaths associated with prescription drugs. Fatal drug overdoses in teenagers and young adults soared 113 % during this same time frame.
What does this mean? Deaths from drugs manufactured by pharmaceutical companies, sold by pharmacies (internet and traditional), and frequently approved by physicians accounted for more accidental overdose deaths than from street drugs, such as heroin. Troubling, you bet!

According to a recent study by the Partnership for a Drug Free America, today’s teens are more likely to abuse prescription and over the counter medications, than illegal drugs. These drugs can be purchased over the internet or over the counter. The National Center on Addiction and Substance Abuse (CASA) at Columbia University reported in 2006 that 9 out of 10 internet sites selling controlled prescription drugs do NOT require a prescription.

The current president of CASA and former U.S. Secretary of H.E.W. recently stated: “Any child can get, without prescription, a highly addictive controlled substance like OxyContin, Valium and Ritalin from drug pushers.” Despite Congressional hearing, CASA reports and increased attention in the press, these drugs continue to be as easy to buy over the internet as candy. Other CASA findings indicate that Xanax and Valium are the most frequently offered controlled prescription drugs over the Internet.

Search “prescription drugs” on Google search engine and thousands of internet pharmacies appear; most like buymedsquick offer the very drugs that have caused the accidental drug overdose deaths to soar, such as Xanax, Hydrocodone, and Valium. Some ask that an online questionnaire be filled out, others only require a valid credit card. Some advertise FedEx next day delivery with DISCREET and UNMARKED packing, others offer “prescription” drugs with “no embarrassing doctor’s visits,” and most appear as unwanted spam on our e-mails with frequently a quote from the scriptures to entice us to open, e.g. Most of us just delete these messages as spam. Some, however, do respond to these e-mails and purchase prescription drugs, including opiates and other potentially dangerous medications.

Dr. Rebecca Patchin representing the American Medical Association states;

illegal Internet pharmacies and physicians who sell or dispense prescription medication without a prescription – or without a valid physician-patient relationship- are a threat to the public health

. Earlier posts on this blog have discussed medical malpractice suits that I have prosecuted against physicians who prescribe over the internet without a valid physician-patient relationship, where the overdoses the the Center for Disease Control now document have occurred. WHY DOES THIS CONTINUE?

The Internet Pharmacy Consumer Protection Act was introduced in 2004 in the U.S. House of Representatives (H.R.840) and 2005 in the U.S. Senate (S. 2464). Senator Feinstein said at the time:

With a credit card and a computer, consumers can get prescriptiond drugs without the existence of a bona fide physician-patient relationship, which can pose an immediate threat to public health and safety

. Both bills were aimed squarely at internet pharmacies, and both were referred to committees and died in Congress. WHY AGAIN?

The internet pharmacies advertising today rarely list an address, never list the states where they are licensed, nor do they disclose the names of the pharmacists filling the prescriptions. Some of the pharmacies dispense these drugs from unsanitary facilities both inside and outside the United States, and are completely unregulated and uninspected.

The Internet Pharmacy Consumer Act would have required: (1) name, address, and telephone number of the internet site to be displayed on each site; (2) the names of the states where the internet pharmacy is licensed; (3) the names of the pharmacists employed and the states in which they are licensed; and (4) if medical online consultations offered, the name of the physician reviewing the online questionnaire and the states in which that physician is licensed.

This legislation would clearly have been a good first step in combating the plague that internet pharmacies are visiting on our communities by facilitating drug overdoses and fatalities. With simple disclosure requirements for Internet sites such as names, addresses and medical and pharmacy licensing information, patients will be better off and state medical and pharmacy boards can ensure that pharmacists and doctors are properly licensed. One can only wonder if the multi-billion dollar pharmaceutical industry had anything to do with the defeat of this reasonable legislation.

Future legislative attempts must balance the competing needs of (1) adequately and responsibly regulating access to prescription drugs that are subject to abuse; and (2) enabling the continued growth of commerce over the internet for responsible pharmacies and physicians. Since very little is presently being done, we as representatives of the families that have suffered overdoses including fatalities can bring medical malpractice, products liability, and pharmacy malpractice lawsuits against (1) the INTERNET PHARMACIES, if you can locate them; (2) the PHYSICIANS who issue online prescriptions without a valid physician-patient relationship; and (3) the PHARMACEUTICAL COMPANIES. If the pharmaceutical industry wanted illegal internet pharmacies to be regulated, they would be. There is simply no way legislation amending provisions of the Federal Food, Drug and Cosmetic Act and the Federal Controlled Substances Act would be defeated without the overt and/or tacit support of the pharmaceutical industry. It is their products that are being marketed by these illegal internet pharmacies.

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