Pubdate: Sat, 18 Oct 2003
Source: New York Times (NY)
Copyright: 2003 The New York Times Company
Contact:  http://www.nytimes.com/
Details: http://www.mapinc.org/media/298
Author: Gardiner Harris
Bookmark: http://www.mapinc.org/topics/narcotics

TWO AGENCIES TO FIGHT ONLINE NARCOTICS SALES

Two federal agencies, the Food and Drug Administration and the Drug
Enforcement Administration, have formed a special task force to crack
down on the growing tide of illicit sales of narcotics on the Internet.

And for the first time, regulators are hinting that those who order
the drugs may face prosecution. "It's illegal to import narcotics,"
Mark B. McClellan, the F.D.A. commissioner, said in an interview. "We
do have steps in place to intercept such products and to take further
legal action."

The task force, called Operation Gray Lord, will include officials
from the Justice Department, some local law enforcement agencies and
perhaps even top law enforcement officers from Canada because much of
the trade originates there. Task force members intend to pursue the
purveyors of prescription narcotics aggressively, but they acknowledge
the difficulty of the task.

Many of the sites are based in countries where the sales are legal,
and officials have few hopes that they will be able to intercept every
package sent through the mail. Many of the packages bear fake customs
certifications, making them especially difficult to track.

"Like anyone else, I'm inundated with spam for hydrocodone, Valium and
Ambien," said Elizabeth Willis, chief of the drug operation section of
the D.E.A.'s office of diversion control. But determining who is
sending the e-mail takes a lot of work, Ms. Willis said. "Some are
registered in Europe, but the drugs are sent from Africa," she said.

"This problem will probably grow as people see an opportunity to make
money," Ms. Willis added.

The task force may close Internet pharmacies in the United States that
have operated in a legal gray area for years by hiring physicians who
write prescriptions based solely on the results of an e-mail
questionnaire.

"If a prescription is written by a doctor based solely on information
from an online questionnaire, it's not valid, so the distribution is
illegal," Ms. Willis said.

The government's crackdown comes as Congress debates legislation that
would legalize the reimportation of prescription medicine from Canada
and Europe as a means of giving Americans access to lower-priced
pills. Drug prices in the United States are often two to three times
those found in Canada and southern Europe. Several Midwestern
governors have recently announced their support for
reimportation.

The drug industry is fiercely opposed to reimportation, saying it is
dangerous and undercuts its ability to finance research. F.D.A.
officials have warned consumers against ordering drugs from Canada and
elsewhere, saying many may be counterfeit.

In the case of prescription narcotics, however, both federal agencies
say they worry that the drugs sold are actually what they claim to be
- - powerful opiates that can cause dangerous addictions. F.D.A.
officials say that the growth in reimportation has made limiting the
trade in narcotics more difficult.

"Different kinds of drug imports carry different risks," Dr. McClellan
said. "As they all come in unidentified packaging, it's difficult to
separate one from the other."

Those who support reimportation legislation have accused the F.D.A. in
recent weeks of playing politics each time the agency announces
enforcement actions against reimportation. But Dr. McClellan said that
"no one should argue that uncontrolled access to controlled substances
is a good idea."

"The political concerns are not the motivation," he said. "The safety
and integrity of the drug supply of the United States is."

Abuse of prescription painkillers is soaring. In 2002, 22 percent of
those 18 to 25 abused prescription pain pills, up from 7 percent in
1992, according to government surveys. A survey of emergency room
visits found that painkiller abuse nearly tripled from 1994 to 2002
and is now as common as marijuana or heroin use. Rush Limbaugh, the
conservative radio commentator, acknowledged recently that he had
become addicted to prescription painkillers.

"We think the nature of drug abuse in this country is evolving and is
moving toward prescription narcotics," said John Taylor, the F.D.A.'s
chief enforcement official.

Most sites selling drugs initially tried to copy the procedures used
in brick-and-mortar pharmacies by requiring prescriptions for all
purchases - a cumbersome process. To speed purchases, some Internet
vendors began hiring doctors who would review written questionnaires
and then write prescriptions for the patient. The pharmacies'
solicitations focused on Viagra and hair- and weight-loss drugs. In
recent months, however, many Internet pharmacies have ended even the
pretense of requiring a doctor's prescription to complete a sale, and
their solicitations include offers for narcotics.

"A few years ago, you couldn't find any sites that would sell
narcotics, and we really looked," Mr. Taylor said. "But recently,
there's been a proliferation of selling controlled substances, and we
think it's highly dangerous."

A recent examination by the F.D.A. of 1,153 packages of imported drugs
found that 25 different controlled medications were among the imported
pills. Bo Dietl, a private investigator hired by the pharmaceutical
industry, recently released a report saying his team found 1,400 Web
sites that sell prescription medicines, and more than 350 of them do
not require prescriptions. The report has received widespread
circulation on Capitol Hill.

The F.D.A. now has 90 different Internet drug investigations under
way, according to a high-level agency official. The agency will hold
a conference next month with drug enforcement officials from other
countries to discuss how to control Internet drug sales.
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MAP posted-by: Larry Seguin