Sorry I do not have the source for this article. I read it on a board, which is not related to OPs. Thought it was interesting though. ghost
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Internet drug customers unlikely to be arrested
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"BJ of Davenport" probably won't be arrested for buying narcotics over the Internet without a proper prescription. Neither will "RT of Nevada," "RB of LeClaire" or the hundreds of others across the nation whose online orders were filled through a Dubuque drugstore this summer.

Regulators say the three unidentified Iowans are among the people who made nearly 5,000 Internet purchases via the Union Family Pharmacy before government inspectors shut down the operation this month. Officials say the customers probably won't be charged if they cooperate with the investigation, the first of its kind in Iowa.

Even if law officers wanted to arrest the buyers, the prosecution would be tricky, several experts said. The purchases were made via Buymeds.com, one of countless Web sites that claim to be legitimate ways to obtain prescription drugs. Authorities say this one didn't require direct consultation with a doctor, as it was supposed to. But in order to convict customers, prosecutors would have to prove the buyers knew the difference between a legal and an illegal site.

Federal and state authorities say such charges are rarely pursued.

"I don't think anyone's going to go out and be a medicine-chest cop," said Bob Brammer, a spokesman for the Iowa attorney general's office.

The quandary illustrates a gray area in the expanding new world of online medication sales.

"This is the Wild West of drug distribution," said John Rovers, an associate pharmacy professor at Drake University in Des Moines.

Some Web sites are legitimate. Rovers said the best way to judge is to look for a seal from the Verified Internet Pharmacy Practice Sites program, which is overseen by the nation's pharmacy regulators.

"That's about the only way you can tell for sure," he said.

Medical authorities fear that the proliferation of pharmaceutical Web sites will allow counterfeit or outdated drugs into the United States. They also worry about patients who take potent medications without first seeing a doctor.

Price is among the big draws of many of the sites, especially those that sell drugs from Canada and other foreign countries.

Local pharmacists say they understand the desire to save money on prescriptions. They fear that constant advertising of medications has blinded people to the dangers of buying and taking them without guidance. "Society and the pharmaceutical industry are getting caught up in just throwing drugs at people. Somehow, we've got to get over that," said Tom Temple, executive vice president of the Iowa Pharmacy Association.

Customers apparently didn't save money in the Dubuque case. In fact, the pharmacy association said some of the prices listed on the Web site were five to seven times higher than a typical Iowa drugstore would charge. Another troubling detail involves the types of drugs sold. State regulators say most of the orders were for stimulant diet pills or narcotic painkillers, both of which can be addictive.

"That's a big red flag," said Jerry Karbeling, another association vice president.

Officials of the Dubuque pharmacy and Buymeds.com didn't respond to requests for comment for this article.

The Web site's parent company reportedly was in the process of moving from Florida to the Virgin Islands when the case came to light. Its manager, Marshall Kanner, told the Virgin Islands Daily News that the company didn't sell drugs. Even though the Web site described Buymeds.com as "your private, secure and convenient online pharmacy," it acted only as a "management and marketing company" to help pharmacists and physicians do business, Kanner said.

By the end of last week, the Web site's glitzy home page had been replaced by a note to its customers that promised"substantial changes." The site said that from now on, contracted doctors only will write prescriptions after they obtain a medical history, see proof of a physical exam, and perform a phone consultation.

The Web site also informed customers that the company has signed on with a licensed mail-order pharmacy with permission to send medicines to most states.

That's something Iowa regulators say Union Family Pharmacy didn't have in most of the 47 states where it sent prescriptions.

The Iowa Board of Pharmacy will meet next month to consider punishment for the three pharmacists and up to eight technicians who worked at the drugstore.

The state board's complaint against the pharmacy named four Florida physicians who allegedly approved prescriptions based solely on the answers to Internet questionnaires.

Iowa and Florida regulators say physicians are supposed to examine patients before they prescribe drugs. The Miami-area doctors haven't been sanctioned, although Florida authorities wouldn't comment on whether they are being investigated. None of the men returned telephone calls for comment.

Medical professionals will debate the ethics of Internet business long after the Dubuque case is over.

The pharmacy association noted that several of its members have Web sites, which their regular customers use for refills and other legitimate transactions.

Dr. Charles Helms, a University of Iowa internist and president-elect of the Iowa Medical Society, said physicians are still sorting out how they should and should not use the Internet.

Some online consultations are fine, especially when they involve long-standing patients, he said. Others might involve emergencies, in which e-mail could be a crucial link.

But Helms said that if the Buymeds.com doctors approved prescriptions for powerful drugs without contacting the customers, they left little moral ambiguity.

"That's clearly over the line," he said.
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