DrugBuyers
Administrator
Reged: 11/18/01
Posts: 1226
Loc: DrugBuyers.Com
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Elizabeth Willis, Chief, Drug Operations,
DEA Office of Diversion Control
Records Comments About On-Line Pharmacies
OCT 21--DEA Drug Operations Chief Betsy Willis today recorded comments about internet pharmacies. She has recorded 4 separate actualities. They are accessible to radio stations and others interested in using the following:
Dial: 1-888-557-6494
Enter: 701, 702, 703, 704 at prompt (note: you will need to dial separately for each)
Sound bites (MP3 files): Clip 1 | Clip 2 | Clip 3 | Clip 4
LINK
Quote:
Elizabeth Willis, Chief, Drug Operations,
DEA Office of Diversion Control
Records Comments About On-Line Pharmacies
The issue of consumers purchasing controlled substances over the Internet has serious legal and public health implications. It is a method of self-medication without the safeguards of an experienced medical diagnosis and monitoring by a trained and licensed physician. Just as we don't allow consumers to walk into a pharmacy and purchase controlled substances without a valid prescription, we don't allow this to take place on the Internet.
Many people have asked about on-line prescribing. A prescription for a controlled substance is valid only if it is written by a DEA-registered practitioner acting within the course of professional practice. This includes having an established doctor-patient relationship based upon a medical history, a physical exam and diagnosis. There must be a logical connection between the medical diagnosis and the controlled substance prescribed. A prescription written based soley upon an on-line questionnaire does not meet these requirements. It is not a valid prescription and the distribution of any controlled substance pursuant to an invalid prescription is illegal.
The responsibility for writing a valid prescription for controlled substances rests primarily upon the physician. It is his or her obligation to ensure that controlled substances are prescribed for valid medical reasons and according to state and federal regulations. However, there is also a corresponding liability that rests on pharmacists to ensure that they dispense controlled substances only pursuant to a valid prescription. If the pharmacist fills a prescription knowing that it is based soley upon a 2-minute telephone consultation or on-line questionnaire, the pharmacist is also violating the law.
These drug products are controlled for a reason. They have been determined to have potential for abuse and addiction. When prescribed, dispensed and used properly, controlled substances are effective in treating a variety of illnesses and medical conditions. But when they are not used according to a physician's direction for a valid medical purpose, they can cause overdose and death.
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"Whosoever is spared personal pain must feel himself called to help in diminishing the pain of others." Dr Albert Schweitzer
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Dante6677
Member
Reged: 08/14/03
Posts: 136
Loc: Fl. Panhandle
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Good post, Ive been copying and pasteing excerpts from dea notices here lately but it seems as no one has any comment.
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Sky_Queen
Fly Girl
Reged: 12/03/02
Posts: 1962
Loc: Texas
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Dante, I've been reading all of this stuff - I'm just not commenting because it's depressing me very much! Thanks all for posting the info though. 
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Billyl
Board Addict
Reged: 06/14/02
Posts: 389
Loc: NorthEast
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I have been posting this stuff since the 2001 guidance. No one comments because they don't want to believe it is true of will ever be enforced. Take care. Billylll
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Foxglove
Newbie
Reged: 10/25/03
Posts: 46
Loc: Lone Star State
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Very informative Billyl I wouldn't mind if you PM me some more info or links.
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The goal of life is living in agreement with nature.
-Zeno, greek Philosopher(335-263B.C.)
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night_shade
Threadhead
Reged: 08/26/03
Posts: 907
Loc: The State of Hockey
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Quote:
A prescription for a controlled substance is valid only if it is written by a DEA-registered practitioner acting within the course of professional practice. This includes having an established doctor-patient relationship based upon a medical history, a physical exam and diagnosis. There must be a logical connection between the medical diagnosis and the controlled substance prescribed. A prescription written based soley upon an on-line questionnaire does not meet these requirements. It is not a valid prescription and the distribution of any controlled substance pursuant to an invalid prescription is illegal.
I'm unsure about specific state laws presently in force, but my argument here is that the DEA has to proove that a physician-patient relationship DOES NOT EXIST in the circumstance that a doctor makes a phone consultation WITH medical records. The records slash phone consult occurs frequently everyday with regular on-call doctors who call in meds to pharmacies without ever having "examined" the patient. So, by default, I would imagine that unless the DEA plans on shutting down after-hours call services and on-call physicians by phone, they cannot make a legal argument against OPs prescribing with records and phone consult.
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Never underestimate the predictability of stupidity.
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Tred
Enthusiast
Reged: 10/18/03
Posts: 261
Loc: USA
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Good point, but what do you think about them (govern.) making a law stating that no doctors in another state can perscribe medication for an individual they have never physically seen? Wouldn't that still allow the call in service that you were explaining earlier? Believe me, I don't want them to introduce a new law, but I have a feeling they're hard at work trying to figure one out.
Then, my last comment would be this.. Couldn't these online places just set up some sort of web-cam/doctor's consult? This would at least show that the doctor is seeing his/hers patients face to face. It's still not physically, but it would def. help things out legally. eh?
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Entertainment Specialist!
Edited by Tred (11/14/03 06:26 PM)
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IMSUSCOT1
Threadhead
Reged: 10/23/02
Posts: 869
Loc: usa
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I would agree with you here except when you say they call in prescriptions without "ever having examined the patient"....if your calling your PCP's after hours service....they may not have examined you for this particular script....but they have examined you and have a chart full of history to back it up....so there is a difference....I'm not trying to be argumentative...just food for thought
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IMSUSCOT1
Threadhead
Reged: 10/23/02
Posts: 869
Loc: usa
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Seeing a patient is of some value...but a hands on examination provides info mere visual exam cannot, such as the relative size of the liver/spleen....feeling the musculature for spasm....assessing Deep Tendon Reflexes (very important in prescribing narcotics for back pain)...see if you have severe back pain, and you have no DTR's....a physician who prescribes a narcotic to treat the pain without addressing the emergent need for you to correct the root problem, will lead to permanent nerve damage...so there are reasons why a physical exam is a requirment.
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night_shade
Threadhead
Reged: 08/26/03
Posts: 907
Loc: The State of Hockey
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IMSU-
Many times I have had to call in after hours and get a doctor I have never seen (or even heard of, for that matter) who has no access to my medical records as he is calling from home, a restaurant, wherever. That is what I referring to in my previous post. My regular doc is RARELY available after hours and I have never seen another doctor at the clinic.
I totally agree that treating symptoms without addressing the primary problem is a big problem and can actually exacerbate the issue. And the on-call doctors at regular clinics usually just prescribe for immediate relief with directions to make a next-day appointment with the regular doc. However, many patients have incorrectable problems that another doctor/s has already diagnosed, but does not treat the symptoms.
I don't utilize online pharmacies at all, but I think there definitely is a place for them in medicine.
TRED-
The interstate prescription issue is the big sticking point, in my opinion.
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Never underestimate the predictability of stupidity.
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