Slashdot Mirror
FDA to Regulate Internet Drug Sales
ThatGuyAZ writes "The Clinton Administration today announced that it'll be seeking to license all internet drug sales. This seems to be the first step in sweeping the power to regulate these transactions from the states to the federal government. (States currently license pharmacists.) I know the /. libertarians want no regulation at all (right up until they receive a bad prescription themselves), but is giving this problem to the federal government really a solution? Will this soon be happening with state-based licensing of lawyers, doctors, etc.? " Very interesting application of the inter-state commerce clause, although my unschooled opinion is that it's a defensible application of said clause.
> I know the /. libertarians want no regulation
> at all (right up until they receive a bad
> prescription themselves)
Gee, that's nice of you to assume that people who don't agree with you must be hypocrites who will discard their principles at the first inconvenience.
As a libertarian, I don't want any *governmental* regulation, because I find it thoroughly immoral to apply or threaten violence against a person just because they bought or sold something without your approval.
But government isn't the only effective source of regulation. For example, the safety of most appliances you buy isn't assured by the government, but by Underwriters Laboratory, a private group. That little "UL" symbol you often see certifies that the appliance in question has passed UL's testing. Companies seek UL certification both because of consumer pressure and (perhaps more importantly) because insurers demand it.
I find third-party certification much more useful in finding quality products and services than government regulation. I recently bought a kerosene heater for emergency heating. What do I know about evaluating the safety of kersone heaters? Nothing. But Underwriters Laboratory knows a lot about the subject, so I made sure that I bought a heater with a solid UL rating. Similarly, when I need an auto mechanic I look for AAA approval and ASE certification.
> Very interesting application of the
> inter-state commerce clause, although my
> unschooled opinion is that it's a defensible
> application of said clause.
Have you ever heard of the separation of powers? Are you aware that the US Constitution explicitly gives Congress the sole power to make laws? Clinton has repeatedly usurped the legislative powers of Congress, but apparently those 900 illegal FBI files contain enough dirty secrets to keep them from squawking. The US used to be a republic, with separate executive, legislative, and judicial branches. It seems that the US is now an empire, with an emperor who can simply impose new laws by decree.
If you walk into the lobby of the FDA there is a large portrait of the comissioner who refused to approve thalidomide for sale in the US despite it being approved in Canada and Europe.
Requireing safety and efficacy studies before approving a drug for sale is a very different issue. The issue here is weather or not I have the right to buy and use a drug that has allready passed those studies without a doctor's permission. Weather or not it is SMART to do that is another matter as well.
Various drugs should indeed be restricted to prescriptions. If every time we got a sniffle and grabbed anti-biotics, whether they are needed or not (i.e. a virus) then we just encourage antibiotic-resistent bacteria (which are very nasty, as my sister just had surgery since antibiotics no longer work).
I agree that that's a problem, however, it seems that the prescription laws didn't exactly prevent the problem. Many doctors have (and some still do) prescribe antibiotics for a virus just to make their patient happy. Why they don't prescribe placibos (sp?) I don't know.
OTOH, since that is a public health issue rather than simply an individual issue, perhaps it is justifiable to seperate it from other prescription drug issues.
For that matter, is the average person going to understand the gobbligook that is written about a medical trial and treatment?
I have read some of that 'gobbligook', and it has mostly made me wonder why some drugs are EVER prescribed. Apparently many doctors are willing to have me take something that I would NEVER decide to take.
As for the lawsuit issue, that's one for tort reform, not the FDA.
where common sense should have played a role.
But common sense SHOULD have played a role here. Common sense should have told the guy:
Researching drugs and their faults is something best left for specialists.
Even with prescription laws, common sense has to play a part lest someone get a prescription for Viagra and decide that if one is good, 5 would be better (people do that with prescription drugs all the time, others take all 4 doses in the morning so they don't forget etc...).
The short answer is NO, because your taking any old drug can in fact affect others in a lot of different ways.
No more so than any other activity. Examples include watching TV while driving, leaving the potato salad for the company picnic out over night, wireing the 'deadman' and the self propel lever back on my lawnmower (I've actually seen someone do that, the results in that case were merely comical, but could have been worse) etc...
When the FDA says something ok to market, it means that in some clinical trial it looks like the benefits of the drug outweigh the risks. NOT that it is 'safe'. There is no such thing as a 'safe' drug.
Agreed, that's why I won't take many drugs at all, including many that doctors hand out like candy. I don't want to find out that I'm the 1% with serious complications from a stupid allergy medication.
Your wise or unwise use of drugs affects no only yourself, but can effect your decendents because of genetic effects when misused. Some drugs are showing effects on third and fourth generations.
In spite of current prescription laws.
Some drugs are such potent teratogens that just traces of the drug in the male sperm are suspected of being able to cause severe birth defects.
I am aware of that. What are they doing on the market? We have laws that cover the case of alcohol (it's considered child abuse), they would equally cover other drugs.
Not only that, but who decides what drugs your children get? We already have too many tragic cases of kids harmed by simple overdoses of liquid Tylenol. I shudder to think what would happen when parents have the ability to buy stronger drugs freely and give them to their children.
I will. There are and allways have been dumb parents, and they often manage to harm their kids through stupidity. All the laws in the world won't stop that.
n addition, things like overuse of antibiotics lead to spread of resistant bacteria. Many countries outside the US have VERY severe problems with this becasue they do not regulate the sale of antibiotics.
We have a problem with that in the US as well. Mostly from doctors who should know better prescribing antibiotics for the flu (at patients' request) and people failing to take the full prescribed course of antibiotics. Actually, that argument is the best argument I have heard yet in favor of prescription laws. I will concede that perhaps antibiotics (at least the ones that are known effective against resistant strains) belong in a special category.
IN ADDITION, a lot of people resent the FDA controlling drugs at all. They take off to Mexico or wherever to take whatever some quack can talk them into. The same libertarian philosophy that rejects the concept of prescriptions also rejects the idea that ANY drugs, be it marijuana, heroin, LSD or thalidomide should be controlled.
Thalidomide actually does have valid medical use (leprosy). It like many other things should have a strong warning label. As for recreational drugs, I do, in fact, advocate legalisation (even though I don't advocate their use)
I do NOT want to be saddled with the taxes to support a brain damaged kid with flippers where his arms should have been, or having to worry about my kid getting a antibiotic resistant form of TB just because you felt you had an overriding right to take any drug you wanted.
Nobody does, but it happens all the time with or without prescription laws. For every problem due to lack of prescription laws, there is likely a problem of someone who might have avoided serious illness with early treatment had a doctor visit not been required (not everyone can afford a doctor visit, but many antibiotics are quite inexpensive).
With these facts in hand, one can make an informed decision instead of just swallowing pills and hoping that the right combination makes you fell better.
Removing prescription laws wouldn't prevent you or anyone else from doing the right thing and having a doctor prescribe your medication. It also wouldn't remove the manufacturers' responsability to make medical grade products, and to label them properly. It wouldn't remove the pharmacists' responsability to dispense what you ask for.
A doctor would still be responsable for what is prescribed to you. Just as he would be if he told you to drink a gallon of (non-prescription) antifreeze and call in the morning.
What prescription laws really are is an assumption that most of us are darwin award cantidates and the foolish notion that we idiots won't 'find' another way to win the award. The same people who would die without prescription laws probably take their prescription sleeping pills with a pint of vodka (because they'll be more effective that way) and operate a blow drier in the bathtub (saves 5 whole minutes in the morning).
If the prescription awards are necessary, perhaps we should also card people (for an electrician's license) before selling them light bulbs, wall switches, or any tool that can be used to work on electrical equipment. Perhaps a mechanic's license to buy auto parts (people DO die regularly from improperly secured cars slipping off the jack).
Or we could save a ton of money and just require warning labels on what are now prescription drugs.
Letting any Joe Bloe in the country pick up whatever prescription drugs he wants is not only stupid, it's negligent. The article states that the legislation is aimed at curbing illegal sales of prescription drugs. What better way to sell something illegally than over the Internet? The legislation only gives the FDA power to verify the quality of online pharmacies and to ensure that they are getting the required authorization before filling any orders for prescription drugs.
With respects to the whole concept of prescribing drugs, the average citizen is an idiot. This is why we have smart people who are licensed to make certain decisions for us, like doctors. If you have a medical problem that can be treated with prescription drugs, you have to get a doctor to make that diagnosis and decision. The doctor writes out a prescription, so that the pharmacy knows you've gotten a doctor's consent before they go handing out potentially lethal drugs. Would you really rather live in a country where anyone can buy any sort of drug and use it as he desires? What happens when that drug, or perhaps a certain mixture, causes sterility? Heart failure? Death? "Oh shucks, he should have known better." ? There are perfectly sane, legitimate reasons we license and prescribe drugs in this country.
Agreed, but another important provision in this law is the power of the FDA to investigate the quality and set standards for online pharmacies. If an online pharmacy consistently mis-fills 10% of its drugs, or skimps out on a few pills out of each prescription, the FDA could then pull the pharmacy's license until they shape up. If the pharmacy continues to operate, the fines are quite severe.
This also makes investigating online pharmacies the explicit responsibility of the FDA. Without this legislation, that responsibility is ambiguous, and would generally require a state or a person to file a lawsuit.
I don't think this legislation has anything to do with international orders.
Of course I'd have to actually read it or have someone give a better summary than what was provided in the article, but it seems to only apply to domestic pharmacies.
It would be kind of hard to require every 'Net pharmacy in the world to get a US license, and if they didn't comply, how is the US going to enforce a fine or penalty?
No, I don't think this law does much in the way of international pharmaceutical orders. In those cases, I would simply hope that the host country would have similar laws (and most, if not all, do) regarding what types of drugs can be sold and how those drugs are sold and transported.
Who do you think is going to be "pushed" out of the US as a result of this legislation (assuming it passes)? The legal, legitimate, quality pharmacies? Really doubtful. The burdons placed on them as a result of this legislation are probably going to be very trivial. Certainly less than the costs of moving their operation to another country. Think of it as a business license. They already have to get one sort of license (or more) for the state they're doing business. What's one more?
So who's left? The illegal pharmacies, for one. Oh damn. Guess they'll have to move their illegal drug operation to another country, or maybe they can just try to hide their web site a little better. Then there's the pharmacies that don't seem to have any sort of quality control. If a pharmacy is consistently mis-filling prescriptions and acting really negligently, I would expect the FDA would pull their license. So I suppose there's a possibility there that they would move to another country. Again, good riddance.
If I'm ordering a prescription from an online pharmacy in the US, I would take much comfort in the fact that we had an oversight body in place licensing and monitoring these pharmacies.
If your entire business consists of 2 72" racks in a datacenter, and a local sysadmin, it's pretty easy to move your company to any country about as fast as you can propagate a DNS change.
Apparently you're forgetting the nature of the business. Pharmacies require taking in stock of drugs, filling personalized prescriptions for specific dosages of those drugs, and shipping them out. We don't care where the web site is; we care where they're doing their business. It takes a bit more effort to move this type of operation to another country than simply relocating data and making a DNS change.
Most countries have their own import/export laws with respects to controlled drugs. If it were so easy to get these things shipped out via standard mail, why aren't more people sending heroin, cocaine and marijuana via the USPS?
Think about it. Somebody else already has.
What if it is sent by a private mail carrier, like DHL?
I may be wrong, but I think private carriers might possibly share some liability here. It's probably quite illegal to ship controlled drugs from one country to another (where it may be illegal in either one). If a carrier is getting lots of international orders from a shifty-looking online pharmacy, an investigation might be performed. Carriers (at least in the US), I believe, have the right to open and inspect any package you put in their custody without a warrant.
This legislation only applies to companies selling *across* state boundaries (thus bringing it into the federal domain). The vast, vast majority of pharmacies sell in a physical store, so they're only subject to the individual state's laws.
I don't necessarily disagree that education in most cases is favorable to education, but really, it's unrealistic.
Perhaps a thousand years ago it was certainly possible for one person to learn the sum of all human knowledge. A hundred years ago one could probably be pretty fluent in most subjects, but today, it's not possible for someone to educate themselves regarding everything that affects his life.
"He should have known better," is something I tend to say pretty frequently, but only when dealing with things where common sense should have played a role. Researching drugs and their faults is something best left for specialists.
Doctors are *trained* to know what types of drugs are best for what situations, when certain drugs shouldn't be used, and what existing medical conditions could make the use of such drugs harmful, or when the risk is acceptable. Further, they may know of a drug that performs the same thing but with a different set of side effects and problems that would be preferable.
Sure, I could probably go to some medical web site, look up my symptoms, find an ailment that causes those symptoms, find a common drug treatment, and do all sorts of research on that drug to make sure there aren't any problems, but who's to say my work is complete or accurate? Perhaps that ailment wasn't really the problem, and taking that drug only exacerbated the situation and caused my untimely death?
The average person is not qualified to make these types of decisions with *controlled substances* that have harmful and fatal side effects when not used correctly or in the correct situations. Nor is the average person qualified to have enough background knowledge in medicine to even attempt a thorough amount of research into their own ailments and what drugs they should take to cure them.
Sure...if noone is anywhere nearby that could
possibly be hit. Otherwise you are endangering
others.
So by this I assume that you do not support statutes for things like "disturbing the peace"? If my neighbor started shooting all sorts of firearms in the air while my baby girl was trying to sleep, you can bet I'd be a bit angry, and there are laws on the books that makes this type of behavior illegal (at least in most cities).
One could argue that allowing a pharmacy to operate negligently or illegally is, in fact, "endangering others."
Why is it any of your buisness if they run a
brothel?
So I guess then that you are also opposed to anti-prostitution legislation, and various zoning laws about where businesses and industries can be built? I personally love the fact that my neighbor can't tear down his house and replace it with a coal-burning factory that produces foul-smelling tires. Not to mention the fact that if my neighbor started up a brothel, the value of my home would probably drop quite a lot, but then that's why we have homeowners associations, yes? Or are you against them also?
Why not? Why is it you are so interested in what
your neibor does in the privacy of his own home?
Do you keep track of what he does...make sure he
isn't having sex outside of marriage too?
I can't really tell if you're trying to have a legitimate argument here or if you're just trying to be annoying. It sounds like you're against all sorts of laws that are already in the books (in this case, laws against the production of illegal drugs)...
If you really have such a beef about these laws, perhaps you should try writing to your local legislature. I sincerely doubt these things will ever be legalized, so maybe it would be in your best interests to move to a lesser-developed country that doesn't have these laws. It sounds like you'd be happier there.
I was kind of
thinking off alone in the middle of a feild
where noone is around.
And as far as I know, this is perfectly legal. I think the original poster was thinking from my frame of reference, in a quiet neighborhood.
Should we require prescriptions
for those too? perhaps ban the sale of them?
How about require the makers of these items to disclose all known health risks and to put serious restrictions on their methods of advertising. And while we're at it, limit the purchases of these things to people that are 18 or 21 years old, so we can be sure they're old enough to make an informed decision on their own.
I suppose we could do exactly the same thing for all prescription drugs, but the resources required to not only put this into effect, but to monitor and ensure full disclosure and compliance on the parts of the makers of prescription drugs would be prohibitive. As prescription drugs tend to be individually things the average person knows little about (unlike alcohol and tobacco, which are quite common), it makes more sense to entrust a certain class of people with the tasks of learning the details about when certain drugs should be used, how they're used, how they're not to be used, and acceptable, less-risky alternatives, and require that class of people to give their consent before these items are given to the general public.
I see nothing wrong with
a brothel. As long as they keep quiet, why not?
OK, aside from the fact that we'd have to get rid of most commercial zoning laws as well as laws banning prostitution (each independently having merits outside of this situation), your argument is that what one does in the privacy of his own home is acceptable. So when does a building cease to become a home and start to become a place of business? Or does it matter? In my opinion, by opening up his doors to customers looking for sex, that place ceases to become simply a private home. While I don't entirely disagree with your point of view here, I would rather not see my neighbor's house turn into a brothel simply because it would attract all sorts of unsavory people and attention to my neighborhood and generally cause me headaches. I'd say let's make this more of a community law/ordinance, but I think for the most part, it already is.
I am firmly against the idea
that the government should have any say in what
people can or can not do in the privacy of
their own home, or with other consenting
adults (ie using drugs, paying for sex).
This is moving out off of the topic at hand, but let me ask you this:
Let's say I invent a drug X that, given a single dose, mimics the effects of alcohol while having an extremely addicting effect on the taker. So addicting, in fact, that one dose is sufficient to addict an adult in such a way that 99% of the people that take it begin taking it regularly. This drug is "marketed" as a quick, safe high by the dealers and quickly spreads.
So you think a substance like this should be allowed to be created and sold? All of the people that end up taking this drug, whether or not they know about its addictive effects, deserve to be hooked on it? And when prices go up tenfold, they deserve to have their bank accounts drained paying for a steady supply? Or do you think they should just "suck it up," "bite the bullet" and check into rehab? Overcoming a drug addiction of a severe magnitude is not a pretty or painless thing. Did they have it coming?
Now, I'm not saying that all illegal drugs have these types of effects, but there are plenty that do. It all boils down to the fact that people today have a need to be protected from their own ignorance and stupidity. To suggest that everyone is capable of making educated, informed decisions about everything that will affect their life is naive.
Now I'm a firm believer in Darwinian natural selection. I do not feel we need to spend so much money and time keeping the stupid people in our country alive and healthy. I do not, however, wish to see pharmaceutical companies marketing their prescription drugs like it were laundry detergent, and things are starting to move in this direction. I am pleased that we have doctors that are trained to know what drugs are required for specific situations and when those drugs can not and should not be used. If we eliminate this requirement, for doctors to give prescriptions for certain drugs, I shudder to think how many people will, incorrectly and sometimes fatally, turn to prescription drugs when they don't need them.
To be honest, it sounds like your beef is more with illegal drugs and how you feel drugs should be legalized entirely than with legislation of online prescription drug pharmacies, and this is out of the scope of this thread.
Whoever committed fraud by claiming that it was a safe drug, and by marketing something so dangerous without adequate warnings, would be mostly to blame
Wow, you're right. Those damn drug dealers. Let's put them in jail!
But the people who took it without bothering to look up any information on the drug are also to blame for their own recklessness.
Right-o. Those kids hooked on crack deserved what they got. Let 'em sit in misery for the rest of their life. But gods, no, let's not blame the drug or the maker.
I hope you're not saying that any real drug, illegal or legal, is nearly that addictive.
It's all about scale. There are *plenty* of OTC and prescription drugs that are addictive in nature, but *how* addictive is one factor in many in determining how a drug should be classified. Drugs with a high-degree of addictibility tend to be made illegal, sometimes regardless of their medicinal value.
If people are incapable of making decisions for themselves, it's because of two reasons.
Perhaps. Without these laws, however, how many more people would be addicted to narcotics? Cigarettes? How many people would -- due entirely to their own mistake -- die or become severely ill due to an improperly researched drug purchase?
Is it worth it for people to be permitted to purchase recreational drugs (which is what they would be -- after all, this whole thing is about getting drugs a doctor won't prescribe for you, right?) if it means a substantial increase in death and illness for people that either don't have the time nor the money to do research?
It's easy to generalize a story, thus making pretty much any topic that fits in that generalization "on-topic."
The story is about legislation giving the US federal government jurisdiction over the licensing and monitoring of Internet pharmacies. It is not about whether all drugs should be made free and legal. I'm not here to debate this with you, but I think it's safe to say the vast, vast majority of Americans disagrees with this standpoint, so it's highly unlikely you will live to see your views realized. Of course, I'm not saying you shouldn't continue with your protests. By all means, continue. I'll just be dropping out of the discussion now.
The scenereo was specifically of a drug that was fraudulently marketed.
...as are crack, cocaine, and other narcotics. There'll always be people out to make a quick buck by not disclosing all of the truth, or outright lying. I was pointing out that, despite laws forbidding this, drug dealers are still out on the streets selling drugs to people that may or may not know the risks. Should we be placing the blame on the users, the dealers, the manufacturers? A combination of both? Or is there no blame at all?
People still have a responsibility to check if what they're about to ingest is safe.
What would you consider a 'responsible check'? How much research must one do before they cease to be irresponsible and become responsible?
Now realize that if we move to a free market, where anyone can pick up any drug they wanted, those that make and sell dangerous drugs are probably going to want to hide a few things here and there, or downplay some risks. That may make it a bit more difficult for someone doing a cursory check on the risks associated with a drug to come up with something that changes their mind. If the company is good at obfuscating the risks, the average person is neither going to understand or recognize the significance of what their research has turned up.
Now who's to blame? The user for not being in the top tenth percentile of educated people, or the manufacturer for listening more to their marketing people than their scientists?
Since both are readily available, I don't see your point.
Just because a law is 90% effective does not mean it's a useless law. Stamping out the law will allow a sort of equilibreum to be established, between the makers and sellers of harmful substances and the users of those substances, each with varying degrees of education about the risks of those substances.
The idea is to prevent people that don't know any better from using something known to be harmful and addicting.
It costs nothing to go to a public library.
Are you really suggesting that everyone go to the public library every time they feel a desire to go out and get some prescription drug for some random ailment they've just noticed?
How many people are going to do that? I'll probably round my estimates to the nearest whole number and say zero.
In a world where people were free to choose what drugs they take, pharmacists would probably want to keep a good amount of information on hand in order to serve their customers
They'll probably only do so if/when it helps them to earn money. I imagine "hole-in-the-wall" type online pharmacies would have plenty of business without wanting or needing to set up information centers for people to research the drugs they're wanting to buy. I'd say the majority of prescription drug purchases are for refills or drugs that the person is probably going to be taking for the rest of their life. Why go to a pricey pharmacy when you can find one that doesn't have to spend money on education, training and offering research material and can get you a much better deal?
So now that we've established that these places will exist, why would a mother on welfare supporting 5 kids want to even start her drug shopping at a classy place to begin with? Chances are, one of her friends has told her she needs to give her kid drug X and Y to clear up two symptoms, so she does goes to Cheap-Ass Pharmacy and orders those drugs. As Cheap-Ass Pharmacy has no reference material (not that she'd take the time to read it anyways), she does not know that drugs X and Y are mutually exclusive and will cause certain death if mixed. Oh damn. Is it her own fault then? Does her kid deserve what he got? What if it's something more benign.. let's say the kid has some kidney disorder that would make drug X potentially lethal, but the mother of course doesn't know this. A doctor would be able to check for this disorder before prescribing drug X. Is it the mother's fault for not knowing this?
government does not need to protect people from themselves. I realize that some people won't be able to handle that.
You're right, because it's been shown time and time again that people are NOT smart enough to be able to survive in this world without some laws designed to protect them from their own stupidity. Look in your home, on the backs of appliances, on the tags on your furniture, on the very plastic bags that these things were shipped in. How many different and distinct warning labels do you see? Every one of those warning labels was brought about because somebody was too stupid to care for himself.
I agree in that I'd like to see the government regulating less than it currently is, but I firmly believe that existing laws regarding the need for prescriptions before drugs can be given are quite necessary and inconsequential. I've probably been prescribed drugs 2 or 3 times in my life, and every time it's been the result of me going to see a doctor. If people are so adament that they be allowed to get potentially dangerous drugs without needing a prescription, what exactly do they need these drugs for? Common sense says to get a doctor to investigate your latest ailment, not to try and diagnose it on your own, yet that seems to be what people are shooting for here, and I don't quite understand why. Under what circumstances would you ever need a prescription drug (versus an OTC drug) without going to see a doctor?
X-rays and drug-hunting devices and dogs are pretty common, I'd wager.
If people are going to take a drug without either professional advice or the information to make their own decision, that is their own responsibility.
What I'm trying to say is that people WILL be taking drugs without adequate information on the risks. There is no possible way someone is going to be able to do all of the research necessary to be sure that a given drug will not affect them adversely, either in concert with another drug they're taking or an ailment, disease or other defect. In fact, people are going to be MORE likely to be influenced by marketing and word-of-mouth than by any degree of research they will be able to do, which (as I'm sure you'll agree) is not the safest way to do your prescription drug shopping.
The only way someone can be relatively sure that they a) need a prescription drug at all and b) know that the drug they need will be safe for them to use (or get an alternative), will be to either consult a doctor, or to utilize some yet-to-be invented computer system that can diagnose illnesses and predict risks imparted by taking a drug or a series of drugs. Sounds like a robotic doctor to me.
I guarantee you that if legislation were dropped requiring a doctor's prescription that there would be a tremendous buying frenzy of prescription drugs that people do not need. There will also be a *significant* increase in the number of ailments, overdoses and deaths that will be a direct result of people purchasing prescription drugs without adequate knowledge or research as to how these drugs are to be used.
It's not a simple matter of convenience here. It sounds like some of you don't want prescriptions simply because you want to get access to drugs that a doctor will not prescribe for you. Chances are, he has a VERY good reason for not prescribing those drugs for you.
I guess we're just going to have to agree to disagree on this. I do see where you're coming from, and in an ideal world, yes, I would imagine everyone would have the means and opportunity to do their own research on drugs and have the maturity and faith in their own bodies to know when they do and do not need to use those drugs, but this is far from an ideal world. People's lives are regularly being destroyed as the result of addictive drugs, and removing the requirement for safeguards such as the current prescription drug system will only serve to hurt people.
I found it quite amusing that so many Libertarians were outraged by this. Let's assume for a second that not everyone is as 'intelligent' as you, and, believe it or not, they could possibly make a mistake. Of all the things sold on the internet, drugs are probably the riskiest. It's unlikely that reading too much of that book from amazon will kill you, nor will listening to track 1 on repeat from a cd do too much damage, however, taking as little as 50% more of the medication you've been prescribed can.
It's all well and good to believe that we deserve certain freedoms; I do too, but keep in mind that not everyone has the requisite knowledge to make use of freedoms.
To put it another way, a lot of people *think* they can handle firearms, maybe some of them do, but the number of accidental shootings in the US is ridiculous. Obviously, people have trouble dealing with too much freedom on occaison.
----------------- "I have a bone to pick, and a few to break." - Refused -------------------
My concern is that continued application of such law to the Internet will begin a trend of Internet-related regulations which will result in new legislation. The first thing that comes to mind is Internet taxation. It has been proposed (and defeated) before, but if the US Government can regulate aspects of Internet trade, I see the attitude toward Internet taxation relaxing a bit.
I think it's important, if you share my concern, to take an opportunity like this to write your Congressperson and express your concern over such controls. Make your opinion clear, complete, and concise -- staffers read such letters, and will get bored with them quickly if they are too long-winded.
What does everyone else think? Could decisions like this soften the attitude toward Internet regulation and lead to taxation of Internet commerce?
-- Never underestimate the power of very stupid people in large groups
We may not imagine how our lives could be more frustrating and complex—but Congress can. – Cullen Hightower
Does this only apply to prescriptions ordered online from US pharmacies? They're already regulated, at least at the state level. If it applies to international pharmacies as well, that means they're hoping to override a very convenient, useful, and oftentimes necessary loophole purposefully left in the US Customs laws. I just don't really see what this attempt at regulation is trying to help; certainly not consumers.
---
"'Is not a quine' is not a quine" is a quine.
"'Is not a quine' is not a quine" is a quine.
Quine "quine?
Without seriously sitting down and thinking about it, I have to say this does not look like a bad thing. Currently similar regulations exist to make sure brick-and-morter drug stores do this, why should online drug stores be any different? I think the perscription system works quite well, or at least is better than the alternatives.
My question is: what about international drug retailers? What is to prevent a company from setting up shop in Outer Mongolia and sending all sorts of drugs (perhaps even `medicinal' pot) without a perscription? Does this already happen? For example, there are several abortion pills that a legal in places like France, but still illegal here. What is to stop me (or, rather, my girlfriend) from just ordering them from a French online pharmacy?
The only way I can see the US `solving' this is actually opening packages and doing chemical samples, and thats a pretty scary thought! What if it is sent by a private mail carrier, like DHL? It gets pretty thorny pretty fast!
Umm, no, it's not. The 10th amendment:
The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.
The licensing of doctors is a state power - my Dad's license is from the Wisconsin Medical Board. The Federal government does not have the power to step in here, and I'm certain the current Supreme Court would affirm that. It's only when things start to cross State lines (sometimes the Fed's idea of "crossing State lines" is pretty laughable) that the Federal Government steps in.
It's a little late to be replying I guess. I agree with you completely that regulatory oversight of medication and its distribution is in general a necessary and even good thing. I only wished to point out that:
(1) Just because regulation at first glance looks like a good thing doesn't necessarilly mean it is, either in practice or in theory (when looked at more closely).
(2) Any regulation, no matter how useful or necessary, carries with it a significant price tag which all too often is not even considered, much less taken into account. With respect to regulating medicine (and food quality, for that matter) our society has (IMHO correctly) decided that that price is well worth paying.
The Future of Human Evolution: Autonomy
I vehemently oppose regulation of speech, etc., but I fail to see the terrible harm that would come of safeguarding against bad medicines.
Consider the folowing scenerio:
Tribal lore in an undisclosed State, on an undisclosed Indian Reservation, has managed to preserve a remarkably effective treatment for [insert your favorite ailment here] in the face of several hundred years of seige to their culture by European settler's.
A large pharmaceutical company "discover's" the tribes technique, finds it to be useful, and co-opts the idea. Perhaps they are granted a patent, or perhaps merely FDA approval. Either way, the regulartory apparatus of our government will always work in favor of the drug pusher^H^H^H^H^H^H company and against the folk doctors in question. The result? It will probably be unlawful for the tribe to continue practicing medicine in the way they have for thousands of years, while the drug company will likely get exclusive rights to market their treatment, probably at a much inflated price.
This is an example where "safeguarding against bad medicines" does indeed do immediate and ongoing harm.
Real world examples? Synthetic THC vs. Marijuana for glaucoma and nausea treatment, for one. Numerous other examples exist -- check out some of the patents granted to the pharmeceutical industry recently, based on folk-cures from Indonesia to Brazil which have (had?) been in use for thousands of years, and are now the sole intellectual property of various drug companies, who will let you use it, for a monopolistically high price.
Regulation can be a good thing and is sometimes necessary, but it has a side which grows ever uglier the greater corporate influence comes to dominate the regulating institution, namely our state and federal governments, and (even when justified and necessary) regulation always carries a heavy price.
The Future of Human Evolution: Autonomy
1. Attempt to impersonate a nurse calling in a perscription.
2. Take a perscription form and write what I want down on it.
One of my relatives is a pharmacist. She is quite good at detecting bogus prescriptions. The typical case is an individual who walks into the pharmacy, looking like a junky, with a badly forged prescription for a highly abusable drug. They usually disappear as soon as she picks up the telephone. Certain drugs must be prescribed on special, numbered prescription forms. If anything is questionable, the pharmacist calls the doctor to verify the prescription. A more common problem is old doctors who will write prescriptions for a fee. They don't care if they lose their license since they were going to retire anyway.
Mea navis aericumbens anguillis abundat
If my aircraft mechanic screws up, there is a good chance that my passengers and I will be killed or seriously injured, not to mention the danger to people on the ground.
I like having the FAA around to certify aircraft mechanics and to make sure that aircraft replacement parts meet the aircraft manufacturer's specifications. Even with the FAA, there have been problems with counterfeit parts getting into the supply chain.
Mea navis aericumbens anguillis abundat
This is a flat out misconception. The federal government has actually been in a pattern of returning power to the states over the past 10 years or so.
Really? I invite you to check out on of the many illegal and unconstitutional evecutive orders our esteemed leader attemped to slip through in between granting favors for money:
Executive Order 13083
You may want to try reading the federalist papers or other writings by the framers of our government and see what the government was meant to be. It stands in stark contrast to what we see today.
Finkployd
A neighborhood pharmacy might, for instance, setup a website so that regular customers can place perscription orders on-line and recieve email notification or instant messages when the perscription is ready to be picked up. They might also make arrangements with the local clinic or doctors.
This legistation would require website that provide strictly "local" service (local to a single neighborhood) to be federally regulated. This seems to largely tip the scales in favor of large national providers of drugs.
Yeah, ok, that makes sense... sure. I never said I didn't agree with people getting meds online. My point is that this legislation merely puts the online med retailers on level ground with all the Eckard's, CVSs, Wal-Mart's, etc. out there. Of course, it is government regulation, so a great many people will fuss about it for that reason alone.
Eric
Now, I'm sure all the states'-righters out there will have problems with this, but in my opinion, there is nothing wrong with this legislation. I don't have widespread knowledge of the workings of other states, but here in NC, it is illegal to purchase perscription drugs without a perscription from a licensed medical practitioner (for the most part, read doctor).
;->), wait for verification (if that indeed is part of the procedure), wait for Bubba to go to the warehouse, search for the medicine (you don't expect them to pay licensed/trained pharmicists do you?) and ship it to you. I'll pay a few extra bucks to get it filled in the store in about 15 minutes.
As stated, the purpose of this legislation is to force online medicine retailers to obtain a valid prescription before selling the drug to the customer. This is the way all drug stores (as opposed to e-drug-stores [this e- crap gets ridiculous sometimes:) ]) work. If they violate this practice, and get caught, they are in deep doo.
In my opinion, this legislation simply requires that online sellers play by the same rules. On the other hand, I'm not sure how they plan to verify a patient's prescription. Do you have to mail them a copy of the paper-prescription? What happens if it is lost in the mail? Do you allow scanned/faxed copies? How do you prevent forgery in those cases?
Personally, if I get a prescription for medicine, I assume my doctor wants me on it as soon as possible. I'm not going to wait for a prescription to get to the retailer in Outer Mongolia (or wherever
In short, I think this is a good idea, but as is the case with all good ideas, it need a good implementation plan for it to be universally accepted.
Eric
I can, with my limited knowlege of medicine and prescriptions, intimate from the press announcement *exactly* what harms it addresses. One, bad drugs from disreputable e-commerce firms can kill. Buy a book or toy or computer part from a shady e-commerce firm and the worst you get is ripped off. Buy your high blood pressure medication from a shady firm, and you could die. Big difference.
Second, I heard all manner of stories about Viagra being sold on the web to people who claimed prescriptions they did not have, or just plain didn't have to provide one at all. Viagra is a medication that has all kinds of warnings about it's use with heart medications and such, and even the megaconglomerate drug stores that are reputable keep a cross-reference of your other scripts to ensure that you don't take two scripts that are contra-indicated.
Finally, control over the distribution method just like they have in brick-and-mortar operations. Don't kid yourself, the DEA already spends plenty of resources keeping errant doctors and pharmacists in line. I know, my cousin is one of them. While pharmacies may be state regulated, they still need a DEA number to operate and are subject to DEA inspections and investigations. This has always been the case, it's not one of the Fed taking on new ground, just adapting to new technology.
My liberatarian background tends to shun fed involvement in state matters, but control of deadly substances is not one of them.
-- "In order to have power, I must be taken seriously." -Mojo Jojo
The issue here is weather or not I have the right to buy and use a drug that has all ready passed those studies without a doctor's permission
The short answer is NO, because your taking any old drug can in fact affect others in a lot of different ways.
When the FDA says something ok to market, it means that in some clinical trial it looks like the benefits of the drug outweigh the risks. NOT that it is 'safe'. There is no such thing as a 'safe' drug.
Right now there is a lot of concern because death rates from prescription drugs are rising rapidly - a lot of new powerful drugs are coming on the market. While these are a great boon, their power also increases the risks.
Your wise or unwise use of drugs affects no only yourself, but can effect your decendents because of genetic effects when misused. Some drugs are showing effects on third and fourth generations.
Even simple drugs like alcohol have bad effects on the fetus. Some drugs are such potent teratogens that just traces of the drug in the male sperm are suspected of being able to cause severe birth defects.
Not only that, but who decides what drugs your children get? We already have too many tragic cases of kids harmed by simple overdoses of liquid Tylenol. I shudder to think what would happen when parents have the ability to buy stronger drugs freely and give them to their children.
In addition, things like overuse of antibiotics lead to spread of resistant bacteria. Many countries outside the US have VERY severe problems with this becasue they do not regulate the sale of antibiotics.
IN ADDITION, a lot of people resent the FDA controlling drugs at all. They take off to Mexico or wherever to take whatever some quack can talk them into. The same libertarian philosophy that rejects the concept of prescriptions also rejects the idea that ANY drugs, be it marijuana, heroin, LSD or thalidomide should be controlled.
I couldn't give a shit if you, as a mature adult go to hell in a handbasket. But you are NOT operating in a vacuum when it comes to drugs.
I do NOT want to be saddled with the taxes to support a brain damaged kid with flippers where his arms should have been, or having to worry about my kid getting a antibiotic resistant form of TB just because you felt you had an overriding right to take any drug you wanted.
Removing prescription controls would unleash a night of horrors on our society. To suggest such is the height of irresponsibility.
I don't see how my chances of getting the wrong drug are any greater just because some verification is made that I have a prescription.
Because if you have a prescription presumably a doctor gave it to you. Assumption: A doctor is more likely to know what drug you need (if any) than a randomly selected person.
The reason this measure is necessary is that there are a lot of idiots out there who want to self-prescribe Prozac or Ridlin or Viagra or something. I think a BETTER measure would be to give the USERS licenses. Here's the kind of scheme I envision:
Person A is born and has no licenses. At age 8 he is given a test.
Tester:"Johnny, pour this hot coffee in your lap".
Johnny: "No."
Johnny then receives a "Can Eat At McDonald's" license.
The applicable test in this case would be given around age 12/13:
Tester: "Janey, take this pill."
Janey: "What does it do?"
Tester: "Cures your condition."
Janey: "What condition? And how?"
Tester: "Just take the pill."
Janey: "No."
Janey now has the "Can Purchase Prescription Drugs Without Body Cavity Search For Perscription" license.
Other licenses include:
"Can View Uncensored Internet" (test involves knowing the difference between instructions for making a bomb and a bomb itself)
"Can Play Violent Videogames" (test involves knowing the difference between fantasy and reality)
"Can Make Right Turn On Red" (test involves being able to recognize oncoming traffic)
---
Linux MAPI Server!
http://www.openone.com/software/MailOne/
(Exchange Migration HOWTO coming soon)
I guarantee that if the average US Citizen was worried about living to see the next day, we wouldn't be having this discussion at all.
I can't fault you're logic; unfortunately, the average US Citizen can very quickly become addicted to a substance without even knowing it. What happens when some online company convinces people that their herb (actually cocain) is good for what ails them. The first 10 doses are cheap, but then the price skyrockets due to 'supply problems' (you know, snowstorms in Canada and such). The poor schmuck ends up sending his/her rent money to get the miracle drug.
Who gets hurt? If it were just the schmuck, I'd say "fuck 'em, he/she gets what he/she deserves. Let 'em die and clean out the gene pool." But it isn't just the schmuck. It's his/her children who have their childhood ruined. It's the average taxpayer who must pay for social services to raise the child once the parent is completely incapacitated by the drug. It's the parent who must watch their child shrivel and die under the effects of the poison. It's the schmucks neighbor who must buy a new stereo after it's stolen to buy more drugs. It's not the schmuck we care about, it's the collateral damage they cause once they're hooked.
The FDA needs to regulate online drug dealers, just like the brick and mortar ones both to protect us from unscrupulous drug dealers and ourselves.
Aah, change is good. -- Rafiki
Yeah, but it ain't easy. -- Simba
I almost hate myself for saying this, but I believe we need to enforce restrictions on controlled substances in this country and around the world (OUCH! That hurt.)
I was a security guard at Ciba-Geigy, a pharma^H^H^H^H^H^Hdrug company, among other chemicals. The place I worked actually concentrated on dyes. Anyway, we would often get calls at the guard desk from people who needed 'emergency supplies' of one drug or another that had certain 'side-effects'. These callers usually got 'irrate' when we tried to explain that we had no way of helping them (usually by saying that they needed to see their doctor).
My brother-in-law just spent Christmas Eve driving around town to various crack houses looking for his adolescent neices father. When the dirty bastard showed up, he had spent every penny he had (which was given to him to buy the child a present) on crack. I can't believe this would happen without the addictive nature of the drug. I enjoy a cigar now and again, but I wouldn't trade the Christmas morning look on my boys' face for one. Drugs like crack can't be handle by normal humans and the government has a responsibility to protect.
I detest government regulation, but in this case I see the collateral damage of a free drug society being worse than federal intrusion. The FDA should have the power to watch over the online drug stores to insure that they don't become online drug pushers.
Aah, change is good. -- Rafiki
Yeah, but it ain't easy. -- Simba
First the usual caveats: I'm not a physician or pharmacist, but I've spent a fair portion of my career as a healthcare IT consultant, so I do know a little about this.
This is probably both needed and not needed. (Remember, though, that Bill and Hillary have not given up on socializing medicine in the US, and will take any incremental steps they can that will interpose government control between you and any healthcare resource. It should go without saying that such control is a bad thing.)
Pharmacies and physicians are registered with the FDA today. Every doc (and presumably every pharmacist) has an "FDA number" that they must use to identify themselves with certain classes of prescriptions, particularly narcotics. (In fact, many of the better medical web sites on the web require an FDA number to get at the "good stuff", which is presumably not safe for viewing by the riff-raff (that's us.))
Based on my consulting experience, it seems that state laws are the primary governing factor in regulating prescriptions, and that the variations from state to state complicate things for providers that operate in more than one state. In particular, only a few states allow electronic prescriptions and/or signatures - most require a written prescription because they are far more traceable, immune to tampering, and tamper evident (very important) than their electronic counterparts.
I'm talking reality, not theory here - I think electronic prescriptions would be a very bad thing: this industry can barely handle its paper, and pays seriously substandard wages to its professionals from CIOs on down. Their chance of doing this well as an industry is near-nil. Doing this right is not a trivial problem: It involves the best cryptographic systems available and must provide all the usual crypto benefits: privacy, authentication, non-repudiation, and a serious audit trail as well. Pluggable authentication was about to make this happen a few years ago, but now that we can't do that, there will have to be an entire infrastructure built on a single crypto technology which will then leave everything vulnerable and slow to react in the event it's ever cracked. The government is more than part of the problem here, so I find their desire to help kind of ludicrous.
While it might be nice to streamline the prescription process across states, it's clearly an area where the states have control today (and are granted that control under the tenth amendment.) Still, it wouldn't surprise me to see an FDA number required on all prescriptions in the near future as an attempt to normalize the process across the states. Unfortunately, that will remove the abilty of some states to continue to use their own, more effective regulations.
Now, whether the FDA should exist at all is an entirely different (and quite valid) discussion topic. (Let's just say the FDA's record is far from sterling, and places it among the very worst Federal violators of the constitution.)
"The future's good and the present is nothing to sneeze at." - Roblimo's last
You make some valid points, but it's quite unfair to paint pharmacists as just "pill counters".
Actually, I trust the pharmacists knowledge of drugs, their uses (indications), interactions, and situations to avoid (contraindications) far more than I trust the doctor's knowledge of the same. Although the compounding chemist of the old days is sadly becoming extinct, many of the newer drugs require active and knowledgeable management by the pharmacist.
This is particularly true with the new classes of drugs called "kinetics", which are custom mixed in response to events in the patient's own body chemistry and require close cooperation between the lab, pharmacist and clinical staff. True, kinetics are mostly used in hospitals, but they are beginning to be used in more outpatient settings, and in any case, pharmacology is one of the most rapidly changing areas of medicine today.
These folks know a lot, and often know it better than the docs, who have enough trouble just keeping up with new treatments without trying to keep up with all the drug innovations, too.
"The future's good and the present is nothing to sneeze at." - Roblimo's last
The rapid rise of antibiotic resistant bacteria in the past few years is truly scary. Sure the docs are somewhat to blame for continuing to prescribe antibiotics when the patient appears to have a cold just to "give them the appearance of doing something". (This is probably THE major problem in medicine - the refusal to admit that there's nothing medicine can do about a lot of things.)
At the same time, they're our first line of defense at containing antibiotic resistance, so controlled access to these drugs is critical.
Do a web search on VISA and VRSA to get an idea of what's at stake here. (VRSA is Vancomycin Resistant Staphlococcus Aureus, VISA is Immune. Staph Aureus is the most common Staph bacterium, and infests most hospitals. Vancomycin is generally regarded as "the antibiotic of last resort", so VISA is very bad news, indeed.)
FYI, if you are interested in these things, you can read much of The Lancet online (the British medical journal) with registration at www.thelancet.com. As an interested party with no real medical background, I think this is a great deal - I could never justify subscribing (it's relatively expensive), but this lets me learn a lot about current research and findings without the cost or hassle of visiting a medical library, which I'd never bother to do - it's just not that important. I started out there doing research on prions, which are even scarier than VISA and a very good reason to wonder if you really want to ever go to the dentist again...
"The future's good and the present is nothing to sneeze at." - Roblimo's last
Various drugs should indeed be restricted to prescriptions. If every time we got a sniffle and grabbed anti-biotics, whether they are needed or not (i.e. a virus) then we just encourage antibiotic-resistent bacteria (which are very nasty, as my sister just had surgery since antibiotics no longer work).
I'm sorry, but for my own health I don't want my cube neighbor going down to the local pharmacy and buying antibiotics for the flu. There are specified doses of various drugs which vary based on age, weight, and family history. If drugs were unregulated we'd have a nightmare on our hands. There'd be lots of ODs and other problems.
As for antibiotic resistant bacteria, they are becoming more and more common, especially in countries that overprescribe antibiotics.
This post is encrypted twice with ROT-13. Documenting or attempting to crack this encryption is illegal.
There's a fundamental problem here... what about every website that's run OUTSIDE OF THE USA?
I predict we'll see more and more of this internet regulation as government agencies slowly realize that they are unable to control or collect revenue from online business under the traditional, over-complicated, time-consuming, labor-intesive process.
How can you impose import restrictions, trade bans, tarrifs, sales tax, etc when you're dealing with encrypted transactions over the internet.
Most online business today chooses to voluntarily comply with various regulations, like what products ebay chooses to not auction, but if ebay chose to allow others to auction prescription or illegal drugs *and* it were located outside the US, what could be done?
Governments can make the rules, but can the rules REALLY be inforced? I bet that once governments start trying to enforce these rules, you'll see businesses move to small countries with the most free business environments.
If your entire business consists of 2 72" racks in a datacenter, and a local sysadmin, it's pretty easy to move your company to any country about as fast as you can propagate a DNS change.
The cold hard reality is that online businesses can use encryption and change location faster than government can figure out how to deciper what's going on and find a way to collect money or regulate.
Attempts to tax and regulate the internet will only end up driving out businesses from opressive countries. The interesting thing is that your company HQ can be anywhere, and your employees can be anywhere else.
Laws and regulations will divide into two types: those that are enforcable in the physical world, and those that are enforcable in the online world.
"However what about above-average joe? How about
/their/ body. And when we wake up one day and find everybody is coked/tripped out, insane, poisoned, etc., we can say "oh, well, it was their choice, they're stupid"...but shit - we'll be out one country.
someone who has done personal research, read
reports, etc and decided that a drug is right
for them? What gives you or anyone else the right
to tell him that he shouldn't be able to decide
for himself? Is it not his body?"
I do agree with you that doctors and pharmicists are not unreproachable holy people. Both make mistakes, sometimes stupid ones. I also think that an individual is capable of doing research and finding appropriate treatments for themselves. For instance, a lot of people use homeopathic or holistic remedies, or so-called "quack" medicine like chiropracty and acupuncture (which yields amazing results for being such "quacks").
However I think that responsibility should be limited to those who can live up to it. Under your libertarian scheme, could I "prescribe" a few crates of morphine for myself, and then sell it out of the back of my car? The privelage of prescribing drugs is withheld for pharmacists because having gone through pharmacological school they, ostensibly, can live up to a higher responsibility.
Logically you can say that people should be able to use whatever foods and chemicals (illegal "drugs" included) they want, because it is
If you concede that it is part of the government's responsibility to protect its populace (hell, we have a military don't we?), then it is natural this would extend to health care. Whether or not one even concedes that is another issue. I for one wouldn't mind money being shifted from weapons that kill people, to feeding and educating people.
Jazilla.org - the Java Mozilla
It's 10 PM. Do you know if you're un-American?
The power to license doctors and regulate the distribution of medicines is absolutely the realm of the Federal government. Moreover, only the Federal government can reglate this area effectively and without bias.
Let's look at the alternatives:
THE CONSUMERS: which is to say, the marketing divisions of the drug companies that stand behind these products. Whatever confidence I may have had in the wisdom of the Average Joe, is now lost in the haze of happy-feely "all natural" and "herbal" labels I see on potent chemicals like St John's Wort and various binge pills^H^H^H^H^H^H^Hweight loss supplements. It's clear that the noble consumer can be won over by smooth talk and obfuscation, all of which is fostered by large corporations that consider 10 or 20 deaths acceptable in the name of profits. "After all, nearly 90% of EZ-Thin Herbal All-Natual Weight Loss Dietary SupplementTM live for five years or more after taking our pill with only minor complications!!!! Proven at the University of Nairobi to make you smarter and more attractive!!!!!! All Natural!!!*"
*(some test subjects experienced heart failure and testicular shrinkage)
THE PHARMACEUTICALS: Don't make me laugh. History is replete with examples of powerful companies that will ignore or downplay the lethal or detrimental effects of their products in the quest for that extra $1M.
THE STATES: Essentially this is the pharmaceuticals all over again. Congressional representatives are effectively owned by Big Money, and there are few institutions with more of that than the pharmaceuticals. Why would a representative prevent a drug manufacturer, that brings perhaps hundreds of jobs to the state, from producing a dangerous drug that might not even have a very large market in the host state? The wonderful thing about the internet is that you can base your operations in Kansas and sell primarily to people in Idaho, or Washington, or vice versa.
With regards to the contention that will undoubtedly be made by some righteous libertarian or other, the Federal government enjoys this power because it is a matter of interstate commerce. Offering products for sale on the internet constitutes a nation-wide purchasing opportunity, unless the host company is unwilling to ship out of state. But in the case of prescription drugs, which carry a high profit margin, I don't think that will be the case.
Now, I do lament the loss of personal discretion that comes with the Feds assuming power in this matter. Informed individuals should have the right to choose. The trouble is that many people believe they are informed when in reality they are sadly, or even dangerously misinformed. That kills people. And it's why we have an FDA to begin with.
-konstant
Yes! We are all individuals! I'm not!
-konstant
Yes! We are all individuals! I'm not!
My grandmother came to this country from a country where drugs were not regulated (at the time). One of the consequences of that is that she had to be more informed about what drugs she was prescribed or prescribed for herself.
Since she's been in the U.S. of A., this knowledge has saved her life no less than 20 times in the last ca.25 years. How? Because while spending time in hospitals (she's old) she has been brought drugs that would have killed her. She is still alive today.
Another consequence is that this knowledge or an interest in it tends to be passed down through generations (like cooking recipes). Never in my household are any drugs taken without consulting a PDR (Physicians Desk Reference) and usually a few other sources. A similar culture can be seen by contrasting cultures that consume alcohol responsibly from an early age and most U.S. cultures, where we are restricted by law from consuming alcoholic beverages before the age of 21yrs.
Incidently, the rabid regulation of drugs in the U.S. prevents the use of less expensive and more effective drugs. Cocaine and paregoric are just two that come to mind. (Check WordNet, btw).
I'm really shocked to see the crack at Libertarians in the story. Especially when it doesn't have anything to do with the issue at hand.
I don't think any of the online pharmacies have been accused of messing up orders. (Though it wouldn't surprise me - real pharmacies do it all the time, and sometimes it kills people). The issue is that they're selling people prescription drugs when they don't really have a prescription. This perpetuates the dangerous idea that the people have any right to determine what they put into their own bodies, so of course the government must put a stop to it. I suppose also at issue is fewer people being forced to go to a doctor just to get a cursory examination, the prescription they knew they needed, and a $75 bill for the office visit.
I don't see how my chances of getting the wrong drug are any greater just because some verification is made that I have a prescription.
Drug interactions and dosages are information that is readily available to anyone, whether or not they are a doctor. An individual doing research for themself can do a much more thorough job than a doctor, who is probably not going to take the time to do any research at all. A doctor could easily forget something, or not be aware of new information.
For that matter, is the average person going to understand the gobbligook that is written about a medical trial and treatment?
I can understand it, and I have no medical training or education. I have to look up new words frequently, but I'm able to tell that I havn't seen that word before and I need to look it up. It's not like I'm not understanding it and not realizing. If someone knows they're not able to read medical literature, then they can consult a doctor. I don't think anyone is arguing against seeing doctors. Just that people who don't want to should have that right.
Since mention was made of what hte libertarians would say about this, I thought I'd give what libertarians would generally agree on in this area. Licensing serves two purposes main purposes -- to provide information to the consumer about whether they can rely on someone, which libertarians would support (but see below), and to prevent consumers from doing business with people the government doesn't approve of.
If I were ordering drugs online, I would like to see that the pharmacy is licensed by someone who I believe is qualified to evaluate a pharmacy, like a state board. I don't particularly care whether it is california's (where i live) board of health that has licensed them. I just want to know that they aren't selling rat poison as aspirin. I don't need a federal law requiring licensing for drug sales over the internet, I just need a federal law that makes fraud a crime, so that no one can say they are licensed by whoever unless they are really licensed by them. You don't need to force people to go for this kind of licensing. People won't buy anything from people who aren't licensed. A better term would be "certified". It's like being UL Listed. In this scenario, my chances of getting a bad prescription are very low.
The other purpose of licensing is similar to the charters governments used to grant. It isn't to protect the consumer, it's to make sure that some industry is in fact controlled by the government. The government wants to keep an eye on drug companies and licensing is the easiest way to do it (why track them down when you can just require them to register). This doesn't have a damn thing to do with my getting a bad prescription, but it does mean that I can't get a bottle of decent painkillers to carry for emergencies when going on off road motorcycle trips without having to worry about whether the federal government approves of what I'm doing.
This is the argument libertarians would give about why this licensing is a bad idea. In fact, we really want to avoid the licensing because we want people to be able to buy their heroin online cheaply so that they don't have to rob us for drug money, or lurk in alleyways and bring down property values.
--Kevin
If you want to know what the Commerce Clause means, it might be wise to consider what the man who was the principal author of the Constitution had to say on the subject. He discussed the matter with great clarity in a letter to Congress, in which letter he explained why he was vetoing a bill (he was President at the time) in spite of the fact that a) he agreed that the project funded by the bill was a worthy cause, and b) it had been argued that the Commerce Clause gave Congress the power to spend the money as the bill proposed to do:
Veto of federal public works bill
March 3, 1817
To the House of Representatives of the United States:
Having considered the bill this day presented to me entitled "An act to set apart and pledge certain funds for internal improvements," and which sets apart and pledges funds "for constructing roads and canals, and improving the navigation of water courses, in order to facilitate, promote, and give security to internal commerce among the several States, and to render more easy and less expensive the means and provisions for the common defense," I am constrained by the insuperable difficulty I feel in reconciling the bill with the Constitution of the United States to return it with that objection to the House of Representatives, in which it originated.
The legislative powers vested in Congress are specified and enumerated in the eighth section of the first article of the Constitution, and it does not appear that the power proposed to be exercised by the bill is among the enumerated powers, or that it falls by any just interpretation with the power to make laws necessary and proper for carrying into execution those or other powers vested by the Constitution in the Government of the United States.
"The power to regulate commerce among the several States" can not include a power to construct roads and canals, and to improve the navigation of water courses in order to facilitate, promote, and secure such commerce with a latitude of construction departing from the ordinary import of the terms strengthened by the known inconveniences which doubtless led to the grant of this remedial power to Congress.
To refer the power in question to the clause "to provide for common defense and general welfare" would be contrary to the established and consistent rules of interpretation, as rendering the special and careful enumeration of powers which follow the clause nugatory and improper. Such a view of the Constitution would have the effect of giving to Congress a general power of legislation instead of the defined and limited one hitherto understood to belong to them, the terms "common defense and general welfare" embracing every object and act within the purview of a legislative trust. It would have the effect of subjecting both the Constitution and laws of the several States in all cases not specifically exempted to be superseded by laws of Congress, it being expressly declared "that the Constitution of the United States and laws made in pursuance thereof shall be the supreme law of the land, and the judges of every state shall be bound thereby, anything in the constitution or laws of any State to the contrary notwithstanding." Such a view of the Constitution, finally, would have the effect of excluding the judicial authority of the United States from its participation in guarding the boundary between the legislative powers of the General and the State Governments, inasmuch as questions relating to the general welfare, being questions of policy and expediency, are unsusceptible of judicial cognizance and decision.
A restriction of the power "to provide for the common defense and general welfare" to cases which are to be provided for by the expenditure of money would still leave within the legislative power of Congress all the great and most important measures of Government, money being the ordinary and necessary means of carrying them into execution.
If a general power to construct roads and canals, and to improve the navigation of water courses, with the train of powers incident thereto, be not possessed by Congress, the assent of the States in the mode provided in the bill can not confer the power. The only cases in which the consent and cession of particular States can extend the power of Congress are those specified and provided for in the Constitution.
I am not unaware of the great importance of roads and canals and the improved navigation of water courses, and that a power in the National Legislature to provide for them might be exercised with signal advantage to the general prosperity. But seeing that such a power is not expressly given by the Constitution, and believing that it can not be deduced from any part of it without an inadmissible latitude of construction and reliance on insufficient precedents; believing also that the permanent success of the Constitution depends on a definite partition of powers between the General and the State Governments, and that no adequate landmarks would be left by the constructive extension of the powers of Congress as proposed in the bill, I have no option but to withhold my signature from it, and to cherishing the hope that its beneficial objects may be attained by a resort for the necessary powers to the same wisdom and virtue in the nation which established the Constitution in its actual form and providently marked out in the instrument itself a safe and practicable mode of improving it as experience might suggest.
James Madison,
President of the United States
There is no greater authority on the meaning of the Constitution than James Madison.
Cthulhu for President! Why settle for the lesser evil?
While the Federal government may have justification to move into the area of prescriptions now that segments of the industry are involved in inter-state comerce, I think the real question is should me have a system of Prescription Drugs at all. Are we all truely better off because we have to go to a doctor in order to recieve a drug to treat an ailment. In this age of information where I can research my symptoms through medical web sites and books why can I not also choose to treat myself with the medication I require. Prescriptions are simply a way to force more people to contribute money to the medical establishment. Sure going to a doctor is normally a good thing to require, but I don't feel the state should be in the postion of a nanny. Medical Care should be a option, yes you can, and often should go get the advise of a Doctor before taking a drug, but requiring such a thing resticts my right to choose how exactly I wish to treat my own body.
To answer your questions:
> Should I be allowed to fire my gun in the air
> randomly?
Sure...if noone is anywhere nearby that could
possibly be hit. Otherwise you are endangering
others.
> should your neighber be allowed to run a brothel
> in his house?
Why is it any of your buisness if they run a
brothel? Oh god no...someone might get paid money
for Sex! Shit! that would just be wrong.
> or a drug lab?
Why not? Why is it you are so interested in what
your neibor does in the privacy of his own home?
Do you keep track of what he does...make sure he
isn't having sex outside of marriage too?
> I've seen anarchy in action, it aint pretty.
No you have seen chaos...anarchy is not chaos.
Anarchy involves mutual voluntary cooperation
not chaos and destruction.
"I opened my eyes, and everything went dark again"
> I think there are two kinds of free-market
> worshippers.
Just to clarify...I am not a free market
worshiper (anymore). I believe in freedom
definitly...but not capitalism. I think
Capitalism breeds inequality of opertunity, and
makes for a system where the rich live lives
of privilidge off the backs of the workers.
(not to mention that it rewards the dishonest...
it doesn't matter how bad it is or how poorly
its made...if you can market it well you get
rewarded with profit...doesn't exactly encourage
moral action)
Anyway...back to the topic....
Yes it is infeasable to just educate everyone.
What I advocate is make the information available.
Make sure everyone who wants it can get it.
Then let it loose. People will not listen. They
may die. However, their deaths will educate others
to the dangers of not doing research. In the end
people will be more educated.
MOST people will still goto Doctors and get
advice that way. I think that in absence of
prescription REQUIREMENTS, the vast majority will
still goto a doctor first.
The best solution, in my opionion, is to not
use an economic system that favors people who
cheat and lie. However, thats not happening very
quickly....and is another topic completely.
"I opened my eyes, and everything went dark again"
> Seriously, why the fsck can't someone be opposed
> to government cartel protection and still
> recongnize that experts are still required.
Its good to hear the voice of reason.
I would like to state for the record...I do know
a good deal more about drugs than "Average Joe
Citizen", I have some access (due to previous
employment and friends related to medical
institutions) to informtation not everyone has
at their fingertips.
I am against prescriptions (as I previously said).
When I get sick...I go see my fsck'n doctor
if my treatment doesn't clear it up or at least
show major improvement in 3 days. (or if the
symptoms are inconsistant with things I am
fammilair with)
I have no problem with getting expert advice. I
love the idea that its there. However...even
then...
Doctor gives me a script? I check it out no matter
what it is. I look up the contraindications and
side effects myself before I start taking it.
> If I lie and say that I don't have a heart
> problem because I want Viagra, it's my own damn
> fault when I die.
Exactly. Just as it would be the pharmacies fault
if they lied about what the drug was. Look at it
this way...pharmacies WANT buisness. If they
tell you that a drug is dangerous for you...they
could save your life. They LIKE that.
Think about it...if you die...your not going to be
a repeat customer. However if they warn you that
it could be deadly because of your condition...
well...you may just be greatful enough that next
time you need medication, you go to them.
I think that if you lie...or refuse to heed the
warnings, then you deserve what you get.
"I opened my eyes, and everything went dark again"
> So by this I assume that you do not support
> statutes for things like "disturbing the peace"?
Well...ok disturbing the peace. I was kind of
thinking off alone in the middle of a feild
where noone is around.
> One could argue that allowing a pharmacy to
> operate negligently or illegally is, in fact,
> "endangering others."
Yes one could argue that. Howevr that same
argument could be applied to sales of tobbacco
or even alcohol. Should we require prescriptions
for those too? perhaps ban the sale of them?
>>Why is it any of your buisness if they run a
>>brothel?
> So I guess then that you are also opposed to
> anti-prostitution legislation, and various
> zoning laws
Yes I am. Granted I agree that they should not be
able to build a coal processing plant next door
to a residental area, I see nothing wrong with
a brothel. As long as they keep quiet, why not?
Its been shown that crime and other problems
associated with prostitution are more a product
of the fact it is illegal and not a legitimate
buisness than anything else.
> I can't really tell if you're trying to have a
> legitimate argument here or if you're just
> trying to be annoying.
A little of both. I am firmly against the idea
that the government should have any say in what
people can or can not do in the privacy of
their own home, or with other consenting
adults (ie using drugs, paying for sex).
> If you really have such a beef about these laws,
> perhaps you should try writing to your local
> legislature. I sincerely doubt these things will
> ever be legalized,
I have written them. Also...why not have them
legalized? They have not been illegal very long.
The "War on Drugs" has been killing this country
for years.
When alcohol was made illegal, men like Al Capone
ruled. They made their money off alcohol and branched into illegal gambling and other things.
Now that other drugs are illegal...almost all
of the same things happend. Drug lords got
rich, ganges like the bloods formed. Murder rate
skyrocketed.
Prohibition decreases supply. Demand stays the
same. Prices skyrocket. Thus profit for selling
goes up. In this way prohibition FUELS the
black market.
In the end all you have is that people who want
to peacefully use drugs in the privacy of their
own homes need to spend alot more money to do it,
and risk being arrested. All for a peacefull
consensual act.
Land of the Free indeed.
"I opened my eyes, and everything went dark again"
> It's easy to generalize a story, thus making
> pretty much any topic that fits in that
> generalization "on-topic."
Very true...and topics tend to wander in
these types of discussion.
However.,..as was stated...its the same system.
I am against this move by the FDA not because
it is the internet but simply because the
"Controlled Substances Act" (which is what all
prescriptions are based on) is horribly
flawed IMO and that it needs to be gotten rid
of completely not extended.
"I opened my eyes, and everything went dark again"
> It's true that people should take responsibility
> for their actions. However, there's a limit
> to how much self-education you can expect
> someone to do.
Perhaps you don't understand our argument?
Noone has argued that doctors and pharmacists
are not needed. The argument is that we, as human
beings, should be allowed to legally obtain and
consume any chemical we wish to consume.
This is not to say that EVERY person SHOULD do so.
It is simply to say that those who wish to do so
should be allowed to do so.
Even if the prescription system were gone, most
people would still go to doctors, they will still
get some recomendation for a certain drug.
The only change we are asking for, is that those
who believe they are qualified to not go that
route, be allowed to not go that route.
> The FDA, IIRC, is made up of appointed
> officials, not elected ones, making it
> a bit harder to corrupt with money.
Not true. How does being apointed make a person
less greedy? Its true it makes them possibly
more suited to the job (having been selected
not by popularity contest but by selection based
on qualifications) but...once there... them
dead green presidents look mighty sweet no
matter how you got your job.
"I opened my eyes, and everything went dark again"
>> No, North Korea is what happens to communism
>> over time
> Er, no. Communist countries start out this way.
> Russia post-1917 was a very ugly place.
Well there are lots of differnt types of
communism and socialism. I have yet to see
a large scale "Communist" country that actually
espouses communist ideals in any way shape or
form (beyond paying lip service to them)
In truth...Lennin and Stalin were much more close
to fascists than Communists. They just called
themselves communist because it was popular at
the time (and perhaps at one point they even
believed it)
As a socialist, and possibly a communist (I am
not that far philosophically developed to
call myself a communist...I am certainly an
anarcho-socialist) I am apaulled at the
misconceptions about socialism and communism
that I see going around. Much of it is the
fault of people like Stalin who were major
world leaders and called themselves communist...
but were not.
Communism calls for an end to separation of
classes (actually socialism in general tends to)
however Lennin and Stalin, and all communist
leaders that I have seen follow them, have
created even worst class division than before.
They created a working class that was basically
everyone...then a small elite "ruling class"
that sat above everyone.
Hardly communist if you ask me.
"I opened my eyes, and everything went dark again"
>> The scenereo was specifically of a drug that
..as are crack, cocaine, and other narcotics.
>> was fraudulently marketed.
>
Well its a nitpick but cocaine (which is what
crack actually is) is NOT a narcotic. Neither
is marijuana, or methamphetamine. The only street
drug that fits the label of narcotic is heroin.
Basically opiates are the major class of narcotic.
Cocaine is more of a stimulent.
> There'll always be people out to make a quick
> buck by not disclosing all of the truth, or
> outright lying. I was pointing out that, despite
> laws forbidding this, drug dealers are still
> out on the streets selling drugs to people that
> may or may not know the risks. Should we be
> placing the blame on the users, the dealers, the
> manufacturers? A combination of both? Or is
> there no blame at all?
Well yes. People will "lie to make a buck". Its
nothing new. If anything I would blame the
capitalist system which ENCOURAGES dishonesty.
However, have you thought even once that if these
drugs were legal, perhaps things might be
differnt?
Think simple economics. There IS a demand for
these drugs in the country. Since they exist, that
means there is a market. Prohibition makes
production illegal, and thus more dangerous.
Supply goes down. What happens next?
Yes. Price goes up. Since cost of manafacture is
the same, that also means profit goes up with
price.
Prohibition FUELS the black market. Now who runs
the black market? Organized crime of one sort or
another. Remember Al Capone? He never would have
been more than a two bit thug if it wasn't for
prohibition.
Now if its legal...you can require quality
manafacturing. Illegal labs can't compete
with Proctor and Gamble. Then the legal "dealers"
are subject to fraud regulations. They can be
required to disclose the truth. Black Markets are
truely free markets, capitalism at its worst.
Now what I really mean to ask. You favor this
FDA regulating prescriptions and all. I have
said I am dead set against it, because I am
against the Controlled Substances Act alltogether
and want to see the whole system done away with.
(so obviously I am against extending it at the
federal level)
Do you think, that if a person takes a drug that
a doctor has not said is ok, that men with guns
should forcibly enter his home and drag him away?
That is the necissary part of control. Do you
believe that when I go home and load up my pipe
and take a few hits of sweet mary jane, that
police should break my door down and drag me
away to jail? (which would prevent me from going
to work and cause me to lose my job etc)
How about when I eat a sugar cube or two (ie use
LSD for the drug naive)? Perhaps when I crack open
my bottle of GHB when I have a bout of insomnia?
DO I deserve to have my door broken down and to be
dragged away and jailed for these horrible crimes?
GHB is not only illegal in this state, but I am
self-medicating without talking to a doctor (of
course I am open with my docotor about all of
these things, however he doesn't recomend them...
course he has never expressed disaproval either)
The system that you are arguing in favor of, even
in favor of extending the power of, says that
I DO deserve to be dragged away and put in jail.
Never mind that I am a programmer. Never mind that
I am an otherwise normal, productive member of
society. According to the system that you espouse,
I deserve to be locked away as a dangerous
criminal.
Now to be reasonable. I am all in favor of the
prescription system, as long as it leaves people
like myself a way to go around it. As long as
capitalism is in place, I realise that we can't
trust coompanies to act responsibly in the
marketing of drugs. I am all for regulation.
However, internet sales?
Internet sales are much harder than walking to
the drug store. It takes days for them to arrive.
That knocks most idiots right out of the picture.
Hell I would even go further. Don't allow pill
sales, but allow anything to be bought by a
chemical supplier USP grade powder. I am competent
in meauring my own dose with a scale.
You can stop idiots without restricting those who
are determined and know what they are doing. Its
a much better solution if you ask me.
Of course, all these regulations can be done away
with once you institute a socialist system that
doesn't reward lieing.
"I opened my eyes, and everything went dark again"
hmmm so people lik myself want no regulation
until we get a bad prescription ourselves? Hmmm
how does regulation prevent bad prescriptions?
Even without Licenceing etc all the drugs they
sell still need to be made in a manner that they
are safe to consume...if not then they are selling
dangerous product. In fact...most of the time the
drugs are made by the same manafacturer as the
normal pharmacies buy from.
Pharmacies are basically glorified pill counters
these days. Licencing doesn't prevent them from
fucking up and counting wrong. It doesn't
prevent them from picking up the wrong bottle
and giving you the wrong pills.
An online pharmacy that sold anything except what
they are advertising is still in trouble for
breaking existing laws...like say fraud.
In truth this regulation is all about control. It
is about the belief of people in the federal
government that they have the right to control
every aspect of our lives. The entire concept of
prescription drugs is founded on the idea that
citizens do not own their own bodies and do not
have the right to self medicate beyond what
Big Brother has Aproved.
Its funny how anti-drug propagandists always talk
about the "Message it sends". I don't know
about you...but I don't like the message that
these control measures send.
"I opened my eyes, and everything went dark again"
> Pharmacists know a hell of alot more than the
> average joe about what you should and should not
> take.
Yes they do...which is why the "Average Joe"
should consult his doctor and pharmasist before
he even considers using any drug.
However what about above-average joe? How about
someone who has done personal research, read
reports, etc and decided that a drug is right
for them? What gives you or anyone else the right
to tell him that he shouldn't be able to decide
for himself? Is it not his body?
> Tell your evangelization shit to the family of
> the man who died because he bought viagra over
> the internet
How about people who took tylanol and died? Lots
of them every year. How about someone who took
a bit more nyquil then they should have and found
out the hard way that they are one of the 1%-3%
of caucasions who are missing the enzyme that
metabolizes Dextromethorphan.
The simple fact is that if you don't consult a
doctor, then its "Buyer Beware". Buying a drug
on your own means that YOU take responsibility
for making sure its not contraindicated.
Noone is to blame for the fuckup but the man
himself. He could have easily done a little
research and found out that information.
> Sure, it's his responsibility to know that, but
> not everybody is as smart as you say you are
Glad you realize that. Its why we have Darwin
Awards. If a person dies because of their own
irresponsibility, I have little pity (perhaps
for the fammily but not for him).
If you want to help out, forget regulation. Go
for Education. People SHOULD know more than they
do. Over the counter drugs account for many deaths
every year.
Believe it or not, regulation ENCOURAGES
irresponsibility. It breeds the attitude that
"Well other drugs are controlled by doctors and
pharmacists, so these must be safe if I can buy
them" so people buy them and start popping away.
"I opened my eyes, and everything went dark again"
On the other hand, this simply gives the FDA some new powers. Since traditionally, the FDA doesn't do a lot, it really doesn't change much. For example, anything your local GNC probably sells, the FDA can't and won't investigate. (It's not a medicine or a food.) For example, here's their stance on homeopathic medicines: "FDA regulates homeopathic drugs in several significantly different ways from other drugs. Manufacturers of homeopathic drugs are deferred from submitting new drug applications to FDA. Their products are exempt from good manufacturing practice requirements related to expiration dating and from finished product testing for identity and strength. Homeopathic drugs in solid oral dosage form must have an imprint that identifies the manufacturer and indicates that the drug is homeopathic. The imprint on conventional products, unless specifically exempt, must identify the active ingredient and dosage strength as well as the manufacturer."
In short, they don't care unless it's a food, cosmetic, or medicine.
Now personally, when I order a few grams of coke, I want coke, not baking soda. At least now I have the FDA to complain to!
(Think about it. If they sent you Premarin instead of antibiotics you'd want someone to complain to.)
No Zen is good zen
I think this law may be either a good or bad...Like many things, it depends on the implementation.
I am currently working for one of the major online pharmacies, and I think there are some misconceptions out there:
All *legitimate* e-pharmacies currently require a verfified prescription in order to ship any type of controlled medication.
This verification can take several forms - an original prescription mailed in (not advisable if you are currently suffering some sort of acute condition), having your doctor call it it, or electronic transmission from your doctor's office.
This law will probably not affect the major players - CVS.COM, PlanetRX, etc., because they already comply with these types of regulation.
It may add another layer of bureaucracy, it's hard to say just yet.