[House Hearing, 110 Congress]
[From the U.S. Government Publishing Office]
ONLINE PHARMACIES AND THE PROBLEM OF INTERNET DRUG ABUSE
=======================================================================
HEARING
BEFORE THE
SUBCOMMITTEE ON CRIME, TERRORISM,
AND HOMELAND SECURITY
OF THE
COMMITTEE ON THE JUDICIARY
HOUSE OF REPRESENTATIVES
ONE HUNDRED TENTH CONGRESS
SECOND SESSION
__________
JUNE 24, 2008
__________
Serial No. 110-186
__________
Printed for the use of the Committee on the Judiciary
Available via the World Wide Web: http://judiciary.house.gov
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COMMITTEE ON THE JUDICIARY
JOHN CONYERS, Jr., Michigan, Chairman
HOWARD L. BERMAN, California LAMAR SMITH, Texas
RICK BOUCHER, Virginia F. JAMES SENSENBRENNER, Jr.,
JERROLD NADLER, New York Wisconsin
ROBERT C. ``BOBBY'' SCOTT, Virginia HOWARD COBLE, North Carolina
MELVIN L. WATT, North Carolina ELTON GALLEGLY, California
ZOE LOFGREN, California BOB GOODLATTE, Virginia
SHEILA JACKSON LEE, Texas STEVE CHABOT, Ohio
MAXINE WATERS, California DANIEL E. LUNGREN, California
WILLIAM D. DELAHUNT, Massachusetts CHRIS CANNON, Utah
ROBERT WEXLER, Florida RIC KELLER, Florida
LINDA T. SANCHEZ, California DARRELL ISSA, California
STEVE COHEN, Tennessee MIKE PENCE, Indiana
HANK JOHNSON, Georgia J. RANDY FORBES, Virginia
BETTY SUTTON, Ohio STEVE KING, Iowa
LUIS V. GUTIERREZ, Illinois TOM FEENEY, Florida
BRAD SHERMAN, California TRENT FRANKS, Arizona
TAMMY BALDWIN, Wisconsin LOUIE GOHMERT, Texas
ANTHONY D. WEINER, New York JIM JORDAN, Ohio
ADAM B. SCHIFF, California
ARTUR DAVIS, Alabama
DEBBIE WASSERMAN SCHULTZ, Florida
KEITH ELLISON, Minnesota
Perry Apelbaum, Staff Director and Chief Counsel
Sean McLaughlin, Minority Chief of Staff and General Counsel
------
Subcommittee on Crime, Terrorism, and Homeland Security
ROBERT C. ``BOBBY'' SCOTT, Virginia, Chairman
MAXINE WATERS, California LOUIE GOHMERT, Texas
WILLIAM D. DELAHUNT, Massachusetts J. RANDY FORBES, Virginia
JERROLD NADLER, New York F. JAMES SENSENBRENNER, Jr.,
HANK JOHNSON, Georgia Wisconsin
ANTHONY D. WEINER, New York HOWARD COBLE, North Carolina
SHEILA JACKSON LEE, Texas STEVE CHABOT, Ohio
ARTUR DAVIS, Alabama DANIEL E. LUNGREN, California
TAMMY BALDWIN, Wisconsin
BETTY SUTTON, Ohio
Bobby Vassar, Chief Counsel
Caroline Lynch, Minority Counsel
C O N T E N T S
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JUNE 24, 2008
Page
OPENING STATEMENTS
The Honorable Robert C. ``Bobby'' Scott, a Representative in
Congress from the State of Virginia, and Chairman, Subcommittee
on Crime, Terrorism, and Homeland Security..................... 1
The Honorable Lamar Smith, a Representative in Congress from the
State of Texas, and Ranking Member, Committee on the Judiciary. 2
The Honorable John Conyers, Jr., a Representative in Congress
from the State of Michigan, and Chairman, Committee on the
Judiciary...................................................... 3
The Honorable J. Randy Forbes, a Representative in Congress from
the State of Virginia, and Member, Subcommittee on Crime,
Terrorism, and Homeland Security............................... 5
The Honorable Steve Chabot, a Representative in Congress from the
State of Ohio, and Member, Subcommittee on Crime, Terrorism,
and Homeland Security.......................................... 6
WITNESSES
Mr. Joseph T. Rannazzisi, Deputy Assistant Administrator, Office
of Diversion Control, Drug Enforcement Adminstration (DEA),
U.S. Department of Justice, Washington, DC
Oral Testimony................................................. 7
Prepared Statement............................................. 10
Ms. Christine N. Jones, General Counsel, GoDaddy.COM, Scottsdale,
AZ
Oral Testimony................................................. 20
Prepared Statement............................................. 22
Mr. William T. Winsley, Executive Director, Ohio State Board of
Pharmacy, Columbus, OH
Oral Testimony................................................. 29
Prepared Statement............................................. 31
Mr. Patrick J. Egan, Attorney-at-Law, Fox Rothschild, LLP,
Philadelphia, PA
Oral Testimony................................................. 55
Prepared Statement............................................. 57
LETTERS, STATEMENTS, ETC., SUBMITTED FOR THE HEARING
Prepared Statement of the Honorable John Conyers, Jr., a
Representative in Congress from the State of Michigan, and
Chairman, Committee on the Judiciary........................... 4
ONLINE PHARMACIES AND THE PROBLEM OF INTERNET DRUG ABUSE
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TUESDAY, JUNE 24, 2008
House of Representatives,
Subcommittee on Crime, Terrorism,
and Homeland Security
Committee on the Judiciary,
Washington, DC.
The Subcommittee met, pursuant to notice, at 11:32 a.m., in
room 2141, Rayburn House Office Building, the Honorable Robert
C. ``Bobby'' Scott (Chairman of the Subcommittee) presiding.
Present: Representatives Conyers, Scott, Smith, Gohmert,
Forbes, Sensenbrenner, Coble, Chabot, and Lungren.
Mr. Scott. The Subcommittee will now come to order.
And I am pleased to welcome you today to the hearing before
the Subcommittee on Crime, Terrorism, and Homeland Security on
``Online Pharmacies and the Problem of Internet Drug Abuse.''
We have a growing problem where dangerous and addictive
prescription drugs can too easily be bought over the Internet
by anyone, including children. All they need to get relievers,
tranquilizers, stimulants and sedatives is access to a computer
and a credit card.
None of the proper constraints, such as local doctors and
pharmacists, exist in the Internet context. In most cases,
there is no identifying information on the Web site with
respect to where the actual pharmacy is located or who operates
the Web site.
A questionnaire is filled out by the customer without
meaningful interaction between the doctor and the patient. And
you could have a situation where a pharmacy in one State fills
a prescription written by a doctor in another State for a
patient in yet another State.
The illegitimate practice is growing and will continue to
thrive. In fact, from 2006 to 2007, there has been a 70 percent
increase in the number of Web sites advertising or selling
controlled prescriptive drugs over the Internet. The 2006
National Survey on Drug Use and Health indicates that almost 7
million people currently misuse prescription drugs.
I hope at this hearing we will be able to find answers to
the following questions: What is the cause and nature of the
problem? To the extent the problem originates from Web sites
outside the United States, how do we crack down on it? How do
we fight rogue Internet sites without overreaching on the
legitimate ones? And are the existing laws adequate to address
the problem?
With respect to the second point, I look forward to hearing
about the ways the private sector can assist in combating
online sales from foreign countries. We need to address the
international aspect of this problem, and strengthening the
public-private-sector collaboration can help provide an
effective solution.
Third point, I would like to stress that any legislation on
this issue is no substitute for educational treatment and
prevention programs.
In addition, before enacting legislation, we need to
consult with legitimate pharmacies who have online Web sites
for their customers so that we do not tread on Americans'
ability to obtain easy access and convenience in seeking their
prescriptions.
And finally, we need to examine whether current laws are
sufficient to address the problem. While a mechanism currently
exists for certifying Internet pharmacies with the National
Association of Boards of Pharmacy, this process is purely
voluntary.
To mandate a registration system for Internet sites, a bill
has been introduced in the Senate, S. 980, the Ryan Haight
Online Pharmacy Consumer Protection Act, and I understand that
a House companion bill on this legislation will be introduced
shortly.
The bill will require businesses who distribute controlled
substances using the Internet to register with the Drug
Enforcement Administration and to report on the nature of their
Web sites. The bill would also prohibit the sale of controlled
substances that are sold over the Internet without
prescriptions and would require doctors to have at least one
in-person consultation with patients for whom they prescribe
controlled medication.
In addition, the bill creates a new crime that makes it
unlawful for any person to knowingly or intentionally deliver,
distribute or dispense a controlled substance over the Internet
except as authorized by the bill. Penalties would also be in
accordance with those offered under the Controlled Substances
Act.
Finally, the bill increases penalties for all illegal
distribution of controlled substances classified as Schedule 3,
4 or 5 drugs. It also adds a mandatory minimum sentence for
trafficking a certain date-rape drug called ``roofies.''
Before passing any legislation, we need to examine these
provisions further, as they are not directly linked to Internet
sales and address drug trafficking generally. If that is the
case, they should be dealt with in another bill.
I look forward to hearing from the witnesses and hope the
hearing will identify the nature and problem of how we can
effectively deal with illegitimate online sales while
protecting the convenience of the legitimate ones.
That said, it is my pleasure to recognize the former
Ranking Member of this Subcommittee, the gentleman from
Virginia, my colleague, Randy Forbes, for his opening
statement.
Mr. Forbes. Thank you, Mr. Chairman. It is always a
pleasure to be with you, and it is great to be back on this
Subcommittee.
And I, too, want to thank all of our witnesses for being
here today. We appreciate your time.
Mr. Chairman, I will yield to the Ranking Member of the
Committee.
Mr. Smith. Thank you.
Mr. Chairman, are you yielding me time, or is the Ranking
Member yielding me time?
Mr. Scott. Well, you have got the time either way.
[Laughter.]
Mr. Smith. I don't want to take up the Ranking Member's
time.
Mr. Chairman, America is no stranger to illegal drugs and
drug addiction. For decades, Congress has fought to curb the
use of drugs such as heroin, cocaine and marijuana. Today
America is facing a new threat: prescription drug abuse.
According to the Office of National Drug Control Policy,
prescription drugs now rank second, only behind marijuana, as
America's drug of choice. The Drug Enforcement Administration
estimates that as many as 7 million Americans are addicted to
prescription drugs. Today, prescription painkillers cause a
higher number of overdose-related deaths than cocaine and
heroin combined.
And large quantities of these drugs are just a few mouse-
clicks away. Hundreds of online pharmacies peddle these highly
addictive painkillers to adults and teenagers without a valid
prescription. The most popular of these drugs is hydrocodone,
more commonly known as Vicodin.
These rogue Web sites can link a patient from Texas with a
doctor in Florida. Based on little more than an online
questionnaire, the doctor writes a prescription, which is then
filled by a pharmacist in a different State.
Teenagers are fast becoming addicted to prescription
painkillers in large part because of their availability on the
Internet. And, sadly, some of them are dying.
On February 12, 2001, Ryan Haight died of an overdose of
Vicodin. He was just 18. An investigation into his death
revealed that Ryan ordered the drug from a doctor he had never
seen and who had never examined him. The drugs were shipped
directly to his home by an online pharmacy.
Congress can and must put a stop to this. And today I join
Congressman Bart Stupak and Congresswoman Mary Bono Mack in
introducing the Ryan Haight Online Pharmacy Consumer Protection
Act of 2008.
This legislation amends the Controlled Substances Act to
address the growing sale of prescription drugs by these so-
called online pharmacies. The bill prohibits the sale or
distribution of all controlled substances by the Internet
without a valid prescription. It requires online pharmacies to
display information identifying the business and any pharmacy
and doctor associated with the Web site. The bill also provides
tough penalties for the illegal sale of prescription drugs.
Identical legislation sponsored by Senator Feinstein and
Senator Sessions unanimously passed the Senate in April, and it
is past time for the House to do the same.
I welcome our witnesses today.
And, Ranking Member Forbes, I yield back the balance of my
time. Thank you for yielding.
Mr. Scott. Thank you.
The gentleman's time has expired. The gentleman from
Michigan, the Chairman of the full Committee, Mr. Conyers.
Mr. Conyers. Thank you, Chairman Scott.
Does Mr. Forbes have an additional comment? I would yield
to him if he does.
Mr. Forbes. Mr. Chairman, I do, but I would be glad to
defer to you and go after that, Mr. Chairman, if you are so
inclined.
Mr. Conyers. Oh, okay.
Well, I thought this was going to be a very simple hearing
here. And then I find out two things.
One, we have got mandatory penalties all over the place.
Now, maybe there is somebody on the panel that thinks that
imprisoning addicts for as long as we can write the numbers in
is a good idea. I think we will have to talk about that.
And, of course, the distinguished Ranking Member of the
Committee, he and I are in ongoing discussions on every subject
before the Judiciary Committee, so we will just add that one to
the list.
But, you know, doubling--we imprison more people than
anybody on Earth, and here we are dealing with a unanimously
passed Senate product that says, ``Hey, let's go for more.''
Schedule 3, from 5 years, plus 2 years, new penalty, 10 years.
A schedule 3, bodily use, 10 years, 20 years. Date rape, oh,
gosh, that is 20 years, easy. And so we go on down the line.
I mean, what is this? Why? What possible salutary effect
can it have? And what kind of deterrent do you think it is
going to have on anybody that may be thinking about doing it?
So I will be talking to my dear friend and colleague, Bart
Stupak, and of course Ms. Bono about this. We need a new bill,
Chairman Scott. I don't want to be fooling around trying to
amend this in the full Committee. And besides, we have got to
be careful how we stop these illegal Internet pharmacy sites
without getting it confused with the legitimate ones.
And so I will put the rest of my statement in the record,
and look forward to the testimony.
[The prepared statement of Mr. Conyers follows:]
Prepared Statement of the Honorable John Conyers, Jr., a Representative
in Congress from the State of Michigan, and Chairman, Committee on the
Judiciary
In 2007, more than 500 internet sites advertised or sold controlled
prescription drugs, such as Vicadin, Oxycontin, Valium, and Ritalin,
and nearly 85 percent of these sites did not require an actual
prescription.
Online pharmacies present enormous implications for the health and
safety of our communities and our children. In most instances, all that
a person needs to buy these drugs is access to a computer and a credit
card. As a result of the absence of any meaningful controls, even
children can purchase prescription drugs online.
Earlier this year, the Senate passed S. 980, dealing with online
pharmacies. While a good start, the measure may have unintended
consequences and impact individuals other than illegal drug dealers.
It is my hope that any bill considered in the Judiciary Committee
satisfies three principal goals.
First, the legislation should not burden our already struggling
health care system. Currently, there are 47 million uninsured Americans
and another 50 million Americans who are under-insured. While some
people buy drugs from these rogue internet sites for illegal purposes,
others purchase them for legitimate medical reasons. We must carefully
evaluate the impact of any measure on the cost of health care and
prescription drugs for these millions of struggling Americans.
For example, my bill, H.R. 676, would establish a universal health
insurance program with single-payer financing that would cover all
medically necessary services, including prescription drugs. This
program would significantly reduce, if not eliminate, these rogue
sites. At the very least, my program would make it much easier to
identify illegal conduct from legal conduct. In the meantime, though,
we need to consider whether there is more focused legislation that we
can implement with respect to rogue internet pharmacies.
Second, the legislation must address the problem of illegal
internet drug dealers. There are many legitimate pharmacies that use
the internet to serve their customers. In addition, many insurance
companies work with legitimate internet pharmacies to provide
prescription drugs to patients, often at a reduced rate and increased
convenience of the patient. The legislation should recognize the value
of these pharmacies, and seek to stop the illegal internet pharmacy
sites without substantially burdening the legitimate ones.
Third, we need to recognize that the answer to substance abuse
problems is not longer sentences in prison. The current penalties for
controlled substance crimes--whether committed on the street or through
the internet--are sufficiently harsh.
Instead of imprisoning drug addicts for even longer periods of
time, we should address the underlying problem of substance abuse. To
that end, we should support educational programs that teach our
children about the dangers of drug use and encourage providing
community activities for our teenagers so that they don't turn to drugs
out of boredom. And, we should support meaningful drug treatment
programs.
I look forward to hearing from all of our witnesses today and hope
they will provide us with a better understanding of the problem and
possible solutions.
Mr. Scott. Thank you. And I thank the Chairman for his
comments.
The gentleman from Virginia?
Mr. Forbes. Thank you, Mr. Chairman.
And, again, we just want to point out that somewhere in
America right now, a person is purchasing highly addictive
painkillers from an Internet Web site. That Web site operator
has no medical training. He is not licensed by the DEA of the
State to dispense prescription drugs. The doctor has never
examined this person, but he writes the prescription anyway,
not for 10 pills or 20, but for 100.
The dangers posed by illegal online pharmacies are real.
The National Center on Addiction and Substance Abuse reports a
542 percent increase in the abuse of prescription opiates among
12 to 17 year olds between 1992 and 2000.
These Web sites dispense large amounts of controlled
substances, many characterized as Schedule 3 or Schedule 4
drugs under the Controlled Substances Act.
The National Association of Boards of Pharmacy operates the
Verified Internet Pharmacy Practices Sites accreditation
process. To receive a VIPPS accreditation, a pharmacy must
comply with the licensing requirements of its State and each
State in which it dispenses medication. However, this
accreditation process is merely voluntary, as the Chairman
mentioned earlier.
Internet pharmacies are not only a source for obtaining
prescription pain medication, a good number of the drugs
purchased from these illegal Web sites are counterfeit. Most
counterfeit drugs come from overseas and are imported to the
United States with false documentation. These drugs are often
expired, diluted or mixed with other toxic substances.
Patients purchasing drugs from these Web sites have no
guarantees as to the drug's safety. Moreover, they may
experience a dangerous drug interaction or side effect from
ingesting drugs without proper medical supervision.
More than 80 percent of packages intercepted and examined
at U.S. mail facilities have contained either unapproved
foreign drugs, controlled substances or counterfeit drugs.
According to the Food and Drug Administration, the number of
fraudulent prescription drugs intercepted by customs officials
nearly doubled between 2004 and 2005.
Last year, the FDA was alerted that drugs such as Ambien,
Xanax, Lexapro and Ativan ordered online were found to contain
a powerful antipsychotic drug. The antipsychotic drug compound
was haloperidol and is used in medications prescribed for
schizophrenia.
Also last year, the FDA issued a warning against the
purchase of the weight-loss drug Xenical from online
pharmacists. Tests showed that capsules purchased off the
Internet did not contain orlistat, Xenical's active ingredient.
Some contained only talc or starch. Others included
sibutramine, the active ingredient in another weight-loss drug,
Meridia.
Although Xenical and its active ingredient, orlistat, are
not listed on the schedule under the Controlled Substances Act,
sibutramine is listed as a Schedule 4 controlled substance.
It is clear from these few examples that illegal online
pharmacies pose a serious threat not only to those who have
used narcotics but also to unsuspecting consumers.
I commend Mr. Smith, the Ranking Member of the Judiciary
Committee, for his leadership on this issue.
Again, Mr. Chairman, I commend you for holding this
hearing.
And I thank all of our witnesses for their time and
expertise, and I look forward to their comments.
And I yield back the balance of my time.
Mr. Scott. Thank you very much.
I would ask unanimous consent that other Members' opening
statements be made----
Mr. Chabot. Mr. Chairman?
Mr. Scott [continuing]. Part of the record at this point.
The gentleman from Ohio.
Mr. Chabot. Thank you, Mr. Chairman. I would ask unanimous
consent to make an opening statement, and I will keep it to
about a minute, if I could?
Mr. Scott. Without objection.
Mr. Chabot. Thank you.
Mr. Chairman, I, again, want to thank you and the Ranking
Member for holding this hearing. And I also want to welcome one
of the witnesses that we have here, who is from the great State
of Ohio, Mr. Winsley, executive director of the Ohio State
Board of Pharmacy.
The problem of prescription drug abuse is real and it is
growing. With more than 7 million prescription drug abusers in
this country, according to the DEA, rogue Internet pharmacies
and Web sites only compound the drug problem, giving criminals
new avenues to prey on the vulnerable.
While passage of the Ryan Haight Online Pharmacy Consumer
Protection Act would be a positive first step, in my view,
effective communication between State and Federal law
enforcement and the private sector, including the pharmacies,
manufacturers and distributors, is, I believe, key to staying
ahead of the criminals and using technology to our advantage.
Again, I thank the Chairman and the Ranking Member for
holding this hearing. And I yield back the balance of my time.
Mr. Scott. Thank you.
Without objection, other Members' opening statements will
be made part of the record at this point.
We have a distinguished panel of witnesses here today to
help us consider the important issues currently before us.
Our first witness is Joseph Rannazzisi, who began his
career with the U.S. Drug Enforcement Administration in 1986.
In 2006, he was appointed to the position of deputy assistant
administrator for the Office of Diversion Control. In this
position, he is responsible for overseeing and coordinating
major diversion investigations, drafting and promulgating of
regulations, establishing drug production quotas, and
conducting liaison with various State and Federal agencies. He
holds a B.S. degree in pharmacy from Butler University and a
J.D. from Detroit College of Law at Michigan State University.
Our next witness will be Christine Jones, general counsel
of the Go Daddy Group. As general counsel, she is responsible
for all legal affairs at the Go Daddy Group, as well as the
Domain Services, Network Abuse, Compliance, and Legal
departments. Her previous legal practice focused on complex
commercial litigation. She worked for the Los Angeles District
Attorney's Office prior to entering private practice. She holds
a bachelor of science degree in accounting from Auburn
University and a J.D. from Whittier Law School.
The next witness will be William T. Winsley, who is
executive director of the Ohio State Board of Pharmacy. He has
been with the Board of Pharmacy since 1988, starting as a
pharmacist investigator, moving to assistant executive director
in 1991, and has been serving as executive director since 1998.
Prior to employment with the board, he was a practicing
pharmacist and pharmacy administrator with three different
hospital pharmacies for a total of 14 years. He holds a B.S. in
pharmacy and an M.S. in hospital pharmacy management from Ohio
State University.
And our final witness will be Patrick J. Egan, who is a
partner at the Fox Rothschild Attorneys at Law, where he is
chairman of the white-collar practice group. He has nearly 20
years of experience in representing businesses, executives,
professionals and other individuals in Federal white-collar
criminal defense matters. His experience includes defending an
Internet pharmacy site in the Federal grand jury investigation.
He graduated from Pennsylvania State University and received
his J.D. from Temple University School of Law in 1986.
We begin with Mr. Rannazzisi.
TESTIMONY OF JOSEPH T. RANNAZZISI, DEPUTY ASSISTANT
ADMINISTRATOR, OFFICE OF DIVERSION CONTROL, DRUG ENFORCEMENT
ADMINSTRATION (DEA), U.S. DEPARTMENT OF JUSTICE, WASHINGTON, DC
Mr. Rannazzisi. Good morning, Chairman Scott, Ranking
Member Forbes, Chairman Conyers, distinguished Members of the
Subcommittee.
On behalf of Acting Administrator Michele Leonhart and the
men and women of the Drug Enforcement Administration, I want to
thank you for the opportunity to discuss the problem of
prescription drug abuse and, in particular, the illegal
distribution of controlled pharmaceuticals via the Internet.
As you may know, nonmedical use of addictive prescription
drugs has been increasing throughout the United States at
alarming rates. According to the 2006 National Survey on Drug
Use and Health, 7 million Americans used psychotherapeutic
drugs nonmedically, with 5.2 million reportedly abusing pain
relievers. Nationally, the misuse of prescription drugs
remained second, only to marijuana.
While forged prescriptions, doctor shopping and simple
theft from medicine cabinets are all means by which highly
addictive pharmaceutical controlled substances are diverted,
the Internet has become an increasingly common method of
diverting these drugs via rogue Internet pharmacies.
The sheer volume of controlled substances being dispensed
anonymously by rogue Internet pharmacies contributes
significantly to the downstream methods of diversion. Illicit
Internet sales of controlled sales of controlled substances
commonly involve 100 or more pills per transaction. These sales
occur hundreds of times per day.
For example, in 2006, DEA identified 34 known or suspected
rogue Internet pharmacies that dispensed over 98 million dosage
units of hydrocodone-combination products. To put this into
perspective, the average legitimate pharmacy in the U.S.
dispenses approximately 88,000 dosage units of hydrocodone-
combo products per year.
DEA investigations of these Internet traffickers have found
that the vast majority are linked to DEA-registered pharmacies
and DEA-registered doctors. It should be noted that there are
legitimate pharmacies that provide controlled substances----
Mr. Scott. Excuse me. Did you say they are or are not?
Mr. Rannazzisi. They, for the most part, are related to DEA
pharmacies that are registered DEA pharmacies and doctors.
It should be noted that there are legitimate pharmacies
that provide controlled substances via the Internet and operate
daily within the boundaries of the law.
However, as a point of clarification, there are many Web
sites on the Internet that merely offer to sell controlled
substances illegally. A Google keyword search such as
``hydrocodone no prescription needed'' reveals thousands upon
thousands of hits.
While the drug-seeker may go through several portal sites
offering controlled substances, eventually the individual will
be linked to the anchor Web site, or what we term the
``Internet facilitation center.'' These facilitation centers
are the linchpin in the criminal scheme. They link drug-seekers
to rogue doctors and rogue brick-and-mortar pharmacies or
illicit Internet pharmacies in exchange for huge profits.
Under current law, however, these Internet facilitation
centers are not required to register with DEA. And the
Controlled Substances Act did not take into account the
technological advances that have taken place since the CSA was
established. The anonymity afforded by the Internet poses
numerous challenges to law enforcement.
Despite the challenges, DEA has identified, disrupted and
dismantled several illegal operations involved in this growing
threat. When we are able to identify these individuals and
businesses, we investigate and shut down those that operate
outside the boundaries of the Controlled Substances Act.
DEA is also targeting the source of supply for many rogue
Internet pharmacies. The DEA registered wholesalers and
distributors. DEA has initiated an education program for
wholesalers and distributors to explain how these rogue schemes
operate and reinforce what their requirements are under the
CSA.
When appropriate, DEA has taken legal action against the
wholesalers and distributors who are not complying with their
statutory obligations and providing rogue Internet pharmacies
with huge quantities of controlled substance pharmaceuticals.
In addition to working with DEA registrants, DEA has also
developed a productive relationship with other businesses that
are affected or inadvertently used to facilitate the Internet
distribution.
Finally, we continue to build upon solid, interagency
partnerships with FDA, FBI, CBP, ICE, as well as the individual
State boards of pharmacy and medicine. With that, it should be
noted that interagency engagement on this topic has been
ongoing for years.
These discussions culminated with the Administration's
formal endorsement of the Ryan Haight Online Pharmacy Consumer
Protection Act of 2008. This bill updates the CSA to set both
permissible and impermissible conduct for Internet Web site
operators, medical practitioners, and pharmacists involved in
Internet distribution of controlled substances. This bill will
provide law enforcement with additional tools to identify and
shut down these illegal operations, thereby helping protect the
American people.
Chairman Scott, distinguished Members of the Subcommittee,
drug traffickers continue to exploit the Internet and threaten
the health and safety of Americans. Nonetheless, the men and
women of the Drug Enforcement Administration remain committed
to bringing to bear all of the resources at our disposal to
fight this growing problem while simultaneously ensuring an
uninterrupted supply of controlled substances for legitimate
demands.
Thank you for the opportunity to discuss this vital issue,
and I would welcome any questions.
[The prepared statement of Mr. Rannazzisi follows:]
Prepared Statement of Joseph T. Rannazzisi
Mr. Scott. Thank you. Thank you very much. I failed to
advise you of the lights before you that indicate the 5
minutes. You did well and came in right under.
The green light will stay on for 4 minutes, the yellow
light for 1 minute. We would ask you to summarize your
testimony in 5 minutes, as best as you possibly can.
Ms. Jones?
TESTIMONY OF CHRISTINE N. JONES, GENERAL COUNSEL, GODADDY.COM,
SCOTTSDALE, AZ
Ms. Jones. Good morning, Mr. Chairman.
First, thank you for the invitation to be here today. We
are grateful for this Committee's attention to this problem and
for recognizing that online drug sales are a problem that must
end.
The purpose of my testimony is to describe the scope of the
problem we all face and how Go Daddy specifically responds to
those challenges.
Go Daddy is interested in this issue because we often get
requests from the DEA, for example, or other law enforcement
agencies to disable online drug sites, and, as of today, there
is no law we can rely on to help them. And we believe there
should be such a law.
So we are committed to taking whatever steps are necessary
and feasible to assist in ending this practice. And we would
also challenge our counterparts on the Internet to do the same.
A domain name registrar serves as, sort of, the point of
entry to the Internet. So, for example, if you wanted to become
ChairmanScott.com, you could go to GoDaddy.com and get that
name. Well, you can't, because I registered that name in
anticipation of this hearing, but if I hadn't done that, you
could. I will be happy to help your staff get that afterwards.
[Laughter.]
No, I won't sell it. It only cost $9.99.
A domain name registrar is different from an ISP like AOL
or MSN or EarthLink in that the ISP provides access to the
Internet; the registrar provides the registration service for a
dot-com name and the like.
Once you have ChairmanScott.com, you would have to build a
Web site, and then you would have to find a place to actually
put the files for your Web site. Again, you could go to
GoDaddy.com for that service. And we call that ``hosting''
service.
A hosting provider differs from an ISP in that the hosting
provider provides space on a computer; the ISP provides access
to the computer that has the data on it.
The Go Daddy Group devotes considerable time and resources
to working with law enforcement on preserving the integrity and
security of the Internet by quickly closing down Web sites and
domain names engaged in illegal activities.
We work with law enforcement agencies at all levels--
Federal, State and local--and routinely assist in a wide
variety of criminal and civil investigations. We also work with
groups like the Anti-Phishing Working Group, Digital Phish Net,
and so on.
We have made it a high priority to use our position as the
world's largest registrar to try to make the Internet a better
and safer place.
Often we end up investigating sites involving online drug
sales. They come in many forms and degrees of severity. And
they include things like sites with invalid contact data; sites
depicting counterfeit or copycat drugs purporting to be drugs
produced by major pharmaceutical companies, and you alluded to
those in your opening statement; sites selling advertising
advocating or promoting the use of drugs by minors; sites which
admit to filling orders without a prescription.
Our investigations also uncovered sites containing offers
to provide controlled substances via prescription provided by a
``doctor'' employed by the Web site operator. These sites
typically don't verify age, medical history or medical
necessity. The result is that any 14-year-old can go on the
Internet and have a supply of recreational drugs sent to their
home via overnight courier with no questions asked.
We take each instance of this seriously and devote high-
priority attention to ensuring full cooperation with law
enforcement in their attempts to remove such Web sites from our
network.
We have nearly 30 million domain names. In fact, tomorrow
we are going to go across the threshold of 30 million domain
names under management. We can't look at all of them. But what
we can do is work with law enforcement to try to address this
problem.
Within the first 6 months of 2008, we have shut down or
suspended over 6,000--6,000--online pharmacy domain names, in
the first two quarters of 2008. When I say ``shut down,'' that
means if it were a brick-and-mortar store, it would be like
putting a lock on the door so you can't do business with those
people anymore.
Six thousand in 6 months--we think that is a lot. And the
trend is growing. For all of 2007, we had 1,300. So the problem
is getting big, and the scale is huge.
And, you know, this isn't just about people trying to save
money on prescription drugs by unknowingly buying counterfeit
brand-name pills. This is about young kids who use their
parent's credit card, they tell them they are buying music or a
videogame or some legitimate purchase; instead, they are able
to stock the weekly party with enough ecstasy for them and all
their friends. It is very, very serious.
The good news about having--well, what we have discovered
is that there is a small core of vendors who run a very large
number of Web sites. And I think Mr. Rannazzisi alluded to
that. The good news is that, for the most part, if you can get
to them and get them to stop, you have a large benefit on the
other end. The bad news is that one company's actions--for
example, Go Daddy--regardless of how much we may help, isn't
enough.
So effective legislation in this area, we think, may help
overcome this problem. If we can either convince the
illegitimate pharmacy sites that it is not going to be in their
best interest to continue the same practices or if we can
standardize the level and type of responses from providers--for
example, our counterparts--we may all be able to see success
for the Internet, much like we have seen within Go Daddy as we
have responded to these.
Again----
Mr. Scott. Can you wrap up?
Ms. Jones. Yes. I just want to say thank you for the
opportunity to be here and to be heard on these issues. And I
will be happy to answer any questions.
[The prepared statement of Ms. Jones follows:]
Prepared Statement of Christine N. Jones
Mr. Scott. Thank you.
Mr. Winsley?
TESTIMONY OF WILLIAM T. WINSLEY, EXECUTIVE DIRECTOR, OHIO STATE
BOARD OF PHARMACY, COLUMBUS, OH
Mr. Winsley. Thank you, Mr. Chairman, for allowing me the
honor of presenting oral and written testimony before you
today.
I am here primarily to describe the limited progress that
the States have made in dealing with the overwhelming problems
presented by the ready access of drugs via the Internet, with
my primary focus of course being on what Ohio has done in this
regard.
I would first like to say that, in my opinion, the people
that I talk about here today are not accurately described by
the term ``Internet pharmacies.'' To me, an Internet pharmacy
is one that is properly licensed to fill legitimate
prescriptions written by a doctor who is practicing in a valid
doctor-patient relationship and they comply with all the laws,
rules and regulations that are necessary, just like most of the
brick-and-mortar pharmacies do. In other words, my concern
today is not with those sites like Walgreens.com, CVS.com,
Medco.com or the many other legitimate pharmacies that are out
there doing business on the Internet.
The Web sites I have problems with are those that I
describe as Internet drug dealers or, more appropriately,
Internet drug traffickers. These sites are responsible for
pouring millions of doses of prescription drugs, controlled
substances, into the hands of consumers with little or no
regard to the possible harm they could be doing.
If that description makes them sound like street-corner
drug dealers, then I have accomplished my purpose here today.
In many cases, there is more similarity to street-corner drug
dealing than there is to legitimate medical care. The advantage
to using the Internet, as Mr. Rannazzisi pointed out, is that
it is easier for the principals to hide.
My written testimony contains brief descriptions of four
investigations that we have conducted in Ohio since 1998. The
methods used by the Internet drug dealers are constantly
changing to counteract the enforcement processes of local,
State and Federal agencies. And it is getting a lot harder to
track them down and even harder to convict them.
Federal help is needed to help slow down this flood of
illicit drug sales.
To demonstrate what I mean by using the word ``flood,'' let
me just talk about the last two cases that we have done in
Ohio. They are described in more detail in my written
testimony.
But each case involved a small, independent pharmacy who
filled illegal prescriptions from the Internet for only 4
months each, only 4 months for each of the pharmacies. And yet,
together, they managed to fill over 14,000 illegal
prescriptions and dispense over 1.2 million doses of
hydrocodone products to people all over the United States. Four
months, two small, independent pharmacies, 1.2 million doses of
hydrocodone products. They also shipped other drugs, but
hydrocodone was the major one.
Now, both of the pharmacists involved had their licenses
revoked by the Board of Pharmacy in Ohio, but the principals in
the scheme were safely tucked away in another State, where we
had no jurisdiction and little ability to get to them.
These cases involved only two pharmacies in Ohio, one in
Columbus and one in Nelsonville, Ohio, which is a small town
about an hour southeast of Columbus. I know there are more
pharmacies in Ohio doing this. We have multiple investigations
going on even as we speak.
From talking to my colleagues around the country, I know
that Ohio is not unique and every State is facing problems like
this. Every State has small, independent pharmacies that are
shipping millions of doses out via illegal Internet
prescriptions. It just boggles my mind to imagine how much
hydrocodone is hitting the streets.
There are some activities going on that will help deal with
this problem. As an addendum to my written report, I have
provided some information about VIPPS, which you have already
heard about, and a new program that NABP has started, known as
the Internet Drug Outlet Identification program.
A review of this report on the Internet drug outlet program
will identify for the Committee a lot more problems than I have
time to talk about today. There are about 139 Internet drug
outlets that NABP has identified as problem sites. Many of them
appear to be linked to one common network. Many of them are
foreign. And most of them do not require a valid prescription.
The States and the Federal agencies charged with dealing
with this problem need some help. I would suggest to you that
Senate 980 appears to provide some of that help for controlled
substances. I would encourage the Committee to carefully review
this bill and move it along so it could become law. With the
addition of the language contained in this bill, Federal and
State agencies will have a lot greater ability to deal with the
people causing all these problems.
Mr. Chairman, Committee Members, thank you for the
opportunity to testify today. I look forward to discussing the
issue with you further when it is time for questions. Thank
you, Mr. Chairman.
[The prepared statement of Mr. Winsley follows:]
Prepared Statement of William T. Winsley
Mr. Scott. Thank you.
I want to recognize the fact that the gentleman from North
Carolina, Mr. Coble, and the gentleman from California, Mr.
Lungren, have joined us.
Mr. Egan?
TESTIMONY OF PATRICK J. EGAN, ATTORNEY-AT-LAW,
FOX ROTHSCHILD, LLP, PHILADELPHIA, PA
Mr. Egan. Good afternoon, Mr. Chairman and distinguished
Committee Members. Thank you very much for the opportunity to
present this testimony. It is with great honor that I do this,
and I appreciate the invitation very much.
I would like to note that the views that I am expressing
are my personal views and not those of the firm that I practice
with.
I am here to discuss the big picture of the Internet
pharmacy and how it works into the overall health-care issues
that this country faces. Because, for every action, there is an
equal and opposite reaction. We have all been taught that since
we were children. And the fact of the matter is that the
Committee and Congress has focused, I believe, and certainly
the bill in the Senate focuses on one area of the issue without
looking at the bigger picture.
At this particular time, what we really need to address is
whether the Internet pharmacy system, as it presently exists,
is one which is benefiting only those who wish to abuse
controlled substances and those who wish to deal drugs to them,
or whether it is also benefiting the larger public who has
health-care issues that need to be addressed.
And I believe that there has not been any type of empirical
research done which would indicate that the majority of people
who purchase prescription drugs via the Internet are doing so
to abuse them or whether they are individuals who could not
otherwise avail themselves to access to those prescription
drugs.
For instance, in this country there are many people who
live in rural areas where it is a long way to go to get to a
doctor. In this country, as we know all too well, there are
many uninsured and underinsured individuals who do not have
access to go to a doctor and obtain a visit when they need to
get prescription drugs.
We have two major problems in this country on the health-
care level. One of them is obesity, and another is pain. Many,
many thousands of people die from obesity every year. What
Congress appears to be doing here is focusing on the issue of
drug abuse and those individuals who suffer from drug abuse,
which is indeed a tragedy, without considering what the actions
that might be taken, what effect they may have on the ability
of others to obtain health care.
An additional concern that I believe should be addressed is
whether, by passing legislation which criminalizes this type of
behavior, what you are really doing is forcing those who would
obtain prescription drugs and controlled substances illicitly
through the Internet away from sites that are run by
legitimate, licensed pharmacies in the United States to sites
that are run offshore, where we have no control, where all of
the evidence indicates that the majority of the drugs are often
counterfeit.
And, indeed, if you look at the particular bill that was
passed by the Senate, essentially what it does is it asks the
DEA to go and take a look at what happens with regard to these
offshore Web sites.
But there is no means for any control over them, because
they are offshore. What you are going to do is take the model
that is presently taking place in this country and you are
going to take that model away, which is going to drive people
who either need pain medication or diet medication to these
offshore sites and away from sites that are presently operated
in what might not appear to be traditionally the way that it
would have been done but, with the issues that are facing this
country and the technological advances, may well turn out to be
a model that might work for the future.
There are presently Internet pharmacies operating in this
country where you are able to obtain a prescription drug
without a face-to-face visit with a doctor. The DEA has termed
that not a valid prescription. The question is whether you want
to codify that in the law. And that is what is being suggested
to you by some of the other distinguished people on this panel.
I would suggest that when you look at the best approach
that it would be to regulate further those pharmacies, rather
than to criminalize their behavior. For instance, there are
computer programs whereby pharmacies can have a check on
addresses and make sure that they are not sending back to the
same address any sooner than they should within the period that
those drugs would be used. So if an individual at this address
orders a drug on day 1 and tries to come back and order on day
3, they are refused.
There are pharmacies that are run by licensed pharmacists
and there are doctors who are licensed doctors reviewing these
questionnaires, and they are not being paid more to grant every
single description. They are being paid by the review. If you
have that in place, you have licensing authorities who can
exercise control over these people. But if you criminalize that
behavior, that particular section of the industry will
disappear, and, instead, what you will have is only offshore
pharmacies.
Moreover, I would like to echo the statements that were
made at the start of this by some of the distinguished Members
of Congress. For decades, Congress has fought to curb drug
abuse. I would suggest that, for decades, Congress has fought
to curb drug abuse through the imposition of more serious
penalties and mandatory minimum sentences. And I would suggest
that the empirical evidence is that, for decades, that has
failed.
The time has come to look at appropriate regulations that
can actually handle these problems without locking up millions,
thousands, whatever the numbers are, of people. And the
mandatory minimum that is attached to this bill has nothing to
do with Internet pharmacies. And, to me, the legislation smacks
of the 1980's, not of 2008, when we need to take an intelligent
approach to these problems.
[The prepared statement of Mr. Egan follows:]
Prepared Statement of Patrick J. Egan
Mr. Scott. Thank you very much.
We have a vote pending, and we will recess----
Mr. Conyers. Mr. Chairman?
Mr. Scott. The gentleman from Michigan.
Mr. Conyers. Could I get two cents in before we go?
Mr. Scott. The gentleman is recognized for 5 minutes for
the purpose of questioning.
Mr. Conyers. We have been doing a little talking and
thinking here. The problem that we have got the hearing on is 1
percent of the total drug problem. The picture that, globally,
trafficking globally in drugs is $300 billion; the U.S., it is
$65 billion. We spend about $45 billion--I think that includes
DEA, as well--in the U.S. fighting it.
And we incarcerate--this year, incarcerated for drug law
offenses is 5,233 people so far. About 25 percent of our
inmates are serving sentences for drug law violations.
Now, here is why we have a legislative branch: for you to
keep doing the same thing over and over and wondering why we
are going to get about that many, even if we did it correctly.
Why is this problem so intractable?
These are annual figures, by the way, these billions that I
am talking about.
What is it about fighting drugs at the Federal level and at
the State level and at the global level? What is happening
here? Does Big Daddy know yet? Or does Little Daddy even know?
What is going on, folks?
Because the first thing we know, we have got to write a new
bill. I am not buying--you know, I was so happy when I came
here this morning, Chairman Scott. I said, ``Finally, the
Senate got ahead of us on something.'' Well, they did, and they
got it wrong. And now we have got to--unanimously wrong. I
mean, it wasn't a close question.
So what is happening? You are the experts. We brought you
here to tell us.
All right, I am going to pick somebody if you don't
volunteer.
Mr. Rannazzisi. I will jump in.
Where can I begin? The fact is that the drugs that are--I
don't know your figures, I don't know where the 1 percent came
from. So I am really in the dark as far as where the figures
are and how you got them.
However, what I can tell you is that the drugs that are
illegally distributed through Internet pharmacies are just as
dangerous as any of the other drugs that are distributed on the
street. Hydrocodone is a very potent narcotic. It will hurt you
just as much as heroin will if taken unsupervised----
Mr. Conyers. No, I am not questioning the potency of these
illegal drugs and legal drugs being pursued commercially
illegally. I mean, what is it about the nature of drugs in our
culture that make this--I mean, we are spending hundreds of
billions of dollars locking up people. We come here with a
dozen mandatory sentences to lock up people more and longer. We
are already incarcerating more people than anybody on Earth,
including China, Russia and anybody else.
That is the problem I want--I don't want an explanation
about how potent the drug is.
Mr. Rannazzisi. I----
Mr. Conyers. All right, I am calling on somebody else.
Mr. Rannazzisi. Well, I just, if I could respond----
Mr. Conyers. That is a good try.
Mr. Rannazzisi. I----
Mr. Conyers. All right, Daddy, Big Daddy, what have you got
to say? Go Daddy.
Ms. Jones. Thank you.
I don't know why people like to do drugs. It has never been
my thing.
I do think that if you are spending $300 billion a year to
fight the problem, we are not educating people enough about the
dangers of it. Right? So if you give me a tool--all I need is a
database that says either you are authorized or you are not
authorized to sell drugs online. That is all I need.
I will have to defer to my distinguished colleagues on drug
sentencing and whether or not 5 years or 10 years is
appropriate for a guy who sells oxycodone to a 12-year-old,
okay, but----
Mr. Conyers. Well, look, I know about your law enforcement
background. You are an ex-prosecutor yourself. So don't blame
the gentleman to your right.
Ms. Jones. Well, I can tell you when I was a prosecutor, a
vast, vast majority of the cases that I tried, drug cases,
right? I tried cases in Compton. You may have heard of it
before. It is outside Los Angeles. Lots of drug users. You know
what? We always had a theory that if we didn't get the guy the
first time, that was okay because he was going to be back. So
it is a big problem----
Mr. Conyers. Well, that should have reflected--you got
awards for that, I presume.
Ms. Jones. I didn't get any awards. And neither did we seek
any awards. That is not why we did it.
But I do think if you are going to take $300 billion a year
and spend on this problem, you might take a little bit of it
and try educating people about the dangers of using drugs.
Mr. Conyers. Well, how about prosecuting effectively, as
opposed to getting longer and longer sentences? And I agree
with you, education is part of it.
Okay, I will give you another chance.
Mr. Rannazzisi. If we could go back to S. 980 a second, I
am kind of confused you suggested that there were minimum
mandatories in S. 980. The way I understand S. 980 to be is
that they are raising the caps for Schedule 3, 4 and 5 drugs,
just raising the cap.
If you look at the guidelines for these drugs, if you are
looking at a Schedule 3 drug, if I am not mistaken, I think a
level 20 in the guideline runs about 40,000 tablets that you
have to be connected to, the distribution of 40,000 tablets----
Mr. Conyers. So you don't think doubling the sentences is
mandatory?
Mr. Rannazzisi. I think that doubling the sentences is a
deterrent, yeah, because right now under the current
guidelines----
Mr. Conyers. I am sure those guys out there look up the
statutory sentencing----
Mr. Rannazzisi. I beg to differ, but I think they do. These
are white-collar criminals. These are people who are doing this
knowingly and intentionally, using their licenses, their
medical licenses----
Mr. Conyers. Yeah, right, that is who she was locking up
out in Compton.
Mr. Rannazzisi. It is a facade for a medical process that
doesn't exist. They are exploiting----
Mr. Conyers. Okay. And I am sure the white-collar criminals
here are very worried about whether there is a mandatory or
not.
Mr. Rannazzisi. I think they--I believe they do.
Mr. Conyers. So that is why the drug problem is getting
worse and worse.
Mr. Scott. If you could hold your point, we have got 2\1/2\
minutes to get to the floor, and you will be the first--you
will get to answer as soon as we get back.
The Committee is in recess.
[Recess.]
Mr. Scott. The Committee will come to order.
Mr. Winsley, you were about to say something when I cut you
off.
Mr. Winsley. Thank you, Mr. Chairman. I just was going to
comment on the purpose of the bill in dealing with the drug
problem.
The drug problem in the United States is made up primarily
of two factors: One is the people that are abusing the drugs,
and one is the people that are providing the drugs to them.
The purpose of this bill is to deal with the people that
are providing the drugs to them. That is the job of DEA, that
is my job, to enforce the laws. We certainly are not opposed to
the treatment programs, but we are not part of the treatment
programs.
This bill, the criminal penalties that are in it, unless I
misread the Federal law, they deal with the trafficking
section, not with the abusing section. This bill does nothing
to the users. This bill only addresses those that are
trafficking. That section of law that is referred to in this
bill deals with those who manufacture, distribute, dispense or
possess for purposes of manufacturing.
And so I just would point out that this bill will deal with
a small part of the problem, but it will deal effectively with
the part of the problem that is caused by those people who are
trafficking in these controlled substances. And that is a big
issue and becoming even bigger.
Thank you, sir.
Mr. Scott. Thank you.
The gentleman from California.
Mr. Lungren. Thank you very much, Mr. Chairman.
I am sorry that the Chairman of the full Committee is not
here because we have had discussions over the years on our
approach to drug problems, and one of the complaints that he
and others have registered is that we don't go after all drug
dealers alike, that it is easy for us to go after drug dealers
on the street corner in the inner-city but we don't go after
them elsewhere.
It seems to me this bill is an approach to try and deal
with another part of the problem, which seems to me we ought to
be concerned about, the abuse of prescription drugs, illegally
dispensing them, illegally making them available outside the
construct of the law that we have set up over the years.
Mr. Egan, I am a little confused about your testimony, and
that is this. If I were to take the arguments that you have
made against this bill, they would be arguments against the
current set of laws that we have with respect to drugs. Is that
correct?
Mr. Egan. I don't think it is necessarily correct, but I do
think you could certainly extrapolate that my view is that the
war on drugs is a failure and that increased sentences and
further criminalization of what is essentially a societal
problem has been taking place for over 25 years. And I think
the evidence is fairly clear that it is not working and that
we, as a society, need to rethink that.
And, frankly, I am hoping that this body will look at that
a whole lot more closely and have the courage to maybe try
something new.
Mr. Lungren. What would you say about the fact that most
recent reports suggest that drug use among young people is
down?
Mr. Egan. I would say that it has a lot more to do with
education.
For instance, if you take what has been going on in the
western states with regard to the use of methamphetamines and
the advertising program that has been taking place out there,
which has been largely funded by private dollars, which has
indicated that the use of methamphetamine has been cut by a
great amount through that type of education, and if you look at
parenting and education of young people on these issues, those
are successful means for attacking the problem.
The problem with criminalization is----
Mr. Lungren. So let me ask you this, since you brought up
methamphetamine. You would not suggest the decriminalization of
methamphetamine, would you?
Mr. Egan. Well, frankly, I think it is off-point, but----
Mr. Lungren. No, no, but you brought it up. So I am asking
you a question. Would you think about seriously decriminalizing
methamphetamine use and distribution?
Mr. Egan. I brought it up as an example of how education
and advertising and information of that nature is more
successful than criminalization.
I don't know necessarily that I would think that it would
be wise to decriminalize methamphetamines. I think that we have
to make intelligent choices and draw certain lines in certain
places.
What I see, however, is a trend for ever-increasing length
of sentences, ever-increasing mandatory minimums, ever-
increasing ``we are going to get tough on this issue'' and a
lot of money spent. And, frankly, it has become quite an
industry, the prosecution of----
Mr. Lungren. Okay. I appreciate that. I would take issue
with you that it has become an industry, as if those involved
in the drug war from the law enforcement side somehow view it
as an industry, in the sense that this somehow gives them a
means of living and so forth.
Mr. Egan. I didn't mean to suggest that----
Mr. Lungren. Well, we ought to be more careful with what we
say about that, because there are a lot of good men and women
working in a dedicated way to try and get rid of the scourge of
drugs because they have seen what the abuse of drugs does to
people in this country, particularly young people. Just about
every family has had an experience with someone not too far
from them who has been ruined by drugs. And I doubt that
anybody is exempt from that.
When you see the devastation that it does to lives, it
seems to me that we ought to attempt to try and fight it as
best we can. We can have arguments on the margins, but it just
seems to me the effort we are making is worth it.
Mr. Rannazzisi, there has been some criticism of the bill
before us with respect to the penalties involved. Let me cite a
couple of sections to you specifically.
Penalties, section 3(e) imposes mandatory minimum sentences
to crimes that did not previously have mandatory minimums, or
at least that is the argument. Specifically, the section
changes existing law so that small amounts of flunitrazepam are
now subject to the same statutory penalties as large amounts.
First of all, is that correct? And what is the reason for
this? And how would that be related to the uniqueness of
Internet pharmacies?
Mr. Rannazzisi. Let me preface this by saying I am not an
expert on sentencing.
From what I understand of the vision of the bill, the
mandatory minimum would only trigger when there is death or
serious bodily harm that results from distribution, known
distribution of that drug, Rohypnol.
I am not very comfortable answering that question because
that is just not my area of expertise, as far as Rohypnol.
Mr. Lungren. Okay. Well, the reason I ask that is it is my
understanding that this section that it refers to, 21 USC
841(b)(1)(C), as currently written, and with reference through
this bill, would impose the mandatory minimum where the
prosecution has proven that ``death or serious bodily injury
resulted from the use of the substance that was unlawfully
manufactured or distributed.''
So, as I understand it--and I just wanted to know if this
was your understanding--if death or serious bodily injury does
not result from the unlawful manufacture or distribution of
this specific substance, the effect of the bill would not be to
have a mandatory minimum. Is that your understanding too?
Mr. Rannazzisi. That is my understanding, that the
mandatory minimum is not triggered. That is----
Mr. Lungren. So all I am saying is that we can talk about
and argue about mandatory minimums--and I have said that on
other statutes I would be willing to look at mandatory
minimums, see whether they are appropriate, those that are
already in law. But I just wanted to make clear that, in this
instance, as I understand this bill, the mandatory minimum only
comes into effect where you have death or serious bodily injury
resulting from the illegal substance referred to.
Mr. Rannazzisi. Yes, sir.
Mr. Lungren. Some would ask that if pharmacies and
physicians are already subject to DEA registration and State
licensure, why is this bill needed?
Mr. Rannazzisi. Because what this bill does is it forces
them--the first thing it does is creates a definition for what
a valid prescription is. It basically sets out guidelines for
what a doctor is responsible for.
The second thing it does--and this is very important to
us--is it makes these pharmacies identify themselves on the Web
site, so we know exactly who is in the pool. If you asked me
right now how many pharmacies, and who are they, distributing
by the Internet, I couldn't tell you. I just don't know----
Mr. Lungren. If I were to ask you that question about
brick-and-mortar pharmacies in a particular State, could you
tell me that?
Mr. Rannazzisi. I could tell you exactly how many brick-
and-mortar pharmacies in each State there are. There are about
66,000 retail pharmacies across the country, and I could tell
you every one of them if they are DEA-registered.
Mr. Lungren. Is that true for you, Mr. Winsley, in your
State?
Mr. Winsley. Yes, sir. There are a little over 2,000 retail
pharmacies----
Mr. Lungren. So what we have here is, because of the
newness of technology and its application, we have an ability
to create distribution centers which are not regulated in any
real sense, compared with the regulation we have developed over
years with respect to dispensing authorities--that is,
pharmacies. Is that correct?
Mr. Rannazzisi. That is correct.
Mr. Lungren. Ms. Jones, you have talked about the number of
online pharmacies that you basically, I guess I would say,
closed down, but you have done your best to make sure that they
are no longer operating with the benefit of Go Daddy.
You had given us some numbers, that, last year, I think it
was 1,300, something like that, that you had closed down. And,
this year, the first two quarters it has been 6,000?
Ms. Jones. Six thousand.
Mr. Lungren. Is that because you are more attentive to it,
or is it because you see an explosion in the numbers, number
one?
And, number two, do you find that there are individuals
that set up multiple such online pharmacies?
Ms. Jones. To answer your first question, it is not that we
are more attentive, because we have had an active, 24-by-7
network abuse department that has been responding to these
issues for a long time now. What we do see is more third
parties reporting instances of online pharmacies to us.
And, by the way, the 6,000 domain names that we disabled in
the first 6 months of 2008 came to us by way of spam
complaints. Okay? And that is really our only tool right now,
is if we know that they are sending out pill spam, the kind of
spam that all of us get in our e-mail boxes every day that
advertises--well, you know what they advertise.
Mr. Lungren. So I should report it to you when I get these,
is that right? [Laughter.]
Ms. Jones. Yes, absolutely.
And to answer your second question, we do see----
Mr. Lungren. I am afraid to even respond to them, afraid
they will get my name. I just get rid of them right away.
Ms. Jones. Just a bit of unsolicited advice: Do not
respond. Do not respond and say, ``Please take my name off your
list.'' It just proves to them that you actually are a good,
valid e-mail address.
But to answer your second question, we do see a core of
users who run multiple, multiple, multiple Web sites. So one
violator may have 100 Web sites of all varying names and types.
They may have some that are devoted to Viagra, some that are
devoted to Propecia, some that are devoted to OxyContin,
Vicodin, ecstasy. Whatever the name is, they register a domain
name that is specifically associated with that particular drug.
So we do see repeat, repeat, repeat offenders.
But today there is nothing that makes the content per se
illegal. So, like, for example, with child pornography, the
National Center for Missing and Exploited Children or the FBI
or ICE or another agency can come to us and say, ``We know that
there is a child pornography site operating on your network;
could you please take it down?'', and we say, ``Absolutely.''
No questions, no notice, ``You go away, because what you are
doing is illegal.''
That is the kind of tool that we are looking for with the
online pharmacy sites, not to disable the valid 2,000 sites in
Ohio, but to disable the invalid, counterfeit, no-prescription-
needed Web sites.
If we had that tool, then we could just say, ``Are you on
the list? If you are not on the list, you have to go away until
you get your name on the list. It doesn't matter to me where
you are. You can be overseas, you can be in any State, could be
on the moon, I don't care. Get your name on the list, or you
have to go away.''
Mr. Lungren. Thank you, Mr. Chairman.
Mr. Scott. Thank you.
Let me follow up on that. There is no list right now?
Ms. Jones. There is no database that we can hit against to
say, ``Are you on the DEA's list? Are you on the FDA's list?''
We don't have that tool.
Mr. Scott. And if there were such a list, you could check
it and eliminate them from your site?
Ms. Jones. Correct.
Mr. Scott. What power would the Department of Justice have
over sites operated in foreign countries?
Ms. Jones. I don't know what power they would have, other
than to say, ``If you are in another country and you want to
sell drugs via a Web site that is available to U.S. users, you
have to get your name on this list.''
Mr. Scott. Well, and if they don't, what enforcement power
would Department of Justice have for someone operating a site
physically located in, say, Iran?
Ms. Jones. Only that they could call up the domain-name
registrar or the hosting provider and say, ``They are on the
list. Could you please disable this Web site?'' Would they have
jurisdiction to go pursue the offense? Maybe, maybe not.
Mr. Scott. Are there hosting sites outside of the United
States?
Ms. Jones. Absolutely.
Mr. Scott. And so they would have no jurisdiction over a
hosting site physically located outside of the United States?
Ms. Jones. Presumably. I mean, I understand that law
enforcement does work with cross-jurisdictional agencies from
time to time. We----
Mr. Scott. And if it is a country with whom we do not have
good diplomatic relations--I think Mr. Egan's point was you
would get rid of all the domestic sites and you would force
people offshore.
Ms. Jones. Potentially. And we have seen that.
Although, the availability and the ease of access of, for
example, not to overuse this, but of child pornography has been
effective. It is much more difficult for just your everyday,
average user to find a child porn site, because what we have
done here is said that content, itself, is per se illegal. And
so it forces the users to have user-to-user access, makes it
much more difficult for a child, for example, to go find that
content.
Mr. Scott. Mr. Winsley, we want to allow the legitimate
organizations to flourish and not the illegitimate ones. One of
the issues is whether or not a face-to-face visit with a
prescribing physician is necessary. We have heard that some
people live in rural areas where this may not be feasible.
Is a face-to-face visit with a licensed physician
necessary?
Mr. Winsley. Mr. Chairman, on every occasion, no. However,
initially, yes.
Our point is and our State medical board's point--I have
included their rule in my written testimony, which has been in
existence since the 1990's--our opinion is that there must be
an established doctor-patient relationship. That means that the
doctor and the patient have come together.
For example, Mr. Chairman, your personal physician, if you
are out travelling and you come down with a sinus infection,
there is no problem with you calling your personal physician on
the phone, saying, ``Here is what my symptoms are,'' lo and
behold, he calls in a prescription across State lines to where
you are, deals with it. But he knows you. He has already done
all the indignities to you that our doctors do to us.
[Laughter.]
He has evaluated you. And so there is an established
relationship.
Mr. Scott. So a requirement that there be at least one
face-to-face visit and a valid doctor-patient relationship
would be not be a problem even in rural areas?
Mr. Winsley. It should not be.
The other issue, Mr. Chairman, is that, in Ohio, we legally
define prescription drugs--we call them ``dangerous drugs.''
That is the legal term. The reason for that is that they are
well-proven--I think Mr. Rannazzisi pointed this out too--but
these drugs are dangerous if they are used inappropriately.
What I point to you in my written testimony is the drugs
that the two Internet pharmacies that we most recently dealt
with dispensed. And if you look at those hydrocodone products,
you will notice that the overwhelming majority of them were the
highest strength available.
And yet, I don't know if anybody on the Committee has had
recent surgery; I am not asking because of the HIPAA privacy
rules. But I will tell you that I did, and I know a lot of
people who have. And when we came out of surgery, the drug that
we were prescribed was Vicodin, five milligrams. And that was
perfectly adequate.
But every drug-trafficking site that we have been involved
with and, in fact, some of the face-to-face drug-trafficking
physicians that we have dealt with, the drugs that they have
prescribed have always been the hydrocodone, 10 milligrams; the
OxyContin, higher level milligram doses, not the doses that
normal patients use.
So not only is there not an established doctor-patient
relationship, but in many of these cases the patients are using
this just to access the highest-strength drugs available.
Mr. Scott. If the Internet sites were required to be
registered, it would be a State board of pharmacy with
jurisdiction over each one that is registered; is that right?
Mr. Winsley. There would be.
Mr. Scott. And you would be able to have some quality
control over what is going on. Which is unlike what is going on
now.
Mr. Winsley. Mr. Chairman, if we know where they are at, we
can reach them.
Mr. Scott. So if they are in your State, you would be able
to oversee for quality control, so consumers would have some
confidence in what they are dealing with. We have heard that
some of these out-of-country sites mail in--you wonder why they
even bother to mail the drugs. Why don't they just take the
money and run? I mean, they close up after 4 months.
But you would be able to provide quality controls so that
the consumer has some confidence that they are getting what was
prescribed?
Mr. Winsley. If they were in my State and we knew about
them, yes, sir.
Mr. Scott. And, Mr. Rannazzisi, if they are registered, the
DEA could do occasional periodic testing to make sure that they
are complying with the laws?
Mr. Rannazzisi. Yes. And they would be identified, and it
would help us out in the long run.
Mr. Scott. But the consumer could check the list to
ascertain whether or not the pharmacy they are dealing with
online is actually a legitimate pharmacy and not some fly-by-
night something from who knows where?
Mr. Rannazzisi. But when the consumer hits the Web site, he
is going to see exactly who he is dealing with. All that
information will be on the Web site. So he could check the
list, but it is going to be on a Web site.
Mr. Scott. Yes, but the Web site is also on the list so he
knows it is not a fraudulent Web site with counterfeit
information.
Mr. Rannazzisi. I think the consumer, if he was worried
about that Web site, could cross-check the Web site with the
State board of pharmacy, which has that information available.
So he would basically be able to know that where he is ordering
from is a legitimate pharmacy.
And that really knocks out a lot of the foreign pharmacies
then, because if you are hitting a Web site that you know has a
DEA registration number and is licensed by the State board of
Ohio, he could check the board, check with DEA, and then order
his drugs.
Mr. Scott. Thank you.
The gentleman from California.
Mr. Lungren. Mr. Rannazzisi, my question is this. I want to
make sure we crack down on the illicit distribution of drugs. I
want to make sure that people in rural areas are not denied
access because of additional impediments.
What is the standard use now for doctors in their
prescribing of drugs, the relationship with the patient? What
does DEA look at, if they were to look at whether a doctor was
prescribing appropriately or not?
Mr. Rannazzisi. Well, to issue a valid prescription, the
doctor has to issue that prescription for a legitimate medical
purpose and in the usual course of that individual
practitioner's practice. That is the standard, that is the
standard that was set by the court, standard that is set in the
regs.
And there are a lot of ways to look at that. But if you
look at what the AMA guidelines and the Federation of State
Medical Boards' guidelines, they discuss Internet prescribing
and particularly what a valid prescription is. They say that,
you know, you have to do a complete medical history. You should
have at least one face-to-face, in-person examination. Those
are the guidelines from the Federation of State Medical Boards
and the American Medical Association.
Bill, if you want to jump in, I think that is what Ohio has
too, doesn't it?
Mr. Winsley. Well, in my written testimony, at the very end
there are copies of our medical board's rule and pharmacy
board's rule dealing with this issue. Those rules came into
effect after our first Internet case back in 1998. And if you
read those, they pretty much are the basis for what FSMB and
AMA have come out with.
Mr. Lungren. Well, see, my point is, I want to make sure,
and I don't think the bill does, that this prospective law does
not go beyond what the common practice would be in a
relationship of a doctor-patient.
It is not required, as mentioned by Mr. Winsley, to have a
face-to-face every time you get a prescription. You have to
have an established relationship with the doctor. And that
could be your physical, and then after that the doctors
establish things. It could be that you have a physical every
year. It could be that you don't see the doctor for 5 years,
but he has your record, he talks with you, those sorts of
things.
I don't want us to be interfering beyond that. But what I
would want us to do is to make sure that if you are getting a
prescription from an online pharmacy, you basically are
following the same regime, the same custom and practice that
you are with a physician when you get it from a brick-and-
mortar pharmacy.
Mr. Rannazzisi. Yes, sir. And that is outlined in the AMA
and FSMB, the Federation of State Medical Boards, guidelines.
Additionally, what the federation says is, treatment,
including issuing a prescription, based solely on an online
questionnaire or consultation does not constitute an acceptable
standard of care.
Mr. Lungren. Let me ask this. Some might say, ``Hey, look,
all this is is the brick-and-mortar pharmacies trying to make
it difficult for the online pharmacies.'' You know, that is
what their axe to grind is in this whole thing.
And these doctors, including the medical societies, they
want to make sure that you are not spinning off patients to
doctors who have embraced the new technology, so that you don't
have to have face-to-face, you can actually converse with your
doctor over the phone or even through the Internet in some sort
of way.
What would you say to that?
Mr. Rannazzisi. I believe we are talking about now S. 980,
the bill has----
Mr. Lungren. Correct.
Mr. Rannazzisi [continuing]. Provisions that deal with
that. They have telemedicine provisions. They have provisions
that deal with certain situations where a doctor may not be
able to do a face-to-face. But it is built into the law.
That bill went through the interagency, and everybody who
looked at it, you know, looked at it from their point of view.
How is it going to affect patient care? That is how HHS looked
at it, and FDA. The Veterans Administration looked at it. When
that bill was drafted, it had the input of every agency that
evenly remotely had some kind of contact with patient care.
The provisions that were put in that bill protect a lot of
the people that, for some reason, can't go to see a doctor.
There are provisions built into that bill that will allow for
exceptions; and also telemedicine, which is an emerging trend.
Mr. Lungren. It is my understanding that the bill has these
penalties attached to people who are in the process of
distributing the drugs, as opposed to the person using. Is that
correct?
Mr. Rannazzisi. That is right. The bill addresses, again,
distributors of the drug, not ultimate drug users.
Mr. Lungren. Thank you very much.
Thank you, Mr. Chairman.
Mr. Scott. Thank you.
Mr. Rannazzisi, how does the distributor or the owner of
the Web site get the drugs, get access to the drugs to begin
with? Does the manufacturer ship them to a warehouse?
Mr. Rannazzisi. The owner of the Web site generally does
not touch the drugs. He is a facilitator. He employs or he
recruits doctors and pharmacists. And those doctors and
pharmacists run the transaction. The facilitator, the Web site
facilitator is a generally a layman. All he does is bring the
doctor and the pharmacy and the patient together for one
transaction.
Mr. Scott. So they have to get--wherever the drugs land,
wherever the warehouse is that the drugs--are they registered?
Mr. Rannazzisi. The pharmacy that dispenses the ultimate
prescription is generally a DEA-registered pharmacy.
Now, obviously, the question was asked about overseas
pharmacies; DEA has no regulatory control over an overseas
pharmacy or distributor. However, here in the United States, we
do.
And, generally, our pharmacies that dispense the drugs are
DEA registrants. Doctors that prescribe the medication are also
DEA registrants.
Mr. Scott. So you already have a list of all of the
domestic sources for the drugs?
Mr. Rannazzisi. I have a list of all domestic pharmacies
that are DEA-registered and all doctors that are DEA-registered
as well. But that list only tells us that they are pharmacies.
It doesn't tell us if they are involved in Internet dispensing.
It doesn't say if the doctor is involved in Internet
prescribing.
Mr. Scott. Is this bill limited to Internet drug sales? Or
do the penalties relate to general sales in addition to
Internet sales?
Mr. Rannazzisi. I believe that the provisions increasing
the caps relate to all Schedule 3, 4 and 5 drugs, and not just
limited to Internet sales of Schedule 3, 4 and 5 drugs.
Mr. Scott. Now, you have acknowledged that there are
mandatory minimums in the bill?
Mr. Rannazzisi. No. The Rohypnol provision, which is--by
the way, Rohypnol is not a pharmaceutical controlled substance
in the United States. It is not a legitimate medication in the
U.S. It is only used outside of the borders of the United
States.
Mr. Scott. And that is the only mandatory minimum that is
in the bill?
Mr. Rannazzisi. That I am aware of, yes. And that is,
again, if there is----
Mr. Scott. Is that the ``roofie''?
Mr. Rannazzisi. Yes, Rohypnol, yes.
Mr. Scott. But there are mandatory minimums for that drug?
Mr. Rannazzisi. The way I understand it, again, is that
that mandatory minimum is triggered if there is death and
bodily harm attached to the distribution.
Mr. Scott. Okay. Are you aware of any studies that show
racial bias in the application of mandatory minimums?
Mr. Rannazzisi. Am I aware of any studies? I am aware that
that subject has been debated in Congress and the Sentencing
Commission, but, no, I am not aware of any studies, no, sir.
Mr. Scott. So if someone were to say that mandatory
minimums are generally imposed in a racially discriminatory
manner, you wouldn't have any evidence to contradict that?
Mr. Rannazzisi. I don't believe I would be the best person
to ask, sir. Again, I am not an expert on sentencing for the--
--
Mr. Scott. Well, you are here--well, so, if we drop the
mandatory minimums out of the bill, would you object to that?
Mr. Rannazzisi. That would be up to the Administration to
make that decision.
Mr. Scott. Are you aware that the Judicial Conference has
described mandatory minimums as often violating common sense?
Mr. Rannazzisi. I am sorry, sir. Could you repeat that
question?
Mr. Scott. Are you aware that the Judicial Conference has
frequently communicated with this Committee describing
mandatory minimums as frequently violating common sense?
Mr. Rannazzisi. Again, sir, no, I am not aware of that.
But, again, I don't follow sentencing----
Mr. Scott. So you don't have any evidence on behalf of the
Administration to contradict the fact that mandatory minimums
often violate common sense?
Mr. Rannazzisi. I would rather not respond to that
question, sir.
Mr. Scott. Okay. The RAND Corporation has studied mandatory
minimums in drug offenses and concluded that mandatory minimums
waste the taxpayers' money. Do you have any evidence to
contradict the fact that the imposition of mandatory minimums
in the bill will waste the taxpayers' money?
Mr. Rannazzisi. No, sir, I don't have any information to
give this Committee on that topic.
Mr. Scott. Can you explain to us whether or not you have
found any studies that show that mandatory minimums work?
Mr. Rannazzisi. Again, sir, I don't know of any studies and
I wasn't prepared to come here to discuss the mandatory minimum
sentences.
Mr. Scott. Well, they are in the bill, and, you know----
Mr. Rannazzisi. Again, there is no mandatory minimum
sentence, other than the imposition of the----
Mr. Scott. So if you are not here to defend the mandatory
minimum, you wouldn't--or at least it is not your call to
support or oppose whether they are removed from the bill.
Mr. Rannazzisi. Again, that would be an Administration
decision.
Mr. Scott. Who exactly would we hear from to ascertain
whether or not you have given up on a provision that has
racially discriminatory qualities to it, violates common sense
and wastes the taxpayers' money?
Mr. Rannazzisi. You could, I am sure, contact the
department. And I will go back and relay that message to the
department.
Mr. Scott. Now, you don't need increased penalties to
enhance enforcement. I mean, even without the enhanced
penalties, if you prosecuted someone and got a conviction, you
would pretty much put them out of business with the present
penalties, would you not?
Mr. Rannazzisi. Obviously, yes, they would be incarcerated
and we would remove their registration and, if appropriate,
seize their assets, yes.
Mr. Scott. Now, what do you need to do to enhance
enforcement?
Mr. Rannazzisi. Again, the bill helps us by creating a pool
of Internet pharmacies that are operating. It is a ready pool
that we could look at and determine who is operating on the
Internet and who is not. It helps us in our investigations to
identify who the players are operating on the Internet.
Mr. Scott. And so, once you have that list, you have the
tools that you need to prosecute those that are operating
outside of the----
Mr. Rannazzisi. Well, no, there are other things: the
establishment of what a valid doctor-patient relationship is,
what a valid prescription is. That is very important; puts
everybody on notice that this is what is expected.
Mr. Scott. Okay, so you make a list. You have, what, the
definition of valid prescriptions?
Mr. Rannazzisi. Yes.
Mr. Scott. Okay, what else do you need to enhance
enforcement?
Mr. Rannazzisi. If you would excuse me 1 second.
Obviously, definition of what the Internet is, what
Internet delivery is; all of the registration requirements that
we have asked for, which we cannot do by regulation; reporting
requirements--that is, if you are operating as an Internet
pharmacy, you have to make certain reports to the attorney
general on the quantity of drugs you are selling via the
Internet.
Mr. Scott. Do you necessarily have to be under a State
board of pharmacy?
Mr. Rannazzisi. Any pharmacy that operates in the United
States is governed by a State board of pharmacy.
Mr. Scott. Is that right, Mr. Winsley?
Mr. Winsley. Yes, sir. If it is a legitimate pharmacy, it
is licensed with the State in which it is located and usually,
if it transports drugs across State lines, with the rest of us
for shipping. You know, in Ohio, for example, anyone who ships
drugs into Ohio is licensed with us. So we have pharmacies
licensed from all over the country.
Mr. Scott. So anyone that ships drugs in response to an
Internet order, if they ship into Ohio, they should be
registered in Ohio?
Mr. Winsley. The law is that they be licensed with us, yes,
sir.
Mr. Scott. And so, if you have some of these well-known
pharmacy Web sites--I have ordered stuff over the Web, not
prescriptive drugs. If I were to order a prescriptive drug over
the Internet, they would have to be licensed in Virginia?
Mr. Winsley. If they were operating legally, which is our
concern here.
The ones we are talking about don't bother to get licensed.
We have no ability to get to them. We know that Ohio people got
drugs, and we know that they had a problem. So when they tell
us where they got them, the site is not anybody that we have
jurisdiction or control over.
And that is the advantage to this bill: It does give the
Federal agencies, DEA in particular, the advantage to deal with
those that are located outside of my State.
Mr. Scott. Okay. So we get a list, we create the pool, we
have reporting to the attorney general, we define the Internet,
we define valid prescriptions. What else is in the bill that
helps you?
Mr. Rannazzisi. The advertising provision. With the bill,
this prohibits people advertising to sell a pharmaceutical
controlled substance illegally.
Mr. Scott. Is spam advertising?
Mr. Rannazzisi. I would have to go back and look at the
spam, but I am--well, yes, I have seen some of those spam
messages, absolutely, ``Hydrocodone without a prescription, no
doctor visit required,'' yes.
Mr. Scott. Ms. Jones, is there any question that spam would
be advertising?
Ms. Jones. Absolutely not. It is absolutely--unsolicited
commercial e-mail is an advertisement.
Mr. Scott. Is?
Ms. Jones. Is.
Mr. Scott. Okay.
Ms. Jones. And I would add another thing, is that the bill,
I think, calls for a display of the compliance with the DEA
list. That would be very helpful, at least from our
perspective, and, I think, noncontroversial.
Mr. Scott. So if someone received an advertisement without
the DEA designation, you would know it was illegal. And if it
came with the DEA logo, you would know where to go to check
them out.
Ms. Jones. I wasn't even thinking of that, but that would
be helpful as well. I don't think the current version of the
Senate bill calls for that. But it would be an interesting
idea, to actually require it in the advertising as well.
Mr. Scott. The gentleman from California?
Mr. Lungren. I am glad to hear that the Chairman is trying
to beef up the bill. Very good. Parts of it.
We keep talking about the mandatory minimums. I just want
to make it clear that, with Rohypnol, what the bill does is
drop the one-gram requirement that currently is in the law, but
it does not change the requirement that, for mandatory minimum,
one must be prosecuted successfully for having death or serious
bodily injury resulting from the use of the substance that was
unlawfully manufactured or distributed.
And the cross-reference to serious bodily injury is ``an
injury which involves substantial risk of death, extreme
physical pain, protracted, obvious disfigurement, protracted
loss or impairment of the function of a bodily member, organ or
mental faculty.'' That is pretty serious stuff.
So we are not really creating a new mandatory minimum. What
we are saying is the one-gram requirement is not there with
respect to the trafficker, so long as you can show that death
or serious bodily injury resulted in that.
Mr. Rannazzisi, are you aware of any studies that suggest
that Rohypnol is particularly utilized by one ethnic group or
another or one racial group or another in the United States?
Mr. Rannazzisi. No, sir.
Mr. Lungren. It is what is commonly known as the date-rape
drug, is that correct?
Mr. Rannazzisi. Yes, it is used in facilitation of sexual
assault.
Mr. Lungren. And it was in the 1990's that Congress passed
laws specifically dealing with this drug for the first time?
Mr. Rannazzisi. Yes, I believe it was in the late 1990's.
The drug is not a pharmaceutical in the U.S.
Mr. Lungren. Right. And in 2006, Congress amended the law
to add a new specific offense prohibiting the use of the
Internet to distribute the date-rape drug.
Mr. Rannazzisi. Yes, sir.
Mr. Lungren. So this is beyond controlled substances or
dangerous drugs. This isn't on any schedule whatsoever for use,
correct, for an FDA-approved use?
Mr. Rannazzisi. It is not approved to be marketed or
dispensed in the United States. FDA has not approved it to be
marketed or dispensed in the United States.
Mr. Lungren. And there has been question about Internet
sites that are offshore. That is referred to in the bill when
it talks about making this bill compatible with the already-
existing provisions of law making it illegal to import
controlled substances into the United States from foreign
countries or territories, correct?
Mr. Rannazzisi. Yes, sir.
Mr. Lungren. In fact, the law says specifically, on the
books, ``It shall be unlawful to import into the customs
territory of the United States from any place outside thereof
any controlled substances of Schedule 1 or Schedule 2, any
narcotic drug in Schedule 3, 4 of 5 of this chapter.''
So it is illegal to import the drugs into the United
States, correct?
Mr. Rannazzisi. As far as controlled substances, I could
tell you that any quantity of controlled substances that are
coming in via carrier or mail, unless it is going to a DEA-
registered importer, it is illegal and it is subject to
seizure.
Mr. Lungren. So this law would help you with respect to
that, in that we would be setting up a schematic in which there
would be information to the consuming public as to whether or
not the site was registered with the DEA.
Mr. Rannazzisi. Yes, sir.
Mr. Lungren. There would be the ability for them to check
that against whatever approved list that you have.
Mr. Rannazzisi. Yes, sir.
Mr. Lungren. There would be an ability for people then to
check with the State involved, either the reported sending
State or the receiving State, as to whether they were
registered.
Mr. Rannazzisi. Yes, sir.
Mr. Lungren. If, in fact, it failed those tests and it
appeared that it was coming from outside the United States,
that would at least give you some indication to start an
investigation as to where it was coming from, and the act
itself would be illegal under the terms of current law,
correct?
Mr. Rannazzisi. That is absolutely correct, sir.
Mr. Lungren. So even though we have the problem with those
that are overseas, this would at least give us more databases
and more information from which to launch an investigation into
what may be an illegal site.
Mr. Rannazzisi. That is correct, sir, yes.
Mr. Lungren. Thank you very much, Mr. Chairman.
Mr. Scott. Thank you.
I just had a couple of points.
One, distributing the date-rape drug over the Internet is
already illegal. What this would do would be to expand that
mandatory minimum to other sales not over the Internet. Is that
right?
Mr. Rannazzisi. I am sorry, sir. I don't follow you there.
Mr. Scott. In 2006, the Controlled Substances Act was
amended prohibiting the use of the Internet to distribute a
date-rape drug, which the Congress defined, included a maximum
sentence of 20 years.
Mr. Rannazzisi. Yes, sir.
Mr. Scott. And another question: One of the problems with
the mandatory minimums is that you not only get the main
perpetrator but everybody who is part of the conspiracy. Is
that right?
You know, you bust a warehouse. Everybody is subject to the
same mandatory minimum sentence, not just the ringleader, but
the people off on a tangent would also be looking at the same
mandatory minimums, even if it made no sense to impose the
penalty on someone who is just out there on a tangent.
Mr. Rannazzisi. I believe that would be up to the United
States attorney where the district is.
Mr. Scott. Wait a minute. But if they were prosecuted and
found guilty, the judge would have no discretion but to impose
the draconian mandatory minimum on someone who was just out
there on a tangent.
Mr. Rannazzisi. Again, sir----
Mr. Scott. So we will leave it to the discretion of the
prosecutor to decide----
Mr. Rannazzisi. Discretion of the judge.
Mr. Scott. Well, unfortunately, with a mandatory minimum,
that is the problem. If it makes no sense, the judge has to
impose the mandatory minimum anyway.
Mr. Egan, did you have something to say about that?
Mr. Egan. Yes, sir. What I wanted to speak to was the fact
that what this does is it takes the discretion to not apply
that sentence to those individuals who maybe are not the main
perpetrator away from the court and places it in the hands of
the United States attorney, who makes that decision based upon
whatever they feel is appropriate under the circumstances of
the case.
So that the application is now vested in the executive
branch and taken away from the judicial branch, where it
properly resides.
Mr. Scott. And if someone has just a distant connection
with the conspiracy and they are brought in and convicted with
everybody else, how much discretion does the judge have in
imposing a mandatory minimum sentence?
Mr. Egan. None.
Mr. Rannazzisi. Again, sir, for this particular drug,
though, that only triggers if there is death or serious bodily
harm.
Mr. Scott. And if you were not the ringleader but, say, a
lookout, you get the same--what is the mandatory minimum?
Twenty years or whatever it is? You get 20 years for being the
lookout? You shouldn't have been a lookout.
And if you are the lookout's assistant, so if you took a
message--this is where the girlfriends get involved--you took a
message for somebody, you are part of the conspiracy, you get
roped in, you get the same mandatory minimum with everybody
else?
Mr. Rannazzisi. Sir, again, that is a question that I am
more than happy to take for the record and respond in writing.
Mr. Scott. Mr. Egan, if somebody takes a message and is
part of the conspiracy and gets roped in, do they get the same
mandatory minimum like everybody else?
Mr. Egan. As long as what the mandatory minimum requires to
have taken place is met by that person's actions, then they get
the mandatory minimum, unless the prosecution decides not to
pursue it. It is totally within their discretion.
Mr. Scott. Thank you.
The gentleman from California?
Mr. Lungren. Just for the record, to make it clear, what we
are talking about is Rohypnol, a date-rape drug--date-rape
drug--approved for no purpose in the United States, no medical
purpose whatsoever--a date-rape drug. And in the distribution
of this date-rape drug, someone is killed or some victim
receives serious bodily injury. And under those circumstances,
the people who conspired together to create that situation will
be subject to a mandatory minimum.
Is that correct, Mr. Rannazzisi?
Mr. Rannazzisi. Yes, sir, that is correct.
Mr. Lungren. Okay.
Thank you, Mr. Chairman.
Mr. Scott. If there are no further questions, we want to
thank the witnesses for their testimony.
Without objection, the hearing record will remain open for
1 week for the submission of additional materials.
And, again, I thank the witnesses.
And, without objection, the Committee stands adjourned.
[Whereupon, at 1:40 p.m., the Subcommittee was adjourned.]