As I mentioned in my internet pharmacy criminal defense legal issues discussion, there are a number of hurdles the government must overcome to convict pharmacists for dispensing controlled substances (i.e. filling medication) without a valid prescription under The Controlled Substances Act. A pharmacist might have no idea that the prescription was a result of an online consultation without a physical examination. There are, of course, ways to impute constructive knowledge through circumstantial evidence in some cases (e.g. a substantial and unexplained increase in out of state prescription orders for painkillers such as hydrocodone); however, this is something the government must prove beyond a reasonable doubt.
A recent case illustrates this problem. The Columbus Dispatch reports on a pharmacist whose license was revoked by the Ohio State Board of Pharmacy for his alleged involvement in an “$85 million illicit-prescription ring.” Pharmacist Steve Holtel denies any wrongdoing, though he admits selling “painkillers and tranquilizers over the Internet from his Stoltz Drugs store.” The Dispatch states that Holtel met
Vinny Camarado, an agent for a company called Internet Health Enterprises. Camarado introduced Holtel to Rick Shipp, a salesman who detailed an opportunity to make money filling Internet-based prescriptions. Doctors affiliated with Internet Health would write prescriptions for people who asked for drugs on certain Web sites. Stoltz Drugs would be one of more than a dozen pharmacies across the country that would receive the prescriptions by fax. It would be Holtel’s responsibility to fill the orders and ship the drugs by courier.
Holtel did not think that the operation was illegal:
Holtel said Internet Health told him that patients were required to visit a local doctor to receive an initial prescription, which would fulfill the needed doctor/patient relationship. The patient would fax proof of that prescription to Internet Health. Physicians working for Internet Health then would contact the prescribing physician to “pick up” the patient. “That’s what I believed made it valid,” Holtel said. “Someone had seen the patient, gave a physical examination, determined that the patient needs a medication, and then consulted with the local (doctor).” When asked whether he knew what he was doing was illegal, Holtel said: “No, I didn’t. Would I have filled the (prescriptions) if I knew, really? Would I risk all I have for that? No, I wouldn’t have.” The main drugs were Vicodin, an addictive painkiller whose major active ingredient is hydrocodone; Percocet, another painkiller, which contains oxycodone; and Xanax, an anxiety medication that physicians who specialize in recovery say is one of the toughest habits to break. Holtel said that on the first few days, he called dozens of patients to ask whether they had legitimate prescriptions. Satisfied that everything was OK, he continued to process orders.
Here, you have a pharmacist whose license was revoked due to, at the very least, a very unclear criminal law (see my article on the Ryan Haight Act). More importantly, even if the law was expressly clear, Holtel even called to confirm the legitimacy of some prescriptions. One must ask, what more is a pharmacist to do? A prescription issued without a face-to-face examination looks identical to one issued after a physical evaluation. Does the law require a pharmacist to investigate every drug prescription?
The content on this post does not constitute legal advice and is for informational purposes only. You should not act upon the information presented on this website without seeking the advice of legal counsel. Should you wish to speak to an experienced criminal defense attorney knowledgeable in internet pharmacy, prescription, and drug law, please feel free to contact me directly.
Tags: Controlled Substances, Criminal Appeals, Criminal Defense, Internet Pharmacy Law, Pharmacies