ONLINE PILLS A RISING THREAT

Authorities Point To Gaps In Laws

STANTON, Ky. -- A Powell County man's arrest last year provided police with
a crucial clue as to why prescription narcotic abuse in Eastern Kentucky
was surging again.

When police arrested Shan Faulkner for allegedly stealing packages from a
shipping center in Stanton, they found 240 sedative and painkiller tablets
- -- all from an online pharmacy in Florida.

Further investigation revealed that at least 15 other companies were
shipping drugs to Eastern Kentucky, with one UPS center receiving up to 200
packages a day, authorities said.

They found that some Internet pharmacies require patients to see doctors
and get prescriptions. But many others issue prescriptions with no
in-person exam and then mail drugs to anyone who can pay.

Kentucky police and prosecutors soon realized state laws were not designed
to stop the flow.

And federal authorities conceded that Internet pharmacies have become a
nationwide problem because of gaps in federal and state laws and because
often they are based overseas.

"We're obviously trying to catch up," said Scott Burns, deputy director of
the White House Office of Drug Control Policy.

Last month, federal agencies arrested 20 people in the United States and
abroad on charges that they used more than 200 Web sites to illegally ship
2.5 million prescription pills worldwide.

The one-year investigation led to charges including money laundering and
smuggling.

Drug Enforcement Administration chief Karen Tandy said the bust represented
"just the tip of the iceberg" in cracking down on "rogue" Internet pharmacies.

"The Internet has become an open medicine cabinet," she said.

Among the obstacles that law enforcement officials say they face are:

No law stops Internet pharmacies from dispensing drugs to people without a
face-to-face meeting with a doctor. Instead, federal law requires only that
prescriptions are "issued for a legitimate medical purpose by an individual
practitioner acting in the usual course of his professional practice."

Also, authorities say it is difficult to charge people who have online
prescriptions with illegally possessing the drugs unless they supplied
false information or have the drugs in the wrong container.

No law allows authorities to search unopened packages at shipping centers,
unless probable cause of a crime exists or if the package is mislabeled by
the shipper.

Internet pharmacies are difficult to track because they can go out of
business and reopen under new names.

The National Association of Boards of Pharmacy says there is no way to
tally online pharmacies.

The problem has grown to the point where FedEx, concerned about the safety
of its drivers carrying such packages, recently stopped delivering them to
parts of Eastern Kentucky or now require pickup in London, Ky.

Laurie Mallis, a spokeswoman for UPS, said the company has no plans to stop
such deliveries.

"Many Internet pharmacies are legitimate, and our customers depend on
them," Mallis said.

Mallis said UPS can open suspicious packages but declined to elaborate,
citing security reasons. Problem resurgence

Eastern Kentucky's prescription drug problem seemed to be slowing two years
ago as the state enforced tighter monitoring of doctors and pharmacies.

Across Eastern Kentucky, signs appeared on doctors' offices informing
patients that OxyContin and similar drugs would no longer be prescribed,
and pharmacies stopped stocking certain drugs.

But police say that about 2003 they noticed a resurgence in the
availability of some drugs, and they weren't sure why.

In the 2000 fiscal year, 2,211 Kentuckians were charged with possession of
prescription drugs in an improper container, a common charge for
prescription drug abuse. That increased by nearly 30 percent, to 2,865, in
2001.

In 2002, with the state monitoring doctors and pharmacies more closely, the
number of charges went up only 11 percent, to 3,178, and in 2003 the number
climbed only 3 percent.

But last year, charges spiked again by 18 percent, reaching 3,917. So far
this year, the state is on pace for slightly fewer charges than last year.

Eleven of the 20 counties with the highest number of such charges since
July 1, 2003, are in rural Eastern Kentucky.

People who treat drug addiction also noticed that abuse was rising.

"The problem is growing at a rate that no one can keep up with," said
Donnie Coots, who operates Joshua's Dream, a church-based drug-treatment
center in Perry County. 'Drug packages'

The key clue to the role played by online pharmacies came in February 2004
when Faulkner was arrested for allegedly stealing two packages from the UPS
center in Stanton. Each had 120 tablets of the sedative Xanax and drugs
containing the painkiller hydrocodone.

After UPS gave police permission to open the packages, Faulkner was charged
with theft of mail and theft of a controlled substance, both felonies.

He was killed six months later in a car crash.

But not long after Faulkner's arrest, Mike Burton, a drug-enforcement
investigator for the Kentucky Cabinet for Health and Family Services, was
talking with him about a case of forged prescriptions when he learned the
term "drug packages" and how easily drugs were available online.

With DEA help, the state subpoenaed UPS records to find out how many
packages were entering Eastern Kentucky.

The results were startling, Burton said.

Ken Drugs, a Tampa, Fla.-based Internet pharmacy, was shipping an average
of 100 packages a week to the UPS center in Stanton, Burton said. Fifteen
other companies were involved. State tracking limited

Burton said word of mouth and spam e-mail messages from pharmacies led to
an increase in Internet-ordered drugs.

"A lot of people thought the spam e-mail from these places was bogus, but
it's not bogus," Burton said.

The state system that tracks prescription drugs -- Kentucky All Schedule
Prescription Electronic Reporting -- has helped catch prescription abusers
and doctors who mis-prescribe drugs.

But Robert Benvenuti, inspector general for the state health cabinet, said
Internet pharmacies have their own doctors so they don't report to the
tracking system.

"The question is how we get our arms around these people," he said.

In September, the Drug Enforcement Administration, Kentucky State Police
and Florida authorities raided four Ken Drugs offices in Florida, seizing
documents, said Steve Cole, a spokesman for the U.S. attorney's office in
Tampa, Fla.

Cole said no charges have been filed, and he declined to comment further.

Calls to the Tampa home of Ken Drugs President Kenneth Shobola were not
returned, and the most recent office listing for Ken Drugs was not in
service. Package crackdown

The drugs kept coming.

Five months after the Florida raid, authorities arrested nine people they
saw leaving the UPS center in Hazard and seized 13 packages of drugs from
online pharmacies containing 120 pills each of Xanax and hydrocodone.

But they were arrested on charges unrelated to the prescription drugs, such
as driving under the influence, because it is not illegal under state law
to simply possess drugs from an Internet pharmacy.

David James, commissioner of the Kentucky Bureau of Investigation, said
investigators may charge them with "doctor shopping" or supplying false
information when ordering pills.

James said gaps in state law make it difficult to charge them with crimes
related to the drugs. Regulating sales

The Florida raid prompted a law passed this year that allows the Kentucky
Board of Pharmacy to require online pharmacies to seek a state license,
report to KASPER, disclose their location and list a toll-free telephone
number on each container. It will take effect at the end of next month.

The Kentucky attorney general's office also will be allowed to prosecute
out-of-state pharmacies, under the new law.

But James said the law does not go far enough because it does not provide
enough ways to prosecute people who buy shipments online without a
prescription or a doctor's exam.

"We plan on getting back together to deal with a possible bill that would
allow us to do that," he said.

In Congress, bills were introduced this year seeking to bar Internet
pharmacies from referring clients to doctors for brief phone consultations
that result in prescriptions.

They would require Web pharmacies to clearly identify the names of sister
companies of doctors and pharmacists working for them.

Coots, whose son died of an OxyContin overdose in 2002, said package
delivery trucks are the new "mules" delivering drugs to addicts in Eastern
Kentucky.

"My son used to drive to Georgia to get OxyContin and cocaine," Coots said.
"Now these trucks bring the drugs right to people's doors."