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The main side-effect was oversleeping — sometimes she would sleep for 14 hours — which would affect her social life. She described the physical effects as like being given gas and air in hospital. Helen said that while most of the websites she ordered from stated that customers should not be using other online pharmacies, she used several.

Also, just healthwise, I wanted to feel better. She said it was hard to get help for her addiction and she eventually decided to undergo withdrawal herself, reducing the amount of codeine before stopping altogether. She sweated profusely and had stomach problems during the process. Leonhart stated, "Cyber-criminals illegally peddling controlled substances over the Internet have invaded households and threatened America's youth for far too long by supplying pharmaceuticals with a few clicks of a mouse and a credit card number.

Couple this information with a study projecting that 6. The government urges all parents to safeguard prescription painkillers when they are in the home for legitimate purposes. Central nervous system depressant drugs are overwhelmingly the most abused substances. Parents need to control access to these medications in their homes when they are done using them. Pharmacists should be aware that prescription drugs are not routinely discarded after the use for which they were prescribed ends.

Parents should be encouraged to dispose of their drugs properly, as well as to make sure they talk to their children about prescription drug abuse. To put some perspective on the magnitude of the problem, in , 34 Internet pharmacies that had no legitimate retail or brick and mortar operations dispensed over 98 million doses of hydrocodone. Based on the average sales of hydrocodone by "real" pharmacies, these 34 Internet facilities dispensed enough of this one drug to supply more than , legitimate patients for a month.

It would take about 1, legally operating pharmacies to dispense the amount diverted by these 34 rogue pharmacies. The Ryan Haight Act will provide necessary legal ammunition to state and federal policing agencies trying to combat the unlawful rogue pharmacies that profiteer from the lure of prescription drugs that many young and some older people seem to be attracted to.

A legal prescription must be presented to a pharmacy before a pharmacist is permitted to dispense any drugs to a person who requests them.

That relationship is defined to include, at a minimum, one face-to-face diagnosis or physical examination. Pharmacies are specifically prohibited from dispensing controlled substances pursuant to an online questionnaire when the pharmacy knows, or at least should know, that the person requesting the drugs has not obtained a prescription following a face-to-face interaction with the prescriber.

The Ryan Haight Act also requires Internet pharmacies to display the following on their Web site: 1 who owns the Web site; 2 the name of the pharmacist associated with the Web site; and 3 the name of any physician working for or with the Web site owner.

An Internet pharmacy is also prohibited from referring the patient to a physician who never sees the patient in the context of a normal patient-physician relationship.

Pharmacies that use the Internet for distribution and dispensing activities will have to obtain a certification from the DEA indicating that the pharmacy is in compliance with all of the laws addressing these issues. That certification will be in addition to the registration requirements of the Controlled Substances Act.

The tricky part of enforcing this law will be in distinguishing between rogue pharmacies that operate on the illegal side of the law and those that provide legitimate services through online activities.

Perhaps the most odious task will be in recognizing legitimate telemedicine practices in rural or underserved areas as opposed to the unlawful acts committed by the rogue drugstores where a patient has never seen the prescribing physician. Addressing this conundrum, the Ryan Haight Act specifies that the patient has to have at least one face-to-face encounter with a prescribing physician before a prescription for controlled substances will be deemed legal. If there is any doubt about the legitimacy of a patient-physician relationship, the pharmacist will have to verify the prescription with the physician.

It would help if the pharmacist making the verification phone call asked for the date and time that the face-to-face encounter occurred. While it is virtually impossible to guarantee that the verification is honest and trustworthy, with a recording of the date and time, pharmacists will have a good-faith defense if their conduct is ever called into question.

The Ryan Haight Act permits state attorney generals to initiate criminal proceedings in a federal court against those involved with illegal Internet pharmacy operations. This provision is designed to help the state enforcement agencies overcome jurisdictional hurdles when Internet pharmacy organizations are located in states other than the one where the medications are being delivered.

One of the aspects that this new law does not address is what to do about the rogue pharmacies that operate outside the U. Statistics suggest that when an Internet provider operating in another country obtains a request for controlled medications, the actual dispensing of the drug happens at a local pharmacy within the U. A major source of distress will occur when American citizens send their prescription orders from a legitimate U. The Ryan Haight Act makes a distinction between lawful acquisition of drugs from outside the U.