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43–987 PDF 2008

S. HRG. 110–472 

ROGUE ONLINE PHARMACIES: THE GROWING 

PROBLEM OF INTERNET DRUG TRAFFICKING 

HEARING 

BEFORE THE

COMMITTEE ON THE JUDICIARY 

UNITED STATES SENATE 

ONE HUNDRED TENTH CONGRESS 

FIRST SESSION 

MAY 16, 2007 

Serial No. J–110–35 

Printed for the use of the Committee on the Judiciary 

( 

(II) 

COMMITTEE ON THE JUDICIARY 

PATRICK J. LEAHY, Vermont, Chairman 

EDWARD M. KENNEDY, Massachusetts 

JOSEPH R. BIDEN, JR., Delaware 

HERB KOHL, Wisconsin 

DIANNE FEINSTEIN, California 

RUSSELL D. FEINGOLD, Wisconsin 

CHARLES E. SCHUMER, New York 

RICHARD J. DURBIN, Illinois 

BENJAMIN L. CARDIN, Maryland 

SHELDON WHITEHOUSE, Rhode Island 

ARLEN SPECTER, Pennsylvania 

ORRIN G. HATCH, Utah 

CHARLES E. GRASSLEY, Iowa 

JON KYL, Arizona 

JEFF SESSIONS, Alabama 

LINDSEY O. GRAHAM, South Carolina 

JOHN CORNYN, Texas 

SAM BROWNBACK, Kansas 

TOM COBURN, Oklahoma 

BRUCE A. COHEN, Chief Counsel and Staff Director 

MICHAEL O’NEILL, Republican Chief Counsel and Staff Director 

(III) 

C O N T E N T S 

STATEMENTS OF COMMITTEE MEMBERS 

Page 

Feinstein, Hon. Dianne, a U.S. Senator from the State of California ................. 15 

Leahy, Hon. Patrick J., a U.S. Senator from the State of Vermont .................... 1 

prepared statement .......................................................................................... 161 

Sessions, Hon. Jeff, a U.S. Senator from the State of Alabama .......................... 3 

Specter, Hon. Arlen, a U.S. Senator from the State of Pennsylvania ................. 2 

WITNESSES 

Califano, Joseph A., Jr., Chairman and President, The National Center on 

Addiction and Substance Abuse at Columbia University, and former Secretary, Department of Health, Education, and Welfare, New York, New 

York ....................................................................................................................... 7 

Haight, Francine H., Founder of RYAN’s Cause, Laguna Niguel, California .... 5 

Heymann, Philip B., James Barr Ames Professor of Law, Harvard Law 

School, and Former Deputy U.S. Attorney General, Cambridge, Massachusetts ....................................................................................................................... 10

McLellan, A. Thomas, Chief Executive Officer, Treatment Research Institute, 

Philadelphia, Pennsylvania, statement .............................................................. 14 

Rannazzisi, Joseph T., Deputy Assistant Administrator, Office of Diversion 

Control, Drug Enforcement Administration, Department of Justice, Washington, D.C., statement ........................................................................................ 13 

QUESTIONS AND ANSWERS 

Responses of Joseph A. Califano to questions submitted by Senators Leahy 

and Specter ........................................................................................................... 27 

Responses of Philip B. Heymann to questions submitted by Senators Leahy 

and Specter ........................................................................................................... 38 

Responses of A. Thomas McLellan to questions submitted by Senators Leahy 

and Specter ........................................................................................................... 45 

Responses of Joseph Rannazzisi to questions submitted by Senators Leahy, 

Durbin and Specter .............................................................................................. 51 

SUBMISSIONS FOR THE RECORD 

American Pharmacists Association, Washington, D.C., statement ..................... 85 

Califano, Joseph A., Jr., Chairman and President, The National Center on 

Addiction and Substance Abuse at Columbia University, and former Secretary, Department of Health, Education, and Welfare, New York, New 

York, statement and attachment ........................................................................ 89 

Federation of State Medical Boards, James N. Thompson, M.D., President 

and Chief Executive Office, Dallas, Texas, statement ...................................... 111 

Haight, Francine H., Founder of RYAN’s Cause, Laguna Niguel, California, 

statement .............................................................................................................. 116 

Heymann, Philip B., James Barr Ames Professor of Law, Harvard Law 

School, and former Deputy Attorney General, Cambridge, Massachusetts, 

statement and attachments ................................................................................. 122 

Marshall, Jon, Kentucky State Police, National Narcotic Officer’s Associations 

Coalition, Frankfort, Kentucky, statement ........................................................ 163 

Page

IV 

McLellan, A. Thomas, Chief Executive Officer, Treatment Research Institute, 

Philadelphia, Pennsylvania, statement .............................................................. 169 

National Association of Chain Drug Stores, Alexandria, Virginia, statement ... 173 

Rannazzisi, Joseph T., Deputy Assistant Administrator, Office of Diversion 

Control, Drug Enforcement Administration, Department of Justice, Washington, D.C., statement ........................................................................................ 178 

(1) 

ROGUE ONLINE PHARMACIES: THE GROWING 

PROBLEM OF INTERNET DRUG TRAFFICKING 

WEDNESDAY, MAY 16, 2007 

U.S. SENATE, 

COMMITTEE ON THE JUDICIARY, 

Washington, DC. 

The Committee met, pursuant to notice, at 10:07 a.m., in room 

SD–226, Dirksen Senate Office Building, Hon. Patrick J. Leahy, 

Chairman of the Committee, presiding. 

Present: Senators Leahy, Feinstein, Specter, and Sessions. 

OPENING STATEMENT OF HON. PATRICK J. LEAHY, A U.S. 

SENATOR FROM THE STATE OF VERMONT 

Chairman LEAHY. Good morning. Today the Committee will be 

holding an important hearing on the growing problem of rogue online pharmacies that illegally traffic in highly addictive painkillers 

and other controlled substances. 

You know, in many ways, the Internet has made our lives better. 

I have been one of its biggest proponents for those reasons. It removes the historic constraints from geography; it provides access to 

information and knowledge that might otherwise remain unavailable, especially to people like myself who live in rural areas. Distance learning, access to medical knowledge at the finest hospitals, 

and increased commercial competition—these are all aspects of the 

Internet that are important. Vermont businesses sell Vermont 

products throughout the Nation and around the world through the 

Internet. At the same time, the Internet has enabled Vermonters, 

and others, better access to convenient and more affordable medicine, which should be stressed. 

But the online sale of pharmaceuticals presents a more complicated and problematic aspect. Rogue online pharmacies increasingly have become a source for the illegal supply of controlled substances. Dangerous and addictive prescription drugs are too often 

only a click away without the proper constraints of local doctors 

and pharmacists. 

Controlled drugs, such as pain relievers, tranquilizers, stimulants, and sedatives, can be too easily bought illegally over the 

Internet. Anyone—including children—can readily obtain dangerous controlled substances from online pharmacies. All they need 

is access to a computer and a credit card. The check and security 

provided by our local pharmacists in local pharmacies—those who 

have served Americans for generations and helped us get well and 

keep us well—is not always replicated online. 

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The 2006 National Survey on Drug Use and Health indicates 

that almost 6 million people currently misuse prescription drugs 

and, of them, more than two-thirds 4.4 million people—abuse pain 

relievers such as OxyContin. Some celebrities have been involved 

in high-profile cases, but I am more concerned about the fact that 

people in every state and increasingly from every age group and 

demographics are affected. When abused, these drugs have enormous potential to cause harm and illness and addiction, and as we 

are going to hear this morning from one of our witnesses, tragically 

even death. 

American teenagers are always particularly vulnerable to Internet drug trafficking. Among young people, prescription drugs have 

become the second most abused illegal drug. In fact, if you exclude 

marijuana, more adults and teens report abusing prescription 

drugs than all the other illicit drugs combined. 

Too many American teenagers mistakenly believe that abusing 

addictive narcotics is a safe way to get ‘‘high.’’ 

As we learned just last week, some drug companies have themselves contributed to that dangerous impression by giving consumers misleading information about the addictive qualities of 

these drugs. Purdue Pharmacies, the maker of the powerful painkiller OxyContin, and three of its corporate executives pled guilty 

to intentionally misleading the public when it promoted OxyContin 

as less addictive than narcotics. It is a sad day when pharmaceutical companies act like tobacco companies and mislead the public rather than alerting the public to the risks associated with the 

use of its products. 

We have legislation referred to this Committee that would create 

potent new tools for law enforcement to prosecute those who illegally sell drugs online and allow State authorities to shut down online pharmacies even before they get started. And I will work with 

the Senators from California and Alabama and others on these 

matters. 

As the longtime Co-Chair of the Congressional Internet Caucus, 

I will ask the Caucus to consider the issue of the growing danger 

that online pharmacies pose to youth. 

Internet drug trafficking has presented another challenge for law 

enforcement. If drug dealers came into our neighborhoods selling 

these kinds of drugs, Americans would be up in arms. 

So I thank our distinguished panel of witnesses for appearing 

today, and I also especially want to thank Senator Specter for his 

work in connection with this hearing. 

[The prepared statement of Senator Leahy appears as a submission for the record.] 

Senator Specter? 

STATEMENT OF HON. ARLEN SPECTER, A U.S. SENATOR FROM 

THE STATE OF PENNSYLVANIA 

Senator SPECTER. Thank you, Mr. Chairman, for scheduling this 

important hearing. The problem of drug addiction has been with 

our society for decades. I first saw it in an intense fashion when 

I was district attorney of Philadelphia four decades ago, and the 

problem has been increasing in seriousness and is a major problem 

in our society. 

3 

With the Internet and technological advances, we now find that 

drugs are accessible by the rogue pharmacies, and the problem is 

one of enormous importance. It came into sharp view in Philadelphia in 2006 when there was a DEA bust of a major Internet drug 

ring run from Philadelphia by two foreign graduate students at 

Temple University and 25 co-conspirators who were arrested in 

four different countries. 

It is possible to have legitimate purchase of drugs over the Internet, but there were only 12 such DEA registered pharmacies. Most 

of the other Internet pharmaceutical sales in the United States are 

legally suspect. Federal law mandates that there is a prescription 

before dispensing the drugs, which we all know, but that is avoided. The Center on Addiction and Substance Abuse discovered over 

3 years the total number of websites been selling prescription 

drugs has increased enormously. The regulation of online pharmacies and doctors consists of a very patchwork arrangement so 

that it is the subject which requires, I do believe, Federal legislation, so I am glad to see such a distinguished panel here today. 

We very much appreciate your presence, Mrs. Haight, with the 

situation that your son, Ryan Thomas Haight, died of an overdose 

of narcotics he had purchased on the Internet without a prescription. 

We have a very distinguished array of experts, and, regrettably, 

we are not going to have a very extensive array of Senators—not 

necessarily distinguished even when present, except for Senator 

Leahy and Senator Sessions. But it is a very, very busy day on 

Capitol Hill. 

I am going to have to excuse myself to return to deliberations 

which are underway on the immigration issue. We have had more 

than two dozen meetings of lengthy duration, mostly in excess of 

2 hours, where 12 Senators sit still—that is, we sit still; our jaws 

are not still—as we try to work through an extraordinarily difficult 

legislative issue. 

Then that is compounded by the problem that we are having a 

series of votes at 10:30, and votes come ahead of everything else. 

That is our basic paycheck in the United States Senate, what our 

voting record is. But I have staff here who will be following the 

proceedings very closely, and I am sorry to miss the testimony, because this is an extraordinarily distinguished panel. 

Chairman LEAHY. During this, as the votes start, we will stop 

and start. Some of you are familiar with that. 

Senator Sessions has worked hard on this. Jeff, did you want to 

say anything? 

Senator SESSIONS. If you do not mind, Mr. Chairman. 

Chairman LEAHY. Go ahead. 

STATEMENT OF HON. JEFF SESSIONS, A U.S. SENATOR FROM 

THE STATE OF ALABAMA 

Senator SESSIONS. I will not be long, because we do have a distinguished panel and we want to hear from them. But I am glad 

that with your leadership and, really, with Senator Specter last 

year, we have had a good chance to move this important legislation 

forward. I am convinced that it is good legislation. As a former 

Federal prosecutor who prosecuted a great many drug cases, it is 

4 

amazing to me that with the regulations we have in so many different areas that even a teenager with very little effort can order 

drugs, controlled substances, off the Internet. It just undermines 

this entire system that we have. 

I remember after I ceased being United States Attorney representing an individual who was a young person that had a knee 

injury, started taking pain pills. He was going all over town. There 

was nothing he would not do. He was president of his class. But 

he just had to have these drugs. The addiction is very powerful. 

Some people think it is because it is a prescription drug, the addiction is not as powerful or cocaine or some of the other drugs. It is 

a powerful addiction, and people do things that destroy them, and 

they cannot seem to stop. And being able to obtain large amounts 

of drugs off the Internet allows that addiction to continue and 

delays the intervention that can be life saving. 

The bill that Senator Feinstein and I have introduced—and I certainly appreciate her leadership. She understands this issue very 

well. She has had a personal experience with people who have tragic losses as a result of prescription drug abuse through the Internet, and it is a pleasure to work with her. 

I was interested to note and am pleased to note that in the 

Washington Times today, there is an op-ed by John Horton, a 

former Assistant Deputy Director of the White House Drug Policy 

Office, and Kristi Remington, a former Deputy Assistant Attorney 

General in the Justice Department, which endorses the legislation 

Senator Feinstein and I have offered. And they note in their article 

that, ‘‘The Online Pharmacy Protection Act, which will be considered today by the Judiciary Committee, brings the law regulating 

the sale of controlled substances into the Internet age and is a vitally important tool in our Nation’s anti-drug efforts. It should be 

sent to the full Senate for passage.’’ They note that, ‘‘Ms. Feinstein 

and Senator Sessions have ensured the bill takes into account legitimate issues concerning telemedicine and the practice of covering practitioners, but in each case, a physician who is familiar 

with the patient, can determine whether medication is truly necessary or if the person is possibly acquiring the prescription drug 

because of an addiction.’’ 

So thank you, Mr. Chairman, and I would offer this article for 

the record. 

Chairman LEAHY. Thank you. It will be included in the record. 

Would you please stand, all of you, and raise your right hand? 

Do you solemnly swear that the testimony you will give in this 

matter will be the truth, the whole truth, and nothing but the 

truth, so help you God? 

Ms. HAIGHT. I do. 

Mr. RANNAZZISI. I do. 

Mr. CALIFANO. I do. 

Mr. HEYMANN. I do. 

Mr. MCLELLAN. I do. 

Chairman LEAHY. We will begin with Ms. Francine Haight. I 

have already chatted with her briefly and, again, I commend you 

for your courage in being here. 

She is the founder of RYAN’s Cause, Reaching Youths Abusing 

Narcotics. It is a nonprofit organization dedicated to educating parVerDate Aug 31 2005 13:17 Sep 02, 2008 Jkt 043987 PO 00000 Frm 00008 Fmt 6633 Sfmt 6633 S:\GPO\HEARINGS\43987.TXT SJUD1 PsN: CMORC
5 

ents, families, and communities on issues concerning the Internet 

and drug abuse. Ms. Haight founded RYAN’s Cause after her 18- 

year-old son, Ryan Thomas Haight, tragically died from an overdose of prescription drugs which he had purchased through the 

Internet. 

Ms. Haight has told her story around the country to help educate 

and bring public awareness to the danger of sales of drugs on the 

Internet. Her son’s story was mentioned in the recently aired HBO 

series ‘‘Addiction.’’ In June of last year, Ms. Haight was a sponsor 

to the first national candlelight vigil out at DEA headquarters in 

Arlington, Virginia, for those that died from the drugs. 

Ms. Haight, I know this is not an easy time for you, but I just 

want you to know how much we appreciate the fact you have come 

here from California to speak, and please go ahead. 

STATEMENT OF FRANCINE H. HAIGHT, FOUNDER OF RYAN’S 

CAUSE, LAGUNA NIGUEL, CALIFORNIA 

Ms. HAIGHT. Good morning. My name is Francine Haight, and 

thank you for inviting me to testify at this hearing about a very 

important topic that tugs at my heartstrings every day. Many of 

the speakers here today will give you statistics and numbers, but 

I am here to put a face to those numbers. And I am very sad that 

today that face is my son, Ryan Thomas Haight. Unfortunately, he 

was a victim of illegal sales of pharmaceuticals through the Internet. 

Ryan was born on December 28, 1982, and died on February 12, 

2001, from an overdose of prescription drugs he had purchased on 

the Internet. He was only 17 when he purchased these drugs, and 

he was only 18 when he died. 

He was an incredible boy. From the time he was little, I always 

believed that he would make a difference in this world. He was intelligent and excelled in school, was an A student and maintained 

a 4.0 or above during his years in high school. He looked forward 

to going to college. 

He was athletic, loved the thrill of competition, played Open Junior Tennis tournaments, and went on to play varsity tennis for 

Grossmont High School in La Mesa, California. He loved to ski, 

snow ski, water ski, kneeboard, and he attempted all sports with 

great enthusiasm. 

But Ryan also loved using the computer. He was thrilled to find 

out that he could chat online, that he could receive and send emails, and that he learn and talk about educational and current 

events. He learned to surf the Internet. It was a perfect place for 

him to use for his papers in school or to seek information he was 

curious about. He used the computer to play games, and he enjoyed 

trading baseball cards on eBay. But on February 12, 2001, that all 

stopped. 

On February 12, 2001, I found Ryan in his bed, lifeless. I tried 

to resuscitate him, but could not bring him back. Ryan had died. 

And I was in shock. Just the night before, we had dinner together 

after he came home from working at a nearby retail store. That 

night I had kissed him and said good night, and he said, ‘‘I love 

you, Mom.’’ Those were the last words I would hear from him. 

Ryan died from an overdose of the prescription drug Vicodin. He 

6 

also had a small amount of Valium and morphine. And I thought, 

How? How did he get these drugs? After one of his friends told me 

that he got them on the Internet, we gave our computer to the 

DEA to investigate. And through their investigation, they found 

how Ryan had ordered the drugs. 

Ryan had made up a story. He had said he was 21. He said he 

had been in a car accident and had back pain, and he made up a 

doctor’s name, Dr. Thomas, which happened to be his middle name. 

Dr. Robert Ogle, whom Ryan never saw and was never examined 

by, prescribed them, and an Internet pharmacy, Clayton Fuchs of 

Mainstreet Pharmacy, delivered them to our home. I was in shock. 

I thought, How could this be possible? I am a registered nurse; 

Ryan’s father is a physician. We know that all controlled substances have to be accounted for. We count each and every drug 

that we give when we administer it to a patient. They are under 

lock and key. How could he get these off the Internet so easily? At 

a time when we were worried about our children being exposed to 

pornography and predators, marijuana and alcohol, we did not 

know that drug dealers were in our own family room. 

After a long investigation and trial, Dr. Robert Ogle and Clayton 

Fuchs, who together made millions by their drug dealings, were 

prosecuted by the United States Attorney in Dallas and are now in 

Federal prison. I attended the sentencing of Clayton Fuchs, and although it does give me some peace that justice was served, it does 

not bring Ryan back. I am still shocked at the ease and availability 

of buying controlled substances on the Internet. I receive e-mails 

every day from 13-year-old children to adults that they are just 

overwhelmed by the problems that they see happening from drugs 

being sold. 

Over the last few months, Ryan’s story has been told in a documentary called ‘‘Online Nightmares,’’ and it was produced by E Entertainment. It has aired about 15 times, and since then the mail 

that I get is just overwhelming in my mailbox. This is an ongoing 

problem. 

After Ryan died, it took me almost 3 years to get enough 

strength to do what I am doing, and I started RYAN’s Cause— 

Reaching Youths Abusing Narcotics. And I have done a lot of news 

and gone out, and I just hope that it will raise awareness of this 

growing problem among our teens in hopes to prevent other families from suffering such a devastating loss. 

I am here today because I want to help fight this war against 

drugs and too many people are dying. 

Congress needs to attempt to counter the growing trend of prescription drug abuse by passing a bill, the Ryan Haight Internet 

Pharmacy Consumer Protection Act or perhaps by adding Ryan’s 

bill as a noncontroversial amendment to the prescription drug user 

fee which governs FDA issues and prescription drug review and addresses the safety issue incumbent in drug sales. 

I am a parent that belongs to a club that I never wanted to join. 

I am an ordinary person who could be your neighbor, your coworker, or member of your house of worship. But drugs took my 

son from me, and some days the grief is still unbearable. Drug 

abuse is an equal opportunity killer. It is not confined to one kind 

of neighborhood, one socioeconomic group, or one kind of child. 

7 

Ryan was the boy next door. We need to do everything we can to 

protect our children. Tighter regulations on the sale of controlled 

substances on the Internet will not totally solve the drug problem, 

but I guarantee you it will help and it is a good place to start. 

Thank you for allowing me to speak and for listening to this very 

important issue. Ryan continues to make a difference. I just did not 

know he would be so far away. 

[The prepared statement of Ms. Haight appears as a submission 

for the record.] 

Chairman LEAHY. Thank you very much, Ms. Haight. We were 

talking about your testimony last night at home. My wife is a registered nurse, and she is struck by what you said about having to 

account for all narcotics, and she remembers how careful those are 

checked and double-checked. You are absolutely right. 

Joseph Califano is the Founding Chairman and President of the 

National Center on Addiction and Substance Abuse, CASA. It is an 

independent, nonprofit think tank affiliated with Columbia University. He is an adjunct professor of public health at Columbia University’s Medical School and School of Public Health and a member 

of the Institute of Medicine of the National Academy of Sciences. 

He has extensive experience in Government. He joined the Kennedy administration in 1961, served as general counsel of the Army 

and Special Assistant to the Secretary and Deputy Secretary of Defense. From 1965 to 1969, he served as Special Assistant for Domestic Affairs to President Lyndon Johnson. From 1977 to 1979, he 

was Secretary of Health, Education, and Welfare in the Carter administration. He is a graduate of Holy Cross and Harvard University Law School. 

Mr. Califano, thank you for being here. Please go ahead. 

STATEMENT OF JOSEPH A. CALIFANO, JR., CHAIRMAN AND 

PRESIDENT, THE NATIONAL CENTER ON ADDICTION AND 

SUBSTANCE ABUSE AT COLUMBIA UNIVERSITY, AND 

FORMER SECRETARY, DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE, NEW YORK, NEW YORK 

Mr. CALIFANO. Thank you, Mr. Chairman, for the invitation to 

testify today. The National Center on Addiction and Substance 

Abuse at Columbia University has studied the Nation’s problem of 

controlled prescription drug abuse and has documented for 4 consecutive years the Internet availability of these drugs. 

In 2005, CASA released its landmark report, ‘‘Under the 

Counter: The Diversion and Abuse of Controlled Prescription Drugs 

in the U.S.’’ This report revealed that our Nation is in the throes 

of a growing epidemic of controlled prescription drug abuse involving opioids like OxyContin and Vicodin, depressants like Valium 

and Xanax, and stimulants like Ritalin and Adderall. 

From 1992 to 2002, prescriptions written for such controlled 

drugs increased more than 150 percent, 12 times the rate of increase in our population and almost 3 times the rate of increase in 

prescriptions written for all other drugs. 

Mirroring this increase in prescriptions has been an increase in 

the abuse of these drugs. From 1992 to 2003, the overall number 

of Americans abusing controlled prescription drugs rose 94 percent, 

7 times faster than the increase in the U.S. population. The numVerDate Aug 31 2005 13:17 Sep 02, 2008 Jkt 043987 PO 00000 Frm 00011 Fmt 6633 Sfmt 6633 S:\GPO\HEARINGS\43987.TXT SJUD1 PsN: CMORC
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ber of 12- to 17-year-olds who abused controlled prescription drugs 

jumped 212 percent, more than triple. 

In 2003, the number of Americans who abused controlled prescription drugs exceeded as you said, Mr. Chairman, the combined 

number abusing cocaine and all other illegal drugs except marijuana, and they are on course to exceed abuse of marijuana on the 

track they are on. Abuse of controlled prescription drugs has grown 

at a rate twice that of marijuana abuse, 5 times that of cocaine 

abuse, 60 times that of heroin abuse. 

Particularly troubling are the implications for our children. From 

1992 to 2002, new abuse of prescription opioids among 12- to 17- 

year-olds was up an astounding 542 percent, more than 4 times the 

rate of increase among adults. In 2003, nearly 1 in 10 12- to 17- 

year-olds abused at least one controlled prescription drug; for 83 

percent of them, that drug was an opioid. Teens who abuse controlled prescription drugs are twice as likely to use alcohol, 5 times 

likelier to use marijuana, 12 times likelier to use heroin, 15 times 

likelier to use Ecstasy, and 21 times likelier to use cocaine, compared to teens who do not abuse such drugs. 

In 2005, 15.2 million Americans abused these drugs including 

more than 2 million teens. The explosion in the prescription of addictive opioids, depressants and stimulants has, for many children, 

made their parents’ medicine cabinet a greater threat than the illegal street drug dealer. But, perhaps the most wide open substance 

supermarket in the world is the Internet. The Internet has become 

a pharmaceutical candy store, its shelves stacked with an array of 

addictive prescription drugs offering a high to any kid with a credit 

card at the click of a mouse. 

For 4 years now, at CASA, in collaboration with Beau Deitl & 

Associates, we have been tracking online access to controlled prescription drugs. In the first quarter of each year, we have devoted 

210 hours to documenting the number of Internet sites advertising 

and dispensing controlled drugs. These findings are a snapshot of 

availability at a given point in time and show trends from year to 

year. They do not capture the total number of sites advertising or 

selling controlled prescription drugs online, which may be many 

times the numbers I am using now. 

Today CASA is releasing the fourth in its annual series of reports entitled ‘‘ ‘You’ve Got Drugs!’ IV: Prescription Drug Pushers 

on the Internet.’’ Here are the report’s disturbing findings. From 

2006 to 2007, there has been a 70-percent increase in the number 

of sites advertising or selling controlled prescription drugs over the 

Internet, from 342 to 581; a 135-percent increase in the number of 

sites advertising controlled prescription drugs; a 7-percent increase 

in the number of sites selling controlled prescription drugs. Eightyfour percent of the sites selling controlled prescription drugs do not 

require a prescription from the patient’s physician, and most of the 

remaining 16 percent of sites that ask for a prescription simply ask 

that it be faxed, allowing a customer to forge it or use the same 

prescription many times to load up on these drugs. 

There are no controls—no controls—to stop the sale of these 

drugs to children. Over the 4-year course of our analysis, the number of selling sites has climbed from 154 to 187. Since there are no 

controls preventing sale of these drugs to children, all a child needs 

9 

is a credit card number and access to a computer and ‘‘You’ve Got 

Drugs!’’ Efforts to crack down on this illegal trafficking are complicated by outdated Federal law written before the Internet and 

inadequate State laws. 

There is a mechanism in place for certifying Internet pharmacy 

practice sites. It is the National Association of Boards of Pharmacy, 

which verifies Internet pharmacy practice sites. However, the process is voluntary. Of the 187 sites found selling in 2007, only two 

were certified. 

The widespread threat to the public health demands that Congress now take action to: clarify Federal law to prohibit the sale 

or purchase of controlled prescription drugs online without an original prescription issued by a DEA-certified physician based on a 

physical examination and evaluation; and require certification of 

online pharmacies to assure that they meet rigorous standards of 

professional practice. 

The Feinstein-Sessions bill is a step in the right direction and an 

important step. We have a few suggestions to strengthen it that we 

can discuss with your staff, but we really applaud, Senator Feinstein and Senator Sessions, what you have done in introducing this 

bill. 

The report we are releasing today makes other recommendations 

that I hope you will consider. 

Mr. Chairman, just in closing, substance abuse and addiction— 

involving prescription drugs, alcohol, nicotine, all of it—is the Nation’s most serious domestic problem. It is implicated in most 

crimes, most killing and crippling illnesses, most domestic violence, 

most child abuse, most homelessness, poverty, most teen pregnancy, and the wildfire spread of AIDS and other sexually transmitted diseases. I have titled my book on this subject ‘‘High Society,’’ and I will give you one simple fact. We Americans are 4 percent of the world’s population; we consume two-thirds of the world’s 

illegal drugs. 

This problem is all about kids. A kid who gets through age 21 

without smoking, using illegal drugs, or abusing prescription drugs 

or alcohol is virtually certain never to do so. Over the past 12 

years, the fastest growing drug abuse among our Nation’s children 

involves prescription drugs. I applaud the work of this Committee 

to curb the availability of these drugs. We will do anything to help. 

We are submitting our report along with my statement for the 

record, and we really appreciate, Senator Leahy, you and this Committee attending to this incredibly important problem. 

[The prepared statement of Mr. Califano appears as a submission 

for the record.] 

Chairman LEAHY. Thank you very much, and the report will be 

part of the record. 

Professor Philip Heymann is currently the James Barr Ames 

Professor of Law at the Harvard University Law School. Professor 

Heymann has served at high levels in both the State and Justice 

Departments during the Kennedy, Johnson, Carter, and Clinton 

administrations, including serving as the Deputy Attorney General 

for the Justice Department from 1993 to 1994. He served as the 

Assistant Attorney General in charge of the Criminal Division from 

1978 to 1981. He spent a lot of time in this room, I might add. He 

10 

was Acting Administrator of the State Department’s Bureau of Security and Consular Affairs, Deputy Assistant Secretary of State 

for the Bureau of International Organizations, and numerous other 

high-level positions in Government. He was also a former associate 

prosecutor and consultant on the Watergate Task Force. He also 

helped establish the Keep Internet and Neighborhoods Safe project 

and developed proposals to reduce illegal Internet prescription drug 

sales to youth. He is a graduate of Yale University and Harvard 

Law School and clerked for former Supreme Court Justice John 

Harlan. 

Professor, the floor is yours. 

STATEMENT OF PHILIP B. HEYMANN, JAMES BARR AMES PROFESSOR OF LAW, HARVARD LAW SCHOOL, AND FORMER 

DEPUTY ATTORNEY GENERAL, CAMBRIDGE, MASSACHUSETTS 

Mr. HEYMANN. Thank you very much, Mr. Chairman and members of the Committee. 

With Mathea Falco, the Director of Drug Strategies, who is sitting behind me, we assembled a group of people from the major 

facilitators of this traffic and from the major enforcement agencies. 

On page 6, we list them in short: Verizon, AOL, AT&T, Earthlink, 

Microsoft, Comcast, Google, Yahoo!, UBS, Morgan Chase, 

MasterCard, Visa, Paypal; UPS, DHL, FedEx, the DEA with Joe as 

their representative, the Department of Justice, and so on. 

Because we wanted to address one aspect of this problem—which 

has been so well described that I am not going to repeat it. We find 

it of the same size and importance and danger that the others have 

described. But we saw in it the prospect of a new form of sale of 

contraband which is, we think, the world of globalization merged 

with the world of Internet. And we think that is going to change 

everything, limiting the reach of drug law enforcement no matter 

how important that may be, too. 

The fact of the matter is the Internet service provider may be in 

the Ukraine, the drugs may be in Somalia, the credit card user— 

the seller of the drugs, the receiver of the money may be in 

Turkmenistan. We are dealing with a brand-new world out there, 

and the aspect of this problem that engaged us was the international aspect—not yet the largest, probably. Most people probably get their prescription narcotics out of their parents medicine 

cabinet. But it will be the largest, and it will be the future. And 

we wanted to tackle the future, and we did in six full-day meetings. 

Now, the secret, we discovered, was that we could—that this 

traffic in Internet globalized contraband can only take place with 

the cooperation of credit card companies, Paypal, Internet service 

providers, search engines. If you think of it from the beginning, a 

search engine is out there advertising the sale of the drug. You 

cannot get to the advertisement—I am sorry. You click on the 

Google advice, and it will send you to thousands and thousands of 

responses to the search by OxyContin without prescription. And 

they will all be selling it without prescription at all. Of course, it 

is just as bad if they use a phony prescription, but they will not 

even bother to use a phony prescription. It will be sent in in a 

brown bag that looks like 2 trillion others coming into the customs 

11 

offices in New York, and it will get through. And if it does not get 

through, the drugs will be replaced. 

So what can you do about this? The Judiciary Committee is looking at a brand-new problem, a brand-new dimension of a very old 

problem—a massive dimension—and it will be the same with everything that can be sold over the Internet, and it will be worldwide. 

OK. Here is what you can do. There is no reason why Internet 

service providers should be putting—they can easily remove from 

your household Internet connection anybody who is promising to 

sell OxyContin, Vicodin, any of a list of drugs, without prescription. 

It is no burden to them. They know how to do that. They are doing 

it now as to other things, such as pornography. They can do it in 

a minute. No cost. 

Google and Yahoo! and Microsoft can, when somebody puts in, as 

I did on Mother’s Day, ‘‘Buy OxyContin without prescription,’’ and 

got 800,000 responses, including a chat room run by Google where 

you can talk to friends about where to buy OxyContin without prescription. When anybody searches for OxyContin without prescription, there can be a banner at the top of the Google, Yahoo!, or 

Microsoft search saying it is illegal to buy this without prescription. That message ought to come right away. 

MasterCard, Visa, Paypal, American Express should trace anybody who is offering to use their credit card as a device to pay for 

the purchase of one of these prescription narcotics without a prescription. They can do that, too. They do it if somebody is misusing 

their credit card. They do it if someone is cheating on their credit 

card. They can do it in a minute, no problem. 

So why aren’t they doing it? In other words, we have powerful 

local companies, thankfully local, facilitating the sale of powerful 

narcotics to children over the Internet. They say they have two big 

problems. One problem is they do not know who they are dealing 

with. The other problem is that they are worried about legal liability. 

With this large group—and without them necessarily all agreeing 

with all of our recommendations, by a long shot, but generally in 

the same ballpark—we put together a model bill that would solve 

those two problems by: No. 1, creating a small, inexpensive but 

technically sophisticated organization, an Internet monitoring 

group that would go onto the Internet and see who is advertising 

the sale of powerful narcotics without a prescription, and notify the 

Internet service providers, the search engines, the carriers, like 

Federal Express, and the credit card companies. That would send 

them all into action, and we would not have to worry about their 

not being able to know. We can tell them who, if the Congress will 

create this small unit. 

Second of all, they need a safe harbor from liability if they act 

on the basis of the recommendations of the Internet monitoring 

group. 

With those two things, the only thing that we think is—right 

now we believe that the finance companies are bound by Treasury 

regulations to act vigorously to stop the use of credit cards in these 

sales. We believe that the Internet service providers are serious 

12 

about their willingness to do this on their own, but we do not like 

the idea of not monitoring them and the finance companies. 

We, therefore, propose that there be an annual accounting to the 

Congress of the number of children—we take those figures every 

year—who are continuing to use narcotics over the Internet and an 

annual accounting of the cooperation of these large companies in 

their delivery. 

Thank you, and sorry for being over. 

[The prepared statement of Mr. Heymann appears as a submission for the record.] 

Chairman LEAHY. That is all right. It is an important subject, 

and I have allowed time for everybody to go over. 

Senator Feinstein is leaving for a vote that has started, and I 

don’t know whether, Senator Sessions, if you want to go. I am 

going to stay here and ask some questions. I will go to vote. When 

she comes back, she will reconvene it, or whichever one of us gets 

back first, we will reconvene it. 

Joseph Rannazzisi is the Deputy Assistant Administrator for the 

Office of Diversion Control at the Drug Enforcement Agency. He is 

responsible for overseeing and coordinating major diversion investigations, establishing drug production quotas and conducting liaisons with the pharmaceutical industry, international governments, 

State governments, other Federal agencies, and local law enforcement agencies. He has a degree in pharmacy from Butler University, received his J.D. degree from the Detroit College of Law at 

Michigan State University. He is a registered pharmacist in the 

State of Indiana. 

Thomas McLellan, Ph.D., is a professor of psychiatry at the University of Pennsylvania and Founder and Executive Director of the 

Treatment Research Institute in Philadelphia. He has published 

more than 300 articles and chapters in addition research, recently 

became the editor-in-chief of the journal Substance Abuse Treatment. Dr. McLellan is well known for his leading role in creating 

the Addiction Severity Index and the Treatment Services Review, 

two of the most widely used instruments in the field of substance 

abuse. His work at TRI is dedicated to reducing the devastating effect of alcohol and other drug abuse on individuals and families. He 

is a graduate of Colgate, Bryn Mawr College, and Oxford University. 

They will be available to answer questions. Their statements will 

be placed in the record. Under our rules, it did not arrive in time 

for statements to be given at this hearing. 

[The prepared statements of Mr. Rannazzisi and Mr. McLellan 

appear as submissions for the record.] 

Chairman LEAHY. Ms. Haight, if I might—and, again, I emphasize, as both Senator Feinstein and Senator Sessions have said to 

me, I know this is painful. First, let me compliment you for speaking out. Those of us who can speak out from theoretical knowledge 

or reading the statistics is one thing. You speak out from personal 

knowledge. I think that is a far more compelling story. Unfortunately, I believe there are other people that could give the same 

kind of testimony, as you have discovered. 

What is the most important thing young people should know? Assuming somebody is actually watching this, what is the most imVerDate Aug 31 2005 13:17 Sep 02, 2008 Jkt 043987 PO 00000 Frm 00016 Fmt 6633 Sfmt 6633 S:\GPO\HEARINGS\43987.TXT SJUD1 PsN: CMORC
13 

portant thing they should know about the dangers of purchasing 

prescription drugs over the Internet? 

Ms. HAIGHT. Well, first of all, I think quite a few of the kids 

today, they are not aware of how prescription drugs are very dangerous and that they can cause death or addiction. And the kids 

really need to be aware and be educated upon prescription drugs 

because they are mostly afraid of cocaine or meth and those type 

of drugs and thinking that they are dangerous. And there has been 

a lot of education out there about that. But prescription drugs really is kind of the new trend for our youth to be using, and so I think 

it is really important that they are educated how dangerous these 

drugs really are. 

Also, they need to be educated that some of these drugs on the 

Internet are not what they are. A lot of them can be counterfeit. 

They have actually found that some drugs have been laced with 

heroin. Some drugs are twice the potency of what they say they are 

because they want them to become addicted. These drug dealers 

want them to come back and buy. 

Chairman LEAHY. Do we change the law then? Do we have to 

change the law to protect the public from these kinds of online— 

Ms. HAIGHT. Yes, and, therefore, we need a law. And these doctors that are writing prescriptions are saying, hey, it is not illegal. 

Chairman LEAHY. You would like to see us make it illegal? 

Ms. HAIGHT. Absolutely. Absolutely. We need to do everything we 

can to protect our youth, and adults as well, that are finding themselves in this situation. 

Chairman LEAHY. Mr. Rannazzisi, would you agree with that? 

Mr. RANNAZZISI. Yes, absolutely. The perception of children, the 

perception of adults that controlled substances that are pharmaceutical are safe and effective because they are manufactured—or 

safe because they are manufactured by a drug company is really 

-it is a misperception that could be deadly. We have seen this over 

and over again. There was a study done where a large percentage 

of adolescents showed—basically reported that they thought—their 

perception was that these drugs were safe to take, where they 

would rather take those drugs than cocaine or heroin. So that perception is out there. So that is absolutely correct. 

Chairman LEAHY. Secretary Califano? 

Mr. CALIFANO. I think that what Joe just said is absolutely right. 

We survey teens every year. We have been surveying 12- to 17- 

year-olds for 11 years, Mr. Chairman, and it is quite clear that 

they think these drugs are safer than street drugs. They do not understand that they aren’t. 

I think it is very important, in addition to law, the kind of legal 

suggestions that Professor Heymann made, which are very similar 

to the ones in the CASA report released today to also think parents 

are very important here. I think parents have really got to understand they are the front line, until we get a law passed, in terms 

of how their kids use the Internet, what they are using the Internet for. And it is very difficult. It is very difficult, but they— 

Chairman LEAHY. Well, and I think there, I think if parents are 

watching this, this may be an eye opener to them, what is available 

there. If we have prescriptions to be filled, we go to the same pharmacy. They make it easy. You can call up on a touch-tone phone 

14 

or a computer, but it is a pharmacy and it is the same pharmacist, 

it is with the records. We will get questions asked when we go 

there, and I am delighted to see it. I mean, they know who I am. 

They will ask for an ID just the same. And I think this should be 

done. And a lot of parents are used to that same thing. 

I think this may be an eye opener to a lot of parents. You know, 

we have—going on computers, these kids are pretty smart, and it 

is pretty easy to hide what they are doing, the chat rooms, the 

number of chat rooms. The professor raised about on OxyContin, 

I mean, the back-door way you can go. Professor, I assume you feel 

we should be changing the law to make this tighter. 

Mr. HEYMANN. Mr. Chairman, we believe that the law should be 

changed and tightened, and certainly the doctors who issue prescriptions without ever seeing the patient should be subject to 

sanctions of some sort. But we keep seeing the end game as a question of companies spread across the globe dealing highly anonymously with kids in— 

Chairman LEAHY. Azerbaijan. 

Mr. HEYMANN. And the only way to deal with that is to enlist 

the cooperation—and I think it will be forthcoming—of the search 

engines, the Internet service providers, and the financing companies. 

Chairman LEAHY. But don’t you need something beyond just a 

banner that says ‘‘Caution, this is an illegal′′—I mean, you have got 

to have the site blocked, don’t you? 

Mr. HEYMANN. That is correct. The banner comes from the 

search engine. The Internet service provider should block the site 

at the request of any parents. 

Chairman LEAHY. I think it should be blocked, period, I mean, 

if you are doing it this way. 

Mr. HEYMANN. It should be blocked, period. There is some remote 

First Amendment problems. It is easy, otherwise. 

Chairman LEAHY. I think we can handle that part. I yield to nobody in the defense of the First Amendment, but I think there is 

a way of doing that. I think you are getting very close to yelling 

‘‘Fire’’ in a crowded theater here. 

Dr. McLellan? 

Mr. MCLELLAN. One thing I would like to add is that in a sort 

of darkly paradoxical way, it is safer to buy drugs over the Internet; at least the drugs are much more dangerous than commonly 

perceived. But if your choices are to go—I live in Philadelphia—to 

52nd and Baltimore and purchase something from a thug versus 

have it delivered into the comfort and privacy of your home with 

virtual certainty, it is safer. 

So in many ways, it is an enticement to start drug use, and that 

is something that I think has not been brought out. A lot of policy 

in this country is considered around starting drugs, like cigarettes 

and marijuana. There are kids today starting drug abuse with 

Vicodin, starting drug abuse with OxyContin, because it is easier. 

Chairman LEAHY. Thank you. Doctor, I am not trying to cut you 

off, but I just got handed a note I have 41⁄2 minutes to get to the 

floor to vote. We will stand in recess until either Senator Feinstein 

or I come back, and we will pick up where we left off. 

[Recess at 10:56 a.m. to 11:04 a.m.] 

15 

STATEMENT OF HON. DIANNE FEINSTEIN, A U.S. SENATOR 

FROM THE STATE OF CALIFORNIA 

Senator FEINSTEIN. [Presiding.] We will reconvene the hearing 

and continue on. 

Mrs. Haight, I just want to say welcome. It is wonderful to have 

you here again. As you know, it was the death of your son that 

really brought my attention to this issue. And as Mr. Califano has 

continued on with it, we see how extensive it is and how many people are able to really receive drugs that otherwise would require 

the prescription of a physician. So I thank you, and although Ryan 

is not with us, he has made a major contribution to this effort. I 

want you to know that. 

Mr. Califano, I think your report is excellent. I would certainly 

recommend it to everyone to take a look at this and read it. And 

Senator Sessions and I have put forward a bill which, as you say, 

does certain basic things. I believe I would be supportive of adding 

that banner that you spoke of, Mr. Heymann, to the legislation, 

and I will talk with Senator Sessions about doing that, see if we 

can do it. As you know, we have changed some sentences in this. 

I think you have raised what for me is a very disturbing part of 

this, and that is, the world community is now such that the Internet facilitates all kinds of criminal enterprises as well as legitimate 

enterprises, and Government becomes not able to regulate. 

I had to leave to vote, and it was a big vote. This is a vote on 

Iraq. If any of you have any other suggestions of how Senator Sessions and I might tighten up our legislation, the floor would be 

open to you. 

I will start with you, Dr. Heymann. 

Mr. HEYMANN. Thank you very much, Senator Feinstein. Of our 

recommendations, the banner is in some sense the least important. 

Again, our total focus is on the international aspect. That is where 

we think it is going, where it substantially is, and we think that 

is the growth area, and we are very anxious, careful to urge you 

not to close one of two doors and just let the traffic go through the 

second door. That will not reduce anything. 

Our most important recommendation is that a monitoring group 

inform MasterCard, Visa, American Express, Paypal whenever it 

finds their logos at the bottom of an offer to sell a prescription drug 

over the Internet without prescription. 

Senator FEINSTEIN. In other words, that our bill create this group 

and empower this group to at least inform—is this what you are 

saying? 

Mr. HEYMANN. We think that one the financing companies are 

informed, present Treasury regulations require them to take action 

to stop the transaction and to report the transaction to law enforcement, the purported transaction. 

Mr. MCLELLAN. And they do it every day. 

Mr. HEYMANN. And they do it. But they say—we do not believe 

that they know who it is—they are not monitoring the website with 

the rigor—the websites, the Internet, with the rigor that they have 

to if we are going to make it dangerous for someone to sell in exchange for a credit card payment. 

So we would like perhaps Treasury to make it perfectly clear 

that that is required whenever they get information, a lead that 

16 

someone is selling narcotics without a prescription over the Internet using their credit card, and we would like to have an organization, a very small one—we called it an Internet monitoring group— 

whose full-time business it would be to monitor the Internet and, 

with the push of a button, send to the credit card companies, to 

Paypal—to the Internet service providers, too, because we want 

something from them—information about who is offering to sell 

without a prescription. 

Senator FEINSTEIN. I would invite Senator Sessions to become involved in this, too, and sort of open it up. My concern is the term 

‘‘monitoring group,’’ which is not an official organ of Government, 

that it seems to me it would be the responsibility of a Government 

agency to do this and be empowered with authority to even shut 

down the site? 

Mr. HEYMANN. Shutting down the site is, let’s say, our second 

most important option. But that will be less useful because it will 

quickly be replaced. And to monitor sites even now will require a 

medium sophisticated program because apparently most of the 

sites are hijacked websites. I was working on it with Mathea Falco 

a month or two ago, and we played it out, and the site turns out 

to be the University of Oregon. Somebody has just hacked into the 

University of Oregon, put up there an offer to sell drugs, and so 

you have to get behind that offer, which will only, I am told, last 

for hours. It is a hijacked front. You have to get behind that to who 

is the real seller, and for that it takes a medium sophisticated program. 

Senator FEINSTEIN. Yes, sir, would you like to add something? 

Then Mr. Califano. 

Mr. MCLELLAN. If I could just add to that, the Treatment Research Institute has worked with Drug Strategies and Harvard in 

doing this, and we think the simplest of all strategies is to simply 

follow the money. The reflex impulse is to close something down 

and have a Government action. Please keep in mind now 88 percent of these sites and the figures behind the sites are offshore in 

countries where it is not necessarily illegal for them to sell drugs 

to Americans. It is illegal for us to buy. 

Please keep in mind also that there are issues of entrapment and 

less than perfect boundaries about authority for the Government 

agencies. That is why we specifically suggested a nongovernmental 

group provide actionable evidence. If you had somebody going on 

a site and actually attempting to purchase and the credit card 

number were exercised by that company, that is actionable evidence. And in hearings that were conducted by Professor Heymann, 

we have heard nothing but support from the credit card companies, 

the delivery agencies, the whole chain of supply, the money supply. 

So we think that may be the strongest, if imperfect, way of bringing this to a restricted end. 

Senator FEINSTEIN. Mr. Califano, did you want to say something? 

Mr. CALIFANO. I share your concern. I would not have it as an 

independent agency. I think if something like this is going to be 

done, it should be done by Government that is going to be responsive, not a private agency. 

I do want to second something that Phil said, though. If you notice in our CASA report, just on the sampling of sites we took, of 

17 

the 152 sites we identified in 2004, by 2005 all but 29 of them were 

gone. As we have done this in that 210-hour period, in the course 

of just those 210 hours, sites disappear and pop up again. So that 

is a very difficult problem. 

I do think that it should be against the law to have on the Internet any pharmacy that has not been certified, and I think that 

alone can have a substantial impact here. And there is a system 

in place for certifying pharmacies, and that can be helpful. 

I think the other parts of your law are—I think it is a good statute, and my instincts would be to give a good portion of this authority to the DEA, which is the right agency to go after this stuff. 

I think it is terribly important. And I also think there is an education campaign here that is important, that we need, whether 

through the Internet or other places, to educate parents and children about the dangers of abusing these prescription drugs. That 

is one thing. 

I think we need to have the Food and Drug Administration be 

required to press these pharmaceutical companies to formulate 

these drugs in ways that make them much harder to abuse. 

OxyContin, all you have to do is crush it, and you could snort it, 

and you have got your heroin high. That is an inexcusable kind of 

approval, and I think also when there are addictive drugs that are 

being allowed to come on the market, before they come on the market, the Food and Drug Administration should have a plan—require the pharmaceutical company to have a detailed plan about 

what to do on the first indication of abuse. That was not true with 

respect to OxyContin. The plan came afterwards. 

Aside from all the criminal conduct of those individuals, I think 

things like that are necessary as well. 

Senator FEINSTEIN. Thank you. 

Mr. Rannazzisi, do you have a comment to make on this, specifically whether it be a Government responsibility or some private entity? 

Mr. RANNAZZISI. Well, ma’am, we reviewed that proposal, and at 

this moment in time we are not prepared to provide a recommendation or comment. But I would like to get back to something that 

we have discussed before with certification in the pharmacies. 

We look at this as two separate problems. There is a our domestic problem and our international problem. Obviously, we have no 

regulatory control over international pharmacies, and most of these 

are not even pharmacies. They are just storefront operations. But 

we do have regulatory control over the domestic pharmacies, and 

as we talked about certifying, DEA does not certify pharmacies to 

operate on the Internet. DEA registers pharmacies to procure and 

dispense controlled substances pursuant to a legitimate or valid 

prescription. 

If you look at the first placard up there, that is a comparison of 

a brick-and-mortar pharmacy, your normal brick-and-mortar pharmacy that operates in your community every day. That is an average number. They dispense about 88,000 tablets of hydrocodone a 

year, hydrocodone combination products. Now, if you look at the 2.9 

million, that is a rogue Internet pharmacy. Now, remember, a 

rogue Internet pharmacy is a DEA registrant. Somewhere down 

the line on that Internet site, they are going to have to get their 

18 

drugs, if they are domestic, from a brick-and-mortar pharmacy that 

is servicing that Internet site. The 2.9 million is the average. We 

took 34 known and suspected Internet pharmacies and looked at 

their purchase records for 2006. Nearly 99 million hydrocodone 

combination products were sold out of those pharmacies 99 million. 

So you could see the great difference. 

If you look at the second placard, the cyber pharmacies, as compared to the brick-and-mortar pharmacies, your average brick-andmortar pharmacy does about 89 percent of noncontrolled substances as compared to 11 percent of controlled substances. Now, 

if you look at those cyber pharmacies, about 95 percent—they are 

not full-range pharmacies 95 percent of their sales are controlled 

substance sales as compared to about 5 percent, about 425 prescriptions a day. So you could see there is a major difference between the brick-and-mortar cyber pharmacies and— 

Senator FEINSTEIN. What are you saying? I mean, do not mince 

words. What are you saying? 

Mr. RANNAZZISI. What I am saying is that those are rogue pharmacies that are dispensing outside the scope of good practice. They 

are doing something illegally. 

Senator FEINSTEIN. So are you saying do not worry about them, 

just let them continue? 

Mr. RANNAZZISI. No. I am saying that we have to do something 

about, yes, absolutely, and we are. 

Senator FEINSTEIN. I am sorry. I am not aware of what you are 

doing. 

Mr. RANNAZZISI. OK. For starters, we are starting to look at their 

purchase records. Every Internet pharmacy that we have seen has 

a purchase footprint. We know based on their sales that they are 

Internet pharmacies. So what are we doing? In addition to going 

after them criminally, we are also going after them—we are taking 

their registrations— 

Senator FEINSTEIN. How many have you gone after criminally? 

Mr. RANNAZZISI. Organization-wise, I could not tell you the exact 

number. I could get back to you on the exact number. 

Senator FEINSTEIN. Yes, we would like to have the number. 

Mr. RANNAZZISI. Absolutely. But I can tell you that we have been 

shutting these pharmacies down using our regulatory authority 

and immediate suspension authority. We have gone after them and 

immediately taken their registration so they cannot dispense and 

procure controlled substances. 

Senator FEINSTEIN. Let me just say something. I introduced this 

bill with Senator Sessions in 2004. We have heard nothing from 

you. There is no comment on the bill, there are no suggestions, 

there is nothing—which indicates to me that it is an agency that 

is not taking this very seriously, to be very candid with you. 

Mr. RANNAZZISI. Well, I take exception to that, ma’am. We do 

take it seriously. In fact, you know, as you can see, using our regulatory authority, we are shutting these down. We are going after 

the distributor instead of the— 

Senator FEINSTEIN. I would like to know how many you have 

shut down, and today you cannot answer that question. 

Mr. RANNAZZISI. I will give you an exact number. 

Senator FEINSTEIN. I appreciate that. 

19 

Senator Sessions, would you like to take over? I know a second 

vote has been called. Or perhaps we should recess again? 

Senator SESSIONS. I may not be able to come back after this vote, 

so I would appreciate the opportunity to share a few thoughts with 

the panel. 

Senator FEINSTEIN. You go ahead. 

Senator SESSIONS. And thank you for your work on this legislation, your commitment to it. These charts up here are stunning to 

me. I thought it was bad, but it is worse than I thought. 

Senator FEINSTEIN. It is. 

Senator SESSIONS. That is a stunning, stunning chart, and I really should not be surprised based on the experience that I have had 

in which you see people want these drugs, they learn how to make 

money off of them, they may be personally addicted to them, they 

just want to try them, whatever. 

Senator FEINSTEIN. Senator, will you continue then? 

Senator SESSIONS. Yes. 

Senator FEINSTEIN. I will go and vote and try and come back. 

Senator Leahy may be back in the interim. 

Senator SESSIONS. Thank you. 

Senator FEINSTEIN. Thank you. 

Senator SESSIONS. [Presiding.] All right. Let me ask this. Mr. 

Rannazzisi, you talked about—I believe, Mr. Heymann, you served 

as Deputy Attorney General. I remember him here a number of 

times, know his experience. He has indicated that there are sites 

up all over saying ‘‘OxyContin without a prescription.’’ Now, how 

can you get OxyContin without a prescription? I mean, how can 

this be? Publicly or all over the Internet, hundreds of sites, apparently. 

Mr. RANNAZZISI. From our experience, those sites are probably 

operating overseas because OxyContin or oxycodone products are 

Schedule II. The level— 

Senator SESSIONS. Which means they have to have a— 

Mr. RANNAZZISI. A written prescription. 

Senator SESSIONS. And if you go to a physician and the pharmacy, they account for every single pill. 

Mr. RANNAZZISI. That is absolutely correct. 

Senator SESSIONS. Everything is done to the nth degree. The prescriptions have to be maintained and kept so your people can— 

now, Mr. Secretary, Mr. Heymann, you have been through this 

Government rigmarole over the years. Both of you have. I am 

aware of how hard it is for the DEA to get a foreign country to cooperate or move quickly against these sites. It is just a nightmare 

for agencies. Could the State Department, if they made it a high 

priority, a condition of good relations or trade, is it a feasible thing 

to think that we could pressure these companies in the foreign 

countries? 

Mr. CALIFANO. I think the odds of the State Department giving 

this a high priority are very, very low, and I will just give you— 

I go all the way back to the Johnson years. When we first saw heroin coming out of the ghettos and into broader society, I talked to 

Dean Rusk, and I said, you know, ‘‘We have got to do something 

with Turkey.’’ That is where all the heroin was coming from in 

1967. And he said, ‘‘Well, we have to be very careful about Turkey. 

20 

We need Turkey as an ally in the cold war, and we have to be very 

measured in our response.’’ 

The same attitude existed when I was Secretary of HEW. In that 

21⁄2 years, trying to get the State Department—with someone as 

distinguished and as special as Cyrus Vance being the Secretary— 

we could not get the State Department to give this subject any priority. 

Senator SESSIONS. Secretary Shultz was not very interested in it, 

either. 

Mr. CALIFANO. Secretary Shultz was not interested in it. And I 

dare say that if you went to Condoleezza Rice and said, you know, 

‘‘We are getting killed by all this stuff coming in’’—it is prescription 

drugs. It is all illegal drugs, the marijuana, the heroin, the cocaine 

pouring in here, heroin from Afghanistan. We are going to have the 

cheapest heroin in the history of the country because of what is 

happening, the way it is coming out of there. If you said, ‘‘Make 

that a priority,’’ I do not think it is real. That is why I think we 

need something like this statute— 

Senator SESSIONS. Now, you think it is impractical—Dr. 

McLellan, you nodded, and I think Professor Heymann—to expect 

that we could solve this problem in that fashion. We probably 

should not go into the details of it because our time is short. But 

is it being shipped from these foreign countries? 

Mr. MCLELLAN. One of the things that is being missed is it is not 

just registered pharmacies in Afghanistan. Remember, they are 

called ‘‘rogue pharmacies.’’ These are little factories that are making Vicodin and OxyContin knock-offs. By all means, they have opiate in them, but they are very difficult to regulate, too. And as Phil 

said, they pop up and they shut down. 

I repeat, taking nothing away from all the typical Federal ways 

to go at this, I suggest right now follow the money. Get the source 

of the dollars and squeeze that neck with the cooperation of existing—and they are very cooperative. The credit card companies, the 

banks behind those companies, and the delivery agencies want to 

stop this. 

Senator SESSIONS. Well, we have a group of people—a small 

group, maybe—who think the Internet is a crime-free zone; that is, 

nothing is a crime on the Internet. And it is religion with them and 

that to mess with it at all is a heresy of some kind, a sinful act. 

But do not want to mess up the Internet and turn it into a lawsuitcreating mishmash of regulations and all. 

Professor Heymann, your idea was that the credit card companies could work with this in a way that they would be happy with? 

Mr. HEYMANN. The answer, Senator, is yes. But we simply do not 

think that law enforcement—we think DEA has the least chance 

of being effective as a law enforcement agency operating in the 

Ukraine or in Somalia because it would require an extradition for 

DEA to make a case. So, first of all, we will not get any cooperation. Second of all, DEA’s concern is making a case before an American court. 

The State Department will also have difficulty, but now and then 

it may very well be able to press the Ukraine or Somalia to bring 

a case against a rogue seller in those places. But we think the 

problem is one of scale. My calculation is that every year, just 

21 

OxyContin and Vicodin are going to more than half a million high 

school students. Every year. 

Senator SESSIONS. A half a million? 

Mr. HEYMANN. Half a million. And so we have to find a way to 

deal with that problem with scale. One case is not going to help 

much. That is why we want the credit card companies to systematically go after everybody who is—and they are trained to do this. 

They are doing it under money-laundering legislation that you 

have passed, and they are very good at it, and they are very accustomed to it. We want them to track down which is the bank that 

is making payment to a dealer. And if they find the bank, they can 

have a contract, which it is very hard for us to regulate a bank, 

the United States to regulate a bank in the Ukraine. 

Senator SESSIONS. My vote time has expired. I hope I have not 

missed it. If you do not mind, we will return, I am sure. 

Mr. HEYMANN. I would appreciate that, Mr. Sessions. 

[Recess at 11:28 a.m. to 11:46 a.m.] 

Chairman LEAHY. [Presiding.] You know, it is interesting. This 

is an example of C–SPAN. While I was on the floor voting—and 

this last vote is still going on—I had two or three Senators in both 

parties come up to me and talk about this hearing and what they 

have been seeing, some of the information they are getting and saying, ‘‘We have got to talk with you and with Senator Feinstein and 

Senator Sessions about this.’’ They did not realize what the problem is. So in case you are wondering, even with this back and forth 

whether it carries, it does. 

Now, we have learned today—and this is a question for everybody on the panel. We have learned today about online rogue pharmacies. They are using electronic forms rather than in-person consultations to give out bogus prescriptions for prescription drugs, including highly addictive painkillers. And it appears that one of the 

loopholes used by what are, I think we would all agree, unscrupulous online pharmacies that allow access to drugs illegally on the 

Internet. 

I want to emphasize that the drug store my family and I go to, 

and others, if you have tight controls in there, it can be very helpful, both to be able to go online or to call and use a touch-tone 

phone. But what Senator Feinstein has done is introduce legislation to require in-person consultation with doctors for any purchase 

of controlled drugs over the Internet. I cannot imagine how that 

would in any way inconvenience—it certainly would not inconvenience anybody in our family. I think Senator Feinstein’s legislation 

could be a first step in attacking the serious problem. 

So let me ask the person from DEA, do you support legislation 

to require in-person consultations for prescriptions used to buy controlled drugs over the Internet? 

Mr. RANNAZZISI. DEA, the Department of Justice, and the administration are looking at all different measures that could be implemented. At this point in time, we are not prepared to make a recommendation of a specific measure. 

Chairman LEAHY. When will you be? 

Mr. RANNAZZISI. I cannot give you an answer right now, sir. I 

could tell you right now that all levels of the Department, the DoVerDate Aug 31 2005 13:17 Sep 02, 2008 Jkt 043987 PO 00000 Frm 00025 Fmt 6633 Sfmt 6633 S:\GPO\HEARINGS\43987.TXT SJUD1 PsN: CMORC
22 

mestic Policy Council, HHS, we are all looking at this together. We 

are having regular meetings to discuss these issues. 

Chairman LEAHY. Do you have any recommendations that have 

been made? 

Mr. RANNAZZISI. Not at this point in time, sir, no. 

Chairman LEAHY. Thank you. 

Secretary Califano? 

Mr. CALIFANO. Let me just note—and it is in our CASA report 

we are releasing today. This is the American Medical Association. 

‘‘Physicians who prescribe medications via the Internet shall establish or have established a valid patient-physician relationship. The 

physician shall obtain a reliable medical history and perform a 

physical examination on the patient.’’ 

Chairman LEAHY. So by this you would agree with Senator Feinstein? 

Mr. CALIFANO. There is no question about that. The four elements of a doctor-patient relationship are that the patient has a 

medical complaint, that a medical history is taken, that a physical 

examination has been performed, and that some logical connection 

exists between the medical complaint, the medical history, the 

physical examination, the drug prescribed. So it is right on. And 

the Federation of State Medical Boards agrees with you, too, Senator Feinstein. 

Chairman LEAHY. Professor Heymann? 

Mr. HEYMANN. As I remember Senator Feinstein’s proposal, it requires at least one meeting, one live meeting with a doctor. That 

seems to me to be exactly right. 

Chairman LEAHY. Ms. Haight? 

Ms. HAIGHT. Yes, I agree with that totally. That is how it has 

always been in hospitals. 

Chairman LEAHY. Dr. McLellan? 

Mr. MCLELLAN. Well, I think it is completely appropriate for all 

legitimate pharmacies, all legitimate physicians, and especially 

those in the United States. I remind you that more than 80 percent 

of everything we are talking about has essentially nothing to do 

with the United States— 

Chairman LEAHY. I understand. I am trying to figure out, 

though, what kind of laws are in place that make it easier to block 

those others, which goes to what Professor Heymann has said 

about the First Amendment things. You are going to have to have 

certain legal requirements if you are going to block activity which 

then becomes illegal and do it constitutionally. 

Mr. HEYMANN. Senator Leahy, our answer to that was to have 

Internet access blocked for sellers of prescription narcotics only at 

the request of the households. In other words, any Internet service 

provider would have to ask every household to which it provides 

Internet service, ‘‘Do you want this to be blocked?’’ If they said yes, 

they would then block any further offers to sell drugs. 

Chairman LEAHY. How many did you find on Mother’s Day when 

you went on? 

Mr. HEYMANN. Well, they have not done that yet, but I literally— 

you know, the Google number at the top— 

Chairman LEAHY. Someone has a BlackBerry nearby. 

Senator FEINSTEIN. Me. Sorry. 

23 

Chairman LEAHY. You are getting a lot of supportive testimony, 

Senator Feinstein. Do not block that. 

[Laughter.] 

Chairman LEAHY. Go ahead. 

Mr. HEYMANN. The google number at the top was 800,000. I 

looked and my search was for ‘‘Buy OxyContin without prescription.’’ It was not Vicodin. It was not steroids. It was a single drug, 

though many of them would overlap. And I only looked at the first 

20 or 30, but each of them looked to me like a purchase—like an 

offer to sell a highly addictive narcotic to anybody without bothering with a prescription. 

Chairman LEAHY. Well, the thing that gets me—I mean, I want 

to find some way to stop it. I think everybody agrees, parents 

would agree, we do not want pornography to go to our kids. But 

kids can move around pretty quickly, usually a lot better than parents can, on the Internet because they live on it. I told the story 

of a 4-year-old grandson wanting to do an interactive—I think it 

was Disney or something like that, a perfectly appropriate thing 

where you could draw pictures, do interactive things. He wanted to 

use the computer to do it. And I said, ‘‘Fine, but I have to get the 

site for you,’’ because I wanted to make sure that is exactly the 

site. The site came up, and he said, ‘‘Yes, that is the one,’’ took the 

mouse out of my hand and said, ‘‘I better take over now because 

it gets very complicated.’’ 

[Laughter.] 

Chairman LEAHY. You mentioned OxyContin. We know how they 

misrepresent how addictive their drugs were in marketing and advertising. The press has been full of this, especially the last couple 

of weeks. According to court records, the makers of the drug, Purdue Pharmaceuticals, agreed to pay more than $600 million in 

fines and penalties. And three of its top executives admitted they 

were responsible for misleading those who bought and prescribed 

the drugs. 

Do we need to change how we regulate these kinds of painkillers? We will go one, two, three, four, five. Go ahead, Mr. 

Califano. 

Mr. CALIFANO. I would make a note of a couple of things. 

One, a quarter of these sites we know claim to be in the United 

States. That has been consistent over the 4 years we have done 

this sample. About half of them say they are overseas, and about 

a quarter of them are unknown origin. So there are sites in the 

United States. 

Two, with respect to what happened with Purdue Pharma, my 

own view is if those guys had been street drug dealers, they would 

be in jail, and they did just as much damage as street drug dealers. 

So they walked. 

And, last, vis-a-vis Senator Feinstein’s point, I would like to 

quote—we have a quote from Joe Rannazzisi in our report that we 

are releasing today, and let me read it. ‘‘A legitimate doctor-patient 

relationship includes a face-to-face consultation where a licensed 

physician can examine the physical symptoms reported by a patient before making a diagnosis and authorizing the purchase of a 

prescription medicine. Filling out a questionnaire, no matter how 

detailed, is no substitute for this relationship.’’ And I realize he 

24 

does not have authority to support in a formal way what you propose in your bill, but that certainly supports it. 

Mr. HEYMANN. We think that there has to be somewhere—and 

I am about ready to concede to Senator Feinstein and to Joe that 

perhaps it should be a governmental responsibility. There has to be 

someone who is monitoring the Internet to see if somebody—to see 

the long list of people who are offering to sell prescription narcotics 

without a prescription. 

Once that is done—and I suggest you put it in the Office of Justice Programs, Senator Feinstein. I do not think it is DEA because 

it is not law enforcement, and the law enforcement is the focus for 

DEA. And Mr. Califano has already commented on the likelihood 

that the State Department would be very vigorous. It will not be 

very vigorous. I would give it to OJP, the Office of Justice Programs, and tell them to set up a small unit. We are talking about 

five, ten people. A few thousand dollars will create the programs, 

and then whenever they get information, send it to the credit card 

companies and expect the credit card companies to cutoff the credit 

and track down who is getting it, and send it to the Internet service providers and expect the Internet service providers to add it to 

their list that is cutoff from any family that does not want these 

ads coming into their house. 

Chairman LEAHY. I have actually gone beyond my time. I am on 

Senator Feinstein’s time. I am going to hand it over to her. Does 

anybody wish to add very, very briefly to what was said? 

[No response.] 

Chairman LEAHY. OK. Thank you. 

Senator Feinstein, I cannot thank you enough for bringing up 

this subject, and I can assure you we will work on it, and the Committee will followup on it. 

Senator FEINSTEIN. [Presiding.] Well, thank you very much, Mr. 

Chairman, and thank you for having the hearing because I think 

it was very constructive. I myself think that we have to develop 

this second part of it, and we will proceed to do so. 

I do not know what is wrong with DEA, but something is. All 

during the methamphetamine discussion, which has gone on for 10 

years from when I introduced the first bill in 1996 to the last bill 

that we did with Senator Talent, I have asked for DEA help, and 

DEA is nowhere. And now once again, on this issue, which clearly 

by your own chart is a big issue and clearly by the statement that 

Secretary Califano read, you have got to agree with it. And yet I 

do not know whether it is partisan or what it is, but I cannot get 

help on these matters from DEA. So I would like to just publicly 

ask for help. I would welcome DEA’s suggestions. I know Senator 

Sessions will as well. We would like to make this as strong a bill 

as possible; that people who sell drugs illegally over the Internet 

without a physician’s prescription, without a physician visit, should 

be prevented from doing so; and if they continue, shut down. That 

is my view, and we are trying to get as close to that as we possibly 

can. 

I do not know that the Internet should be able to facilitate acts 

which are not legal in this country. But when you have young people who, as Senator Leahy testified and Mrs. Haight testified with 

her son, are so facile on the Internet, are young, want to try anyVerDate Aug 31 2005 13:17 Sep 02, 2008 Jkt 043987 PO 00000 Frm 00028 Fmt 6633 Sfmt 6633 S:\GPO\HEARINGS\43987.TXT SJUD1 PsN: CMORC
25 

thing, can have exposure to a whole illegal field of very powerful 

drugs, it is extraordinarily dangerous. 

Dr. Heymann, I am amazed. This was on Mother’s Day that you 

pulled up 800,000 sites? Or was it hits? 

Mr. HEYMANN. Let me send you what I pulled up, Senator Feinstein. 

Senator FEINSTEIN. Well, could you define for me again what it 

was? 

Mr. HEYMANN. I put into Google, ‘‘Buy OxyContin without prescription.’’ I believe the number was 800,000 hits. In an instant, 

800,000 hits. I looked through the first 20 to make sure we were 

not picking up a lot of other things, and the first 20 were overwhelmingly offers to sell OxyContin using a credit card to whoever 

pushed a button on that website. 

Senator FEINSTEIN. Do you remember how many of these were 

in country as opposed to out of country? 

Mr. HEYMANN. You cannot tell from the website, though Dr. 

McLellan has some judgment on that. 

Mr. MCLELLAN. Yes, in fact, our group was the group that discovered this. Dr. Robert Forman had the first article about this, and 

we have been tracking it scientifically since then. And, by the way, 

800,000 is about the same number for that substance since 2002. 

And I say that because, to the credit of DEA and the credit of a 

lot of law enforcement, there have been a lot of busts in this country, and they have knocked out huge rings, and it does not stop because they pop up just as fast. The market is overwhelming. There 

is a very brisk business in this, and it is not going to go away simply by local law enforcement. 

You can tell the registry of a site by digging into, you know, 

where it is—that takes a lot more work. It is almost not worth it 

because literally tomorrow, if you stopped my website today, literally tomorrow, and in another country, in the snap of a finger, 

I would have another one up. 

Senator FEINSTEIN. And the drug, Dr. Heymann, that you were 

looking for was OxyContin? 

Mr. HEYMANN. It was OxyContin, and Vicodin would have been 

many more, I suspect. Many more than 800,000. It was OxyContin. 

Senator FEINSTEIN. All right. Does— 

Mr. MCLELLAN. Two million nine hundred thousand. 

Senator FEINSTEIN. Two million nine hundred thousand? 

Mr. MCLELLAN. For Vicodin. 

Senator FEINSTEIN. Hits for Vicodin? 

Mr. MCLELLAN. If you put ‘‘No prescription Vicodin’’— 

Senator FEINSTEIN. Would you turn on your microphone, please? 

Mr. MCLELLAN. Sorry. If you put the words ‘‘No prescription 

Vicodin’’ in Google, right here, right now, you will have no less 

than 2,500,000 hits. 

Senator FEINSTEIN. So, clearly, I mean— 

Mr. MCLELLAN. And 88 percent of them are direct offers to sell. 

I should just say one quick thing. Remember, a telephone is a computer. Now it is clear that if you have a purchase and you give 

them your website, they will text message you. Some of these pharmacies will text message you, ‘‘Need a refill?’’ And if the kid says 

‘‘Yes,’’ you get billed in ring tones, almost as though they are trying 

26 

to make it impossible for Mom and Dad to check as to what is actually being bought. 

Senator FEINSTEIN. Clearly, there is a big problem, and clearly, 

DEA ought to be producing some solutions. I would like to ask for 

those solutions. I would like to ask, respectfully, for DEA’s views, 

any suggestions you might have as to how we can take actions 

which can effectively stop this. I just hate to think that we have 

to throw up our hands and say it cannot be stopped. 

Mr. RANNAZZISI. Ma’am, if I may, we have never said that it cannot be stopped, and we will provide any technical advice that you 

need, and I think we have to your staff in the past. But the fact 

remains that when you do a search like that, most of those are portals or informationsites. When you get right down to it, when you 

get right down to the anchor sites that are selling the drugs, there 

are far fewer than 800,000, or whatever the number is. And domestically those sites are being serviced by one pharmacy or two pharmacies or a hundred pharmacies. Each pharmacy is servicing—I do 

not know how many. They could be servicing 30, 40, 50 websites. 

So the key is not the sites. The key is those pharmacies. The key 

is to hit the pharmacies and to shut them down. The sites are 

going to regenerate. 

Senator FEINSTEIN. Well, then, why doesn’t DEA shut them down 

in this country? 

Mr. RANNAZZISI. We are. We are using our regulatory authority— 

Senator FEINSTEIN. Again, I have asked you how many have you 

shut down, and you cannot give me a number. 

Mr. RANNAZZISI. And I told you, ma’am, I will give you an exact 

number that we have shut down. 

Senator FEINSTEIN. I was just handed your written remarks, 

which during 2006, SOD has coordinated over 90 investigations resulting in the arrest of 64 individuals and the seizure of approximately 14 million dosage units of controlled substances and approximately $30.9 million in United States currency. 

Mr. RANNAZZISI. Yes, ma’am. You wanted the number of pharmacies. 

Senator FEINSTEIN. So at least you were doing something. 

Mr. RANNAZZISI. Well, in all of our investigations, we follow the 

money, and we put people in jail. That is what our job is. But you 

wanted an exact number of pharmacies that we shut down, and I 

told you I would get back to you on that. 

Senator FEINSTEIN. OK. Fair enough. Fair enough. 

Mr. RANNAZZISI. OK. 

Senator FEINSTEIN. I think the other thing is any suggestions 

DEA might have for legislation which is aimed at shutting them 

down. I recognize the Constitution, I recognize the difficulties, but 

we have to find a way to do this. 

Mr. RANNAZZISI. Yes, ma’am. 

Senator FEINSTEIN. I think that is probably it, unless somebody 

else has something that they would like to say. I would like to 

thank you all very much. I know some of you came from long distances, and it is very much appreciated. 

So thank you, and this hearing is adjourned. 

[Whereupon, at 12:05 p.m., the Committee was adjourned.] 

[Questions and answers and submissions for the record follow.] 

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