![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 25 to 49 of 73. Go back in thread:
Posted by Mark H. on September 21, 2001, at 3:51:41
In reply to Re: Posting policy, posted by Dr. Bob on September 19, 2001, at 17:45:37
There are multiple issues to consider, some of which have already been mentioned.
1.) First, most of us know the importance of working WITH our doctors to find the right balance of treatment, including medications, for our conditions. Circumventing the process of getting help from a licensed physician and pharmacist is simply dangerous and unnecessary under most circumstances.
2.) Legally speaking, most of us know little or nothing about federal law and regulations regarding the importation of medications for personal use. Travelers who have been prescribed a medication in another country may bring their medications into this country, but the mail-order use of off-shore pharmacies is a phenomenon that arose mainly with widespread use of the Internet.
At least one UK-based pharmacy (that carefully limits the types of medications and supplements they offer) includes an elaborate written explanation with every shipment of what they believe is the total legality of a US citizen's right to order (and their right to provide) medications that are not controlled substances (Scheduled), including a threat to sue any agent or representative of the US government who interferes with the delivery of their shipments. They cite agency guidelines indicating that it is allowable to import up to a three-month supply for personal use under the care of a physician (but not necessarily requiring a prescription -- this is where it seems to get a bit grey). I honestly don't know how one would sort this out.
At the other end of the spectrum, one online drugstore recently mentioned here disclaims ANY responsibility for or knowledge of the importation requirements of the consumer's country. I take this to mean that a consumer in the United States could innocently push the "buy" button, provide his/her name, address, phone and credit card number, and be faced with two types of unintended exposure: significant financial loss in the form of non-refundable payment in the event of seizure of the shipment by Customs, and legal liability for the importation and possession of medications that may turn out to be controlled substances. Note that this pharmacy offers syringes and needles, anabolic steroids, thyroid preparations, antihypertensives and other powerful, potentially dangerous medications, as well as Tylenol!
3.) I don't know if others have already mentioned this issue, but another factor is over-charging. Many of the online sources for prescription medications charge TWICE OR MORE the retail price for their medications. If they were selling gasoline or groceries, no one would buy from them at all. Some even take the additional step of including an online physician consultation as part of the cost of the medication (e.g., for Viagra).
4.) Purity and patent violations are another consideration. The rogue pharmacy I mentioned above offers a choice of manufacturer for many of the meds it offers. Do you really want to take a generic version of your medication whipped up by an unlicensed facility in Thailand?
In the end, I am concerned that abuse of the openness of the Internet and e-commerce will bring about restrictions that will make the legitimate use of off-shore pharmacies unavailable to those who really need it. A good example would be the story cited elsewhere of a French citizen in the United States who had been treated successfully with a medication not available here -- should he not be allowed to continue to obtain his medication while in the United States? But if too many people abuse the availability of controlled substances without prescriptions, I predict we will lose all personal choice in the matter whatsoever.
I'm sorry that these considerations are not more conclusive.
Best wishes,
Mark H.
Posted by Neal on September 23, 2001, at 0:31:28
In reply to Re: Posting policy, posted by Dr. Bob on September 19, 2001, at 17:45:37
Gee, that's too bad if we have to have a censored site here. One of the things I have liked here was the openess, the sense that everything was on the table to be discussed. It's hard for someone who's never been depressed to understand, the desperation that people have who's depression is not under control. That's what stimulates the discussions of foreign meds, and 3 posters that I know of have been helped by them.
Posted by Dr. Bob on September 23, 2001, at 14:25:49
In reply to Re: Posting policy, posted by Neal on September 23, 2001, at 0:31:28
> if you don't feel comfortable with the sites posted then you should base your decision on that. If you decide in that direction, (and I'm hopeful that you won't) there will still be posters who ask for sites and give out their e-mail addresses so they will get the information anyway, I imagine. And I hope that will be okay?
Sorry, but if I didn't want people learning from this site how to do something illegal, then I think I'd have to say that asking for -- or offering to give out -- that information would *not* be OK, at least not here.
----
> Gee, that's too bad if we have to have a censored site here. One of the things I have liked here was the openess, the sense that everything was on the table to be discussed. It's hard for someone who's never been depressed to understand, the desperation that people have who's depression is not under control. That's what stimulates the discussions of foreign meds, and 3 posters that I know of have been helped by them.
I agree, it's too bad, but this site has already been "censored" for a long time. The question now is where to draw the line, not whether to draw one.
I understand that some people are desperate, but (1) I don't think the answer is necessarily to do something illegal, (2) if someone did decide to do that, they could ask elsewhere, and (3) discussion of the medications themselves would still be fine here.
Bob
Posted by shelliR on September 23, 2001, at 14:57:49
In reply to Re: Posting policy, posted by Dr. Bob on September 23, 2001, at 14:25:49
> > if you don't feel comfortable with the sites posted then you should base your decision on that. If you decide in that direction, (and I'm hopeful that you won't) there will still be posters who ask for sites and give out their e-mail addresses so they will get the information anyway, I imagine. And I hope that will be okay?
>
> Sorry, but if I didn't want people learning from this site how to do something illegal, then I think I'd have to say that asking for -- or offering to give out -- that information would *not* be OK, at least not here.
>Okay, then I must have misunderstood the meaning of this exchange:
As you may know, I decided I didn't want people asking for medication from or offering medication to others here. Is there a difference between offering to give someone a medication you have and telling them how to get it online?
*People would still be free to exchange sites on their own if they wanted, I just wouldn't be so involved myself.*
Shelli
Posted by galtin on September 23, 2001, at 15:08:36
In reply to Re: Posting policy, posted by Dr. Bob on September 23, 2001, at 14:25:49
> > if you don't feel comfortable with the sites posted then you should base your decision on that. If you decide in that direction, (and I'm hopeful that you won't) there will still be posters who ask for sites and give out their e-mail addresses so they will get the information anyway, I imagine. And I hope that will be okay?
>
> Sorry, but if I didn't want people learning from this site how to do something illegal, then I think I'd have to say that asking for -- or offering to give out -- that information would *not* be OK, at least not here.
>
> ----
>
> > Gee, that's too bad if we have to have a censored site here. One of the things I have liked here was the openess, the sense that everything was on the table to be discussed. It's hard for someone who's never been depressed to understand, the desperation that people have who's depression is not under control. That's what stimulates the discussions of foreign meds, and 3 posters that I know of have been helped by them.
>
> I agree, it's too bad, but this site has already been "censored" for a long time. The question now is where to draw the line, not whether to draw one.
>
> I understand that some people are desperate, but (1) I don't think the answer is necessarily to do something illegal, (2) if someone did decide to do that, they could ask elsewhere, and (3) discussion of the medications themselves would still be fine here.
>
> Bob
This is a reasonable compromise on both philosophical and liability issues. After all, our purpose is to share information about the meds themselves, not how or where to get them. I haven't seen any posts extolling the pricing and service of, say, one drug store chain above another. Liability issues, unfortunately, must be cognizant of the worst case scenario--somebody dying from a medication obtained through information publicly exchanged on the site. At this point, legality concerns would be very much in the forefront. What site manager or sponsor wants to operate under this threat.As Bob says, there are other ways to get information on how to obtain renegade drugs sans script. The obvious one is to talk to knowledgeable posters off site. That leaves everybody else able to focus on the meds themselves, rather than their procurement. This is the site's primary purpose--why fool with it?
galtin
Posted by Shar on September 23, 2001, at 15:16:04
In reply to Re: Posting policy, posted by Dr. Bob on September 23, 2001, at 14:25:49
"I understand that some people are desperate, but (1) I don't think the answer is necessarily to do something illegal, (2) if someone did decide to do that, they could ask elsewhere, and (3) discussion of the medications themselves would still be fine here."
I think it gets very tricky at this point to draw the line based on illegality. If this viewpoint prevails, people will not be able to talk about taking illegally obtained drugs. Or using illegal drugs. Or, warning readers of, say, a bad experience they had with an overseas pharmacy, because they would have to name the pharmacy (source) of the meds.
There are things talked about here, on many different topics, that include reports or self-reports of illegal activity--to one degree or another. I hope the plan is not to consistently apply the 'is this perhaps illegal' standard to all posts. We will need a psycho-lawyer then to sort out what is ok and what is not.
Shar
> > if you don't feel comfortable with the sites posted then you should base your decision on that. If you decide in that direction, (and I'm hopeful that you won't) there will still be posters who ask for sites and give out their e-mail addresses so they will get the information anyway, I imagine. And I hope that will be okay?
>
> Sorry, but if I didn't want people learning from this site how to do something illegal, then I think I'd have to say that asking for -- or offering to give out -- that information would *not* be OK, at least not here.
>
> ----
>
> > Gee, that's too bad if we have to have a censored site here. One of the things I have liked here was the openess, the sense that everything was on the table to be discussed. It's hard for someone who's never been depressed to understand, the desperation that people have who's depression is not under control. That's what stimulates the discussions of foreign meds, and 3 posters that I know of have been helped by them.
>
> I agree, it's too bad, but this site has already been "censored" for a long time. The question now is where to draw the line, not whether to draw one.
>
>
>
> Bob
Posted by Dr. Bob on September 23, 2001, at 15:17:49
In reply to Re: Posting policy » Dr. Bob, posted by shelliR on September 23, 2001, at 14:57:49
> I must have misunderstood the meaning of this exchange:
>
> > As you may know, I decided I didn't want people asking for medication from or offering medication to others here. Is there a difference between offering to give someone a medication you have and telling them how to get it online?
> >
> > *People would still be free to exchange sites on their own if they wanted, I just wouldn't be so involved myself.*I hadn't yet considered the scenario you presented, and had to think about it, but at this point, I think my stance would be, doing so on their own would have to include finding those to do so with.
Is there a difference between someone asking for information to be posted here and asking here for it to be emailed to them?
Bob
Posted by shelliR on September 23, 2001, at 15:52:48
In reply to Re: Posting policy, posted by Dr. Bob on September 23, 2001, at 15:17:49
>
> Is there a difference between someone asking for information to be posted here and asking here for it to be emailed to them?Of course there is. In the first scenario there is information about sites up on your board, so in some way, *perhaps* you can be held accountable (or seen as offering support) for the posting *if* it turns out to be an illegal scenario. If somewhat says "can someone tell me where to get X, my email address is ...@..., then you do not even have to assess whether getting X is legal or not, because the information is not being posted on your board. As far as you know it could be absolutely legal to get X. The poster may have a prescription from his pdoc (say adrafinil, for example) and still not know where to obtain that drug.
Anyway, if your decision was to be based on legality alone, why did you even ask us for our input. I agree with Shar. Why not just ask an attorney?Shelli
Posted by jane d on September 23, 2001, at 16:46:31
In reply to Re: Posting policy, posted by Dr. Bob on September 23, 2001, at 15:17:49
> Is there a difference between someone asking for information to be posted here and asking here for it to be emailed to them?
>
> BobDo you really want to be put in the position of having to read between the lines of every post? "Please e mail me information on buying drugs" is easy but what if they merely post that they wish they had the option of using foreign meds and leave their email address showing?
Jane
Posted by Dr. Bob on September 23, 2001, at 18:09:44
In reply to Re: Posting policy » Dr. Bob, posted by jane d on September 23, 2001, at 16:46:31
> I think it gets very tricky at this point to draw the line based on illegality. If this viewpoint prevails, people will not be able to talk about taking illegally obtained drugs. Or using illegal drugs. Or, warning readers of, say, a bad experience they had with an overseas pharmacy, because they would have to name the pharmacy (source) of the meds.
It definitely is very tricky to draw a line. My preference has always been not to, but sometimes I do think there's more to be gained by facing an issue than avoiding it.
People would still be able to talk about taking drugs and to warn others about the dangers. They just wouldn't be able to say where specifically they obtained them.
----
> > Is there a difference between someone asking for information to be posted here and asking here for it to be emailed to them?
>
> Of course there is. In the first scenario there is information about sites up on your board, so in some way, *perhaps* you can be held accountable (or seen as offering support) for the posting *if* it turns out to be an illegal scenario.But even if someone just posts a request to be emailed, couldn't I perhaps be seen as offering support for that request?
> Anyway, if your decision was to be based on legality alone, why did you even ask us for our input. I agree with Shar. Why not just ask an attorney?
Sorry if it seems like I'm ignoring your input. I do value it, however, and it does help me think this through. As I said, I hadn't thought about your scenario before...
Lawyers can tell you the law, but they can't necessarily tell you how it will be interpreted and applied, that's up to the courts and may depend on the circumstances of the specific case.
----
> Do you really want to be put in the position of having to read between the lines of every post?
No, but see above.
> what if they merely post that they wish they had the option of using foreign meds and leave their email address showing?
You're not going to make this easy for me, are you? :-)
That would in fact seem like an invitation be emailed such an option. I guess it would depend on how sure I felt about what I read between the lines?
Bob
Posted by SLS on September 24, 2001, at 1:13:43
In reply to Re: No prescription needed, posted by stjames on September 18, 2001, at 1:17:08
> James - I am confused. I am sure that I have seen you mention that you smoke pot - an illegal activity. Have you had some kind of epiphany about breaking the law? A law like the one that determines which drugs must be prescribed by a physician and which ones are OTC. How is this different? - Jane
>
> James here....
>
> It is a question of degree. It is a minor offence for possision, where I live. A fine at best. My docs all know I smoke pot.
>
> Having meds without a script is a felony. Playing doc, without a real Dx is dangerous.
>
> I do realize some have no choice but to get their meds illegally. But do we have to hear about it every day ? People seem to have no problem finding drugs ! I also feel that many metally ill are very impressionable and it is very hard to understand all the info to make an informed desicion.
>
> jamesI noticed someone's reference to this thread on the PB board, so I figured I'd check it out. I've managed to make it this far. I'll work on the rest tomorrow (if my hippocampus is cooperative).
Hi James.
I think I know where I'm heading with all of this, but I want to be able to take in what everyone else has offered.
Actually, this is just a brief comment/question. I don't think it is necessary for you to address the issue regarding your illegal acts. As I understand the point being made, the real question is whether or not you suggest to others on Psycho-Babble that they smoke pot and tell them where they can get it.
Do you?
I've never seen you do it. If you haven't, then, as I see it, there is no incompatability between your position on this issue and your described behaviors.
- Scott
Posted by Jane D on September 24, 2001, at 2:52:47
In reply to Re: Posting policy, posted by Dr. Bob on September 23, 2001, at 18:09:44
> > I doubt I will ever use this information to order drugs.
... As usual, I think that more information is always best.
>
> OK, but it wouldn't really directly affect your own mental health?My initial response to this was going to be along the lines that banning discussion of many things, opiates for example, would have no direct affect on me. In the end, however, as more and more topics were banned it almost certainly would. This is just another familiar abstract argument - though still a valid one.
Recently, in a more morbid state of mind, I've been able to envision just how easily this could become personal. The choice here is not always between buying overseas on your own or seeking a doctor's prescription for FDA approved meds. The choice may be between making a last ditch effort to go it alone or giving up completely. Suicide (and when will discussing that become taboo?) or just drinking yourself into oblivion will always be options. Today, the next step for me is to try another doctor. But in darker moments I'm already envisioning being 10 years older, and having tried many doctors, only to be where I am now. And I've been asking myself what comes next. Ordering my own meds is one next step, one I would feel obliged to try before giving up entirely. At that point, whether it was an effective course would be irrelevant. It would be better than the only other alternative I saw open. This may still be hypothetical but it's a future that feels very real right now. It is reassuring to know that there is one more layer of options between me and total desperation.
This doesn't address whether the information should be posted here. I know that there are other sources. Today, when I don't need it, I know I could find those sources. If I was desperate enough to need it I probably couldn't.
> I'm not trying to tell you what to do, I'm just not sure I want to be so associated with this myself.
What, specifically, bothers you about this? I don't think you have a legal exposure here but, in a direct analogy to the original argument, if the risks are yours, the decision is also yours. Morally, I think that the potential usefulness of these posts outweighs the potential risk to readers, especially since both are hypothetical. Again it's your call but I'd be interested in hearing why you choose what you do.
One thing that really does bothers me about this entire thread is that I feel the legal threats have been made to promote an entirely different, less supportable, agenda as indicated by the quotes below."No one should be that naive so assume lay people are able to ponder the medical and legal implications on this issue. How can most do this when the issues are so technical"
and "Guess we don't need health professionals, anymore (nm)"
I think both quotes fairly represent the posters positions as presented in many other posts. They suggest to me that this is really about whether people should be allowed to (and are competent to) make their own health decisions. The implications of deciding that people in general are not really does frighten me. The suggestion that I personally am not enrages me.
Jane
Posted by Mitchell on September 24, 2001, at 6:53:21
In reply to Re: Posting policy » Dr. Bob, posted by Jane D on September 24, 2001, at 2:52:47
> The choice may be between making a last ditch effort to go it alone or giving up completely.
There might be other choices, too, such as between making a last ditch effort to go it alone, and purchasing mail order drugs from an off-shore source then being charged with a crime.
> One thing that really does bothers me about this entire thread is that I feel the legal threats have been made to promote an entirely different, less supportable, agenda as indicated by the quotes below. … They suggest to me that this is really about whether people should be allowed to (and are competent to) make their own health decisions.
Maybe it is about that for some people, but my interest is to protect people's right to make their own health decisions. If people who want to control their own health care are invited to participate in illegal activity, acceptance of self-care could be damaged. If I needed to do something illegal as part of a self-care plan, I would not do it out in public, such as on the Internet, or at least I would be very savvy about how I use the Internet to facilitate something that might be illegal.
Far from being an advocate against self-care, I would rather see a general loosening of controls on healthcare, if we could do it while still having in place systems for quality assurance and as long as low-income clients enjoyed similar quality assurances as would moneyed clients. I also advocate for expanded free speech, including the freedom to encourage people to use substances that are now banned. But reasonable advice for a person maintaining a forum that offers a modicum of free speech would be to not do things that would jeopardize the forum itself.
The risk that people will make a wrong choice if allowed unregulated access to drugs is a legitimate element of the discussion here, though it is not a great concern for me. The same risk clouds a forum such as this with regard to information that might encourage a person to plead with their doctor for an inappropriate medication, or learning in this forum how to report a symptom in proper terms to get a prescription for a medication that prove dangerous or inappropriate.
The real risk, and I think the one the administrator cited, is the risk of providing a forum where people may advocate participation in illegal activity. To be more precise, I don't think the concern is that people will advocate illegal activity, but rather that the forum will be implicated in illegal activity. I think an administrator would do well to consider how an attorney general might view a discussion where amateur diagnoses are coupled with recommendations of medications and instructions about how to get those medications outside the law.
The main concern seems to be that purchase of meds from an off-shore pharmacy without a prescription is illegal. It is also illegal to facilitate such purchases. Providing a forum where people exchange links along with recommendations to try specific medications from those sites could be seen as facilitating and promoting purchases without a prescription. As far as I know, people can offer on these boards reasonable and civil arguments for opiates, for marijuana, for ecstasy, for any other illegal drug, or for any approved or unapproved medication, but they cannot use the board to help people obtain those drugs outside the law.
It seems to me, the best thing a person could do if they want to be allowed to direct people here to offshore pharmacies would be to cite a legal authority (other than the claims of the overseas merchants) that would show why they believe it is legal to import non-scheduled drugs without a prescription.
Posted by Jane D on September 24, 2001, at 11:19:36
In reply to Re: Posting policy, posted by Mitchell on September 24, 2001, at 6:53:21
> > The choice may be between making a last ditch effort to go it alone or giving up completely.
>
> There might be other choices, too, such as between making a last ditch effort to go it alone, and purchasing mail order drugs from an off-shore source then being charged with a crime.Or there might not be other choices. Or there might not be any risk of being convicted of a crime. I doubt you can point to any case of someone being convicted for importing personal amounts of drugs in schedule 3 or less (to use your definition of the words for the sake of clarity).
> If I needed to do something illegal as part of a self-care plan, I would not do it out in public, such as on the Internet, or at least I would be very savvy about how I use the Internet to facilitate something that might be illegal.
> Far from being an advocate against self-care, I would rather see a general loosening of controls on healthcare, if we could do it while still having in place systems for quality assurance and as long as low-income clients enjoyed similar quality assurances as would moneyed clients.Quality assurance but not options? You seem to be saying we should be quiet about the internet option in order to preserve it for the sophisticated who are already in the know. Banning this information disproportionately penalizes the poor who are latecomers to the internet, who do not have the option of traveling abroad in person or of doctor shopping until they find one who will rubber stamp their import requests.
> The real risk, and I think the one the administrator cited, is the risk of providing a forum where people may advocate participation in illegal activity. To be more precise, I don't think the concern is that people will advocate illegal activity, but rather that the forum will be implicated in illegal activity. I think an administrator would do well to consider how an attorney general might view a discussion where amateur diagnoses are coupled with recommendations of medications and instructions about how to get those medications outside the law.
> The main concern seems to be that purchase of meds from an off-shore pharmacy without a prescription is illegal. It is also illegal to facilitate such purchases.
Your concern is touching which makes me wonder why this sounds so much like a threat. Perhaps some of your previous posts, where you have expressed a general hostility to this site, have caused me to misinterpret your meaning here.
The liability of the board owner is unproven. It is also unlikely to materialize out of thin air. If there is any at all it will end up, in practice, being determined by the level of the so called offense. That is unclear here. I spent several hours with most of the sites listed and I'm damned if I know what they say. I did not, however, find much to support any of the claims made here about what they say. It seems that the sites can be used as a kind of strange rorschach test - where what you see in the text has everything to do with your beliefs and nothing to do with the seemingly deliberate ambiguities of what is actually written there. It is that ambiguity that makes all your scenarios unlikely at best.
That said, this is an area that is sure to be clarified. Why not wait for the clarification to take place? You probably won't have to wait long. I suspect we may soon see a very entertaining dance where drug companies, who make most of their profits from their US sales, are eager to restrict the import of approved drugs from less expensive sources while preserving their option of bypassing the FDA by encouraging importation of non approved drugs.
Jane
Posted by Jane D on September 24, 2001, at 11:32:29
In reply to Re: No prescription needed » stjames, posted by SLS on September 24, 2001, at 1:13:43
Sorry Scott - This thread may well have moved beyond that issue but at the time of my original post it was still relevant. I referred to a post on the original thread on PB that was used to re open this subject that I, at least, thought had been resolved. See
http://www.dr-bob.org/babble/20010917/msgs/78960.htmlThis certainly implies that illegality is a sufficient reason not to do this.
Jane
Posted by Dr. Bob on September 24, 2001, at 12:19:37
In reply to Re: Posting policy » Dr. Bob, posted by Jane D on September 24, 2001, at 2:52:47
> banning discussion of many things, opiates for example, would have no direct affect on me. In the end, however, as more and more topics were banned it almost certainly would.
But, again, it wouldn't be all discussion of opiates, or whatever, just discussion of where specifically to obtain them...
> I know that there are other sources. Today, when I don't need it, I know I could find those sources. If I was desperate enough to need it I probably couldn't.
I guess you're right, in a case like that, it would have a real impact on what you could do...
> > I'm not trying to tell you what to do, I'm just not sure I want to be so associated with this myself.
>
> What, specifically, bothers you about this? I don't think you have a legal exposure here but, in a direct analogy to the original argument, if the risks are yours, the decision is also yours. Morally, I think that the potential usefulness of these posts outweighs the potential risk to readers...I guess partly it's the potential risk, and partly I'm just not sure it looks good?
> both quotes ... suggest to me that this is really about whether people should be allowed to (and are competent to) make their own health decisions.
Others may wonder that, but this site wouldn't be here if I didn't think people could make decisions for themselves.
Bob
Posted by SLS on September 24, 2001, at 14:36:23
In reply to Re: Yes, prescription needed, posted by Mitchell on September 18, 2001, at 20:03:51
> Juries can use common sense to weigh the merits of factual claims, but to return a criminal conviction, courts require a citation of law. Try US Code : Title 21, Section 844, with regard to possession, and US Code : Title 21, Section 829 with regard to dispensing of controlled substances. "Controlled substance" is defined at US Code : Title 21, Section 802. Schedules of controlled substances are at US Code: Title 13, Section 812. Revised schedules are published in the Code of Federal Regulations, Part 1308 of Title 21, Food and Drugs
Please forgive me for not reading the entire thread before writing this. I hope it's not too out of place. Some of the posts are really long.I pretty much know where I'm at with all of this, but am not yet ready to make any declarations. I would rather play Devil's advocate for now. However, at this point, I am beginning to think the best answer to this question is also the most simple. I am so glad that someone started this thread. This is a crucial issue, the resolution of which will determine the fundamental nature of Psycho-Babble. I know I'm pretentious, but I'm sure this can be overlooked. I seem to like the sound of my own keystrokes.
I experienced something very interesting as I tried to read through some of Mitchell's posts. It actually served as a real-life reflection of something I wrote along a relevant thread on Psycho-Babble (original flavor). As I was reaching the end of his commentary in his second post, I stopped and smiled. I realized that I was becoming an unwitting accomplice in placing myself in a position to make carefully considered, perfectly logical, but very possibly misguided decisions. At some point early in his first post, I came to assume that Mitchell was a legal scholar. His verbiage and sophistication of approach seemed extremely authoritative. In high school, I discovered that I possess an aptitude for legal reasoning and rhetoric. I am confident in my ability to understand and assess points of law. However, I am without factual knowledge. Given the big words used by Mitchell in his posts, I found myself ready to rely on his statements as being accurate in fact and his interpretations as learned. I was doing this unconsciously. I don't think I am unique in displaying this tendency, although I might be so among the people participating in this discussion. The point is, I became vulnerable to making injurious decisions based upon the statements and opinions of someone I just "met", and without knowing the first thing about his background. I had no less freedom to make decisions for myself then than I do now. I am over 18 years old. I consider myself to be reasonably smart. Yet, because of my absolute ignorance of the law, I tended to defer to someone else the decision-making process.
Interesting. For all I know, a few unlucky innocents may have considered my gibberish similarly authoritative.
By the way, I still hold Mitchell in high regard at this point.
I feel very lucky to be exposed to and have available to me the facts, intellect, judgment, and passion possessed by the people here. I find Psycho-Babble to be a real asset to me.
Sincerely,
Scott
Posted by SLS on September 24, 2001, at 14:55:25
In reply to Re: No prescription needed » SLS, posted by Jane D on September 24, 2001, at 11:32:29
Dear Jane,
(Don't worry. This is not a Dear Jane letter).
:-)
> > As I understand the point being made, the real question is whether or not you suggest to others on Psycho-Babble that they smoke pot and tell them where they can get it.
> Sorry Scott - This thread may well have moved beyond that issue but at the time of my original post it was still relevant.
I think it remains the crux of the issue, and deserves more focus.
> I referred to a post on the original thread on PB that was used to re open this subject that I, at least, thought had been resolved. See
http://www.dr-bob.org/babble/20010917/msgs/78960.html> This certainly implies that illegality is a sufficient reason not to do this.
I think we are in agreement that it is not.
- Scott
Posted by SLS on September 24, 2001, at 15:11:59
In reply to Re: Posting policy, posted by Mitchell on September 24, 2001, at 6:53:21
Hi Mitchell.
> The real risk, and I think the one the administrator cited, is the risk of providing a forum where people may advocate participation in illegal activity. To be more precise, I don't think the concern is that people will advocate illegal activity, but rather that the forum will be implicated in illegal activity. I think an administrator would do well to consider how an attorney general might view a discussion where amateur diagnoses are coupled with recommendations of medications and instructions about how to get those medications outside the law.
Regarding legality, I think we should allow that to remain the responsibility of those who facilitate this website to ascertain. It's really their problem and not yours or mine.
- Scott
Posted by Mitchell on September 24, 2001, at 17:26:06
In reply to Re: Posting policy » Mitchell, posted by SLS on September 24, 2001, at 15:11:59
Jane, It is reasonable to ask the administrator here to join in efforts to expand consumer access to medicine, but it is also reasonable that he would decline, if only out of an abundance of caution or concern for his professional image. I would like him to campaign aggressively for an end to the violent war against users of illegal drugs, but I am contented that he provides a site where the lay public can occasionally compare the pharmacology of legal and illegal medications.
Scott, the reason that legality is a concern for the general readership here and not just for the administrator is that readers might, as you suggested, reach conclusions about what is or is not legal based on intelligent sounding but misguided information that the administrator allows here. If he allows posts that encourage mail order use of non-U.S. pharmacies by U.S. residents, and which include statements asserting the legality of the practice, a person could reach a faulty conclusion that the practice is legal. It is not. We could compare this to passengers' responsibility when riding in a automobile. It is everyone's concern that the driver be aware of traffic signals.
Jane, you are correct that I cannot cite a single case where a person has been prosecuted from importing less-than-schedule-three medications, though your reference to "my" definition of controlled substances is flawed. My definition is inconclusive at this point, because all I have to go on is the Title 21 definition, which only seems to address scheduled drugs. I still need to know if other drugs, flouxatine, for example, are considered scheduled controlled substances or if they are addressed somewhere else in federal law. I suspect this was covered in the Prescription Drug Marketing Act but I have not yet read that act to see what provisions it established.
One writer agrees with you, Jane, that prosecution of consumers for illegal importation of pharmaceuticals is rare. According to a health care attorney quoted in American Medical News, the FDA goes after the pharmacies themselves and not physicians or consumers. Risk for physicians involved with non-U.S. pharmacies could arise at the level of state health boards, though the attorney found no such examples. http://www.ama-assn.org/sci-pubs/amnews/pick_01/bil20625.htm
But E-Commerce Times found an example of consumers arrested for importing prescription drugs:
"Just last week, the U.S. and Thai officials announced the arrests of twenty-two people in Thailand who illegally exported prescription drugs to the United States. Additionally, six people who purchased drugs from three Thai pharmacies were arrested in New York."
(The Dark Side of E-Commerce, By Lori Enos: E-Commerce Times, March 27, 2000; http://www.ecommercetimes.com/perl/story/2825.html )We don't know much about the nature those six New York cases, such as what the six suspects purchased, or if they were convicted, but those six might not be the only examples. It is nearly impossible to determine if anyone in the U.S. has ever been convicted for possession of prescription medications, such as flouxatine, without a prescription. One would need to search the records of every county courthouse and every district of the U.S. court system. To my knowledge, those records are not catalogued in such a way as would allow a person to easily identify such a specific charge. Such cases would only show up "on radar" if they rose to the level of appeals courts. However, I would bet I could find several prosecutions in counties around the U.S. of people who possessed valium without a prescription. Valium is one of the medications offered by the mail-order pharmacies, some of which claim a person does not need a prescription to buy from them.
Two other problems with advocating importation of prescription drugs by consumers:
1. The FDA is actively investigating the practice and anyone who is now involved could be targeted by a unique first-time enforcement action.
http://www.house.gov/commerce_democrats/press/107ltr18.htm2. With the United States targeted for warfare by a shadowy group willing to attack civilians by any means available, importation of un-regulated drugs represents a salient opportunity to introduce a virulent pathogen. Over-the-counter medications have been compromised, with lethal consequences, by inexperienced and amature criminals. Overseas sources of medications bypass the rudamentary safeguards in place for U.S. consumers, and could allow perpetrators to hide their identity. We don't want to believe it could happen, but we didn't want to believe anyone would attack our cities, either. Let's all beware.
Other links:
1. The U.S. House of Representatives Committee on Energy and Commerce has been investigating a number of issues pertaining to the sale of pharmaceutical products over the Internet. Information regarding this investigation is provided on this page:
http://www.house.gov/commerce_democrats/pharmacy/onlinepharm.shtml
2. Defense Attorney Rick Collins on FDA guidelines for importation of unapproved unscheduled drugs.
"The guidance is not, however, a free license to import unapproved (and, therefore, illegal) drugs, even in small, personal-use amounts. Even if all of the circumstances noted in the guidance are present, the drugs remain illegal, and the FDA may decide that such drugs should be refused entry or seized."
http://www.t-mag.com/html/body_81attor.html3. ***** Five stars for this one:
David Mills, Cybermedicine: The Benefits and Risks of Purchasing Drugs Over The Internet, 5.2 J. TECH. L. & POL'Y 1, http://grove.ufl.edu/~techlaw/vol5/medicinefinal.htm (2000).
Posted by stjames on September 24, 2001, at 18:15:54
In reply to Re: Prescription needed, posted by Mitchell on September 24, 2001, at 17:26:06
> Jane, you are correct that I cannot cite a single case where a person has been prosecuted from importing less-than-schedule-three medications
James here....
In the state of Louisiana, Howard Young was
prosecuted and found guility. For non scheduled meds.James
Posted by Dr. Bob on September 24, 2001, at 21:12:27
In reply to Re: No prescription needed » Jane D, posted by SLS on September 24, 2001, at 14:55:25
> > Sorry Scott - This thread may well have moved beyond that issue but at the time of my original post it was still relevant.
>
> I think it remains the crux of the issue, and deserves more focus.
>
> > I referred to a post on the original thread on PB that was used to re open this subject that I, at least, thought had been resolved. See
> http://www.dr-bob.org/babble/20010917/msgs/78960.html
>
> > This certainly implies that illegality is a sufficient reason not to do this.
>
> I think we are in agreement that it is not.Sorry, I'm confused. What is it that you think remains the crux of the issue and deserves more focus? Illegality of what is a sufficient reason not to do what?
Bob
Posted by galtin on September 24, 2001, at 22:14:27
In reply to Re: Posting policy, posted by Shar on September 23, 2001, at 15:16:04
> "I understand that some people are desperate, but (1) I don't think the answer is necessarily to do something illegal, (2) if someone did decide to do that, they could ask elsewhere, and (3) discussion of the medications themselves would still be fine here."
>
> I think it gets very tricky at this point to draw the line based on illegality. If this viewpoint prevails, people will not be able to talk about taking illegally obtained drugs. Or using illegal drugs. Or, warning readers of, say, a bad experience they had with an overseas pharmacy, because they would have to name the pharmacy (source) of the meds.
>
> There are things talked about here, on many different topics, that include reports or self-reports of illegal activity--to one degree or another. I hope the plan is not to consistently apply the 'is this perhaps illegal' standard to all posts. We will need a psycho-lawyer then to sort out what is ok and what is not.
>
> SharThis run of exchanges comes down to four issues:
1. There is a big difference between people REPORTING the commission of illegal acts and discussing with others HOW TO commit such acts in the future. The latter exposes the site to potential liability. People can REPORT whatever they want; discussing with other posters HOW to commit a probably illegal act is something else.
2. When drawing the line between what is legal and illegal is tricky, why not err on the side of clarity. Besides. . . .3. The purpose of the site is not to discuss ways to obtain illegal meds or ways to obtain legal meds by illegally means. We can discuss any medications we want, whether obtained at the local pharmacy or by courier from Bolivia. A poster can share the therapeutic wonders of swallowing ten red frogs, without giving the directions to the pond where the frogs live.
4. Bob's position does not prevent anybody from obtaining any drugs from wherever they want. It just moves these discussions off-line.
galtin
Posted by SLS on September 25, 2001, at 0:50:19
In reply to Re: the crux of the issue?, posted by Dr. Bob on September 24, 2001, at 21:12:27
Dear Dr. Bob,
The crux of the issue as I see it is whether or not to allow the posting of messages within which someone has *recommended* to someone else:
1. that they initiate a change in their treatment regime outside the milieu of the doctor-patient relationship, regardless of legal issues.
2. that they take a drug that is not approved by the FDA.
3. a source from which one may procure FDA-approved medications without the requirement of a prescription.
4. a source from which one may procure medications that have not been approved by the FDA, with or without a prescription.
5. a course of action that is known to medicine as being injurious.
Just so that nobody busts my chops just yet, I am neither advocating nor remonstrating a specific course of action or philosophical judgment here.
Dr. Bob, you have the power of the password, so as I see it, you are to be the one to make these judgments. I guess you have a few important decisions to make, even if it is your decision to do nothing. The crux of the issue is whether or not a line should be drawn separating that which one may and may not recommend to another or provide as information, and to use this criteria to allow or disallow individual posts. That's what we are talking about here, right?If I were in your position, I would make the very first thing I do tomorrow when I wake up in the morning be the obtaining of legal council to make determinations as to your (institution's) liability in providing this forum as it currently exists, and what specific events, should there be any, expose you to criminal or civil prosecutions. Once that is done, the remaining issues are largely altruistic and logistical in nature.
Regarding the statement, "This certainly implies that illegality is a sufficient reason not to do this", I was offering my own sentiments as it related to the moral and philosophical justifications for, or desirability of, restricting or discouraging a specific speech. Being in such a position that I have no guarantees that any combination of FDA-approved drugs will relieve me of pain and functional impairment, I can't help but to own the perspective that that the status of a medical alternative be illegal is not sufficient for me not to suggest it to others or pursue it myself.
I hope this clarifies my intent.
- Scott
Posted by stjames on September 25, 2001, at 12:26:40
In reply to Re: No prescription needed » stjames, posted by SLS on September 24, 2001, at 1:13:43
> Actually, this is just a brief comment/question. I don't think it is necessary for you to address the issue regarding your illegal acts. As I understand the point being made, the real question is whether or not you suggest to others on Psycho-Babble that they smoke pot and tell them where they can get it.
>
> Do you?James here...
You make a good point. I also have never had any problem with you mentioning your choice to self medicate, as it is kept within the context of "this is what I do" and not advocating that others do the same.
james
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