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Former FBI Director Louis Freeh Updates His 2017 Report on the Threat of Congressional Drug Importation Proposals

Former FBI Director Louis Freeh has released an addendum to his 2017 Report on the Potential Impact of Drug Importation Proposals on U.S. Law Enforcement, concluding:

…the government has not done enough to evaluate and improve the capacity of law enforcement to deal with a new pipeline of drugs into the U.S. drug supply, all while . . . more illegal drugs are being shipped to the United States. Passing any drug importation scheme would erase the little progress we have made and set law enforcement further back on their heels.


Guerra C, Mackey TK. “USA criminal and civil prosecutions associated with illicit online pharmacies: legal analysis and global implications.” Med Access @ Point Care 2017; 1(1): e104-e118.

  ABSTRACT The rise of digital technologies has created a complex online environment that now includes illicit Internet pharmacies, online facilitators, advertising sites, and foreign entities. Collectively, these networks create significant patient safety risks, including acting as unregulated access points encouraging prescription drug use. Although law enforcement is active in combatting this form of cybercrime,…


Mackey TK, Liang BA*. Global Reach of Direct-to-Consumer Advertising Using Social Media for Illicit Online Drug Sales. J.Med Internet Res. 2013 Sept 12; 15(5):e105.


Background: Illicit or rogue Internet pharmacies are a recognized global public health threat that have been identified as utilizing various forms of online marketing and promotion, including social media.
Objective: To assess the accessibility of creating illicit no prescription direct-to-consumer advertising (DTCA) online pharmacy social media marketing (eDTCA2.0) and evaluate its potential global reach.


Liang BA*, Mackey TK, Lovett KM. Illegal “No Prescription” Internet Access to Narrow Therapeutic Index Drugs. Clin Ther. 2013 Apr 15; S0149-2918(13)00167-7.

Abstract BACKGROUND: Narrow therapeutic index (NTI) drugs, because of proximity of therapeutic amounts to toxic amounts, require close professional oversight, particularly when switching formulations. However, safe use may be compromised by unsupervised switching through access to online "no prescription" Web sites. OBJECTIVE: We assessed no prescription online availability of NTI drugs, using an academically published…


Campbell N, Clark JP, Stecher VJ, Goldstein I. Internet-ordered viagra (sildenafil citrate) is rarely genuine. J Sex Med. 2012 Nov;9(11):2943-51. Epub 2012 Aug 27.

Abstract Introduction.  Counterfeit medication is a growing problem. This study assessed the requirement for prescription, cost, origin, and content of medications sold via the Internet and purporting to be the phosphodiesterase type 5 inhibitor Viagra (sildenafil citrate). Methods.  Pfizer monitored top search results for the query "buy Viagra" on the two leading Internet search engines…


Liang BA,* Mackey TK. Stem Cells, Dot-Com. Sci Transl Med. 2012 Sept 12; 4;151:151-9.

Abstract. Direct-to-consumer (DTC) advertising of suspect goods and services has burgeoned because of the Internet. Despite very limited approval for use, DTC stem cell–marketed “treatments” have emerged for an array of conditions, creating global public health and safety risks. However, it remains unclear whether such use of stem cells is subject to drugs or biologics…


McCoy D, Pitsillidis A, Jordan G, et al. PharmaLeaks: understanding the business of online pharmaceutical affiliate programs. In: Security’12 Proceedings of the 21st USENIX conference on Security symposium. Pages 1-1; USENIX Assn Berkeley, CA 2012.

Abstract: Online sales of counterfeit or unauthorized products drive a robust underground advertising industry that includes email spam, "black hat" search engine optimization, forum abuse and so on. Virtually everyone has encountered enticements to purchase drugs, prescription-free, from an online "Canadian Pharmacy." However, even though such sites are clearly economically motivated, the shape of the underlying…


Jackson G, Patel S, Khan S. Assessing the Problem of Counterfeit Medications in the United Kingdom. Int J Clin Pract. 2012 Mar;66(3):241-50.

Abstract Counterfeit medicines pose an ever-increasing threat to public health, although precise tracking of illegal counterfeit prescription drug activity is difficult. Available data indicate that all types of medications have been targeted. Adverse health effects, including death, have resulted from using counterfeit medications; consumers who self-medicate without appropriate interactions with the healthcare system rarely receive…


Liang BA*, & Mackey TK, Online Availability and Safety of Drugs in Shortage: A Descriptive Study of Internet Vendor Characteristics. J Med Internet Res. 2012 Feb 9;14(1):e27.

ABSTRACT  Background: Unprecedented drug shortages announced by the US Food and Drug Administration (FDA) have severely affected therapeutic access, patient safety, and public health. With continued shortages, patients may seek drugs online. Objective: To assess the prevalence of online marketing for current FDA shortage drugs and potential patient safety risks. Methods: We performed a descriptive study of the…

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