criminal, civil, and administrative penalties for its violation.10 At its
inception, the CSA recognized that drug abuse was primarily a public
health issue, not exclusively a law enforcement problem.9,12 Although
the DEA is the primary drug enforcement agency at the federal level, drug enforcement also exists at the state level and among several
overnmental efforts to prevent morbidity and mortality
associated with the use and distribution of pharmaceutical
drugs is nothing new. In 1906, the federal government passed
the Pure Food and Drug Act in an effort to “prevent the ‘manufacture, sale, or transportation of adulterated or misbranded…drugs,
medicines, and liquors.’ ”5 Prior to the act, opioids such as morphine
and heroin were freely available and at times sold by “hawkers and
door-to-door peddlers.”6,7 In 1914, the federal government passed
the Harrison Act and relied on the taxing authority in the US Constitution to help control drug distribution.1,6 Over the next 6 decades,
Congress passed an assortment of drug control laws until 1970, the
year the federal Controlled Substances Act (CSA) was enacted into
law.8 The CSA consolidated a wide range of existing drug laws into
one federal scheme and divided drugs into Schedules I through V
based on medical use and potential for harm.9 The CSA and its subsequent regulations would require prescribers to apply for and maintain a license with the federal Drug Enforcement Administration
(DEA) and abide by federal and state rules concerning the prescribing and dispensing of controlled substances.10
IN THe CONTeXT OF
PReSCRiPTiON DRUGS, THe CSA
AND iTS STATe COUNTeRPARTS
ReMAiN POWeRFUL TOOLS
TO PUNiSH OFFeNDeRS FOR
PHARMACeUTiCAL DiVeRSiON
AND PReVeNT OTHeRS
FROM DiVeRTiNG.
diverse, overlapping laws and jurisdictions (for example, local, county,
and state police). In fact, the overwhelming majority of drug enforcement occurs at the state and local levels, not the federal level.13
In the context of prescription drugs, the CSA and its state counterparts remain powerful tools to punish offenders for pharmaceutical
diversion and prevent others from diverting. Some prescribers, patients, and nonpatients have engaged in patently criminal conduct.14
And while no drug law i 26&