It is an honor to transmit herewith the Report of your Committee directed to study and make recommendations with respect to the pharmacy and drug laws of the Commonwealth.

The Committee met regularly for the past 13 months. All meetings have been open. The first several sessions were widely advertised and a number of persons and representatives from various organizations appeared and offered suggestions. Additionally, staff and individual committeemen gave an unusual amount of time in study, travel and research.

The Committee sought information from sister states, professional societies and the federal government. Laws, regulations and proposals were researched.

The greatest problem area appeared to be drug abuse, the illicit use of drugs -- with marijuana leading the list and causing the most concern.

Areas of specific interest that received considerable attention were:

Reorganization of the several sections of the Pharmacy and Drug Act into one chapter for logical sequence and understanding;

Educational requirements for pharmacists, including college, practical experience and continuing education;

Licensing of pharmacists including examinations and reciprocity with other states;

Drug diversion-the breakdown in normal channels of distribution whereby a useful drug finds its way into non-professional hands and illegal use;

Comprehensive studies of present penalties for drug violations, including a comparison of our present laws with those of sister states, and those in effect and under consideration by the federal government.

The result of these studies suggests our greatest problem to be in the area of drug abuse especially with respect to marijuana. This market is fed by illicit drugs and legal drugs that have been diverted.

Your Committee therefore set about to improve and update the Pharmacy and Drug Act as it concerns the practice of Pharmacy and the distribution of legitimate drugs, with particular attention given to the problem of illicit drug traffic.

Our recommendations are included in the proposed legislation submitted here --

Some of the more significant proposals are:

1. Continuing education requirement for pharmacists. To fulfill his obligation as a professional the pharmacist must continue his education throughout his years of practice or he will fail to meet his obligations to the public in the ever changing drug armamentarium. Encouragement by professional societies has failed to persuade a satisfactory percentage of practicing pharmacists to avail themselves of these educational opportunities. We therefore recommend a requirement in this area to be enforced by the Board.

2. Licensing physicians to practice pharmacy. Under current law any licensed physician is authorized to obtain a permit to practice pharmacy if he practices in a town of less than 1,000 population. The original intent of this provision was to provide for exceptional situations where no pharmaceutical service was available. However, in recent years and particularly since Medicaid, increasing numbers of physicians are securing these permits in areas where pharmaceutical service is reasonably available. Abuses in this area are evident in the administration of the government sponsored medical care programs. We propose that the Board be authorized to determine when the public interest requires. that a physician be authorized to practice pharmacy.

3. Drug Classification. The several special laws covering narcotics, dangerous drugs, abuse drugs and others have been brought under one heading and divided into schedules. Each schedule is defined according to appropriate scientific criteria. Such classifications tend to conform with those established by the federal government. These classifications characterize the potential for abuse and afford a rational guideline for the various penalty provisions.

Under the proposed law, scheduled drugs can be dispensed only by pharmacists or licensed practitioners. Not included in the scheduled drugs are a host of over-the-counter drugs which are subject to abuse and contain ingredients with potential harmful effects. In this State there is presently no adequate restriction on the sale of these drugs. It is the unanimous view of this committee that the present availability of these drugs presents a grave threat to the public health; and the Committee is also of the opinion that where these drugs are available, a pharmacist should be present to consult with the consumer to prevent misuse and abuse.

It is apparent to the Committee that any proposed restriction on the sale of these drugs will arouse opposition from diverse economic interests which might overshadow the numerous significant proposals here offered for consideration. For this reason, no regulation of these drugs is contained in these proposals; but, we have attached a suggested amendment to the legislation proposed by this Report which will effect this regulation.

It is the hope of the Committee that the General Assembly will give serious consideration to this problem.

4. Penalties. Conflicting opinions were expressed as to the degree of penalty in the area of drug abuse-particularly for the first offender. We believe the penalties suggested are appropriate and wish to call your attention to the provisions for "Conditional Discharge for Possession as First Offense". This provision would permit a court latitude in certain cases where usual penalties appear too severe, and where rehabilitation appears probable, for the first offender.

In general, our proposed changes in penalties for violation of this chapter have three effects: (1) to provide greater discretion for judges in assessing punishment, (2) to reduce somewhat the penalty for simple possession of certain drugs, and (3) to deal with greater severity with those violators who traffic in illegal drugs.

5. Licenses. Fees for pharmacies, wholesalers and manufacturers have been increased. Better controls for licensure are recommended that will result in more effective prevention of drug diversion from legitimate to illicit markets. The responsibility of the licensed pharmacist-in-charge is clearly defined.

6. Mail order prescriptions and advertising. Mail order prescriptions disregard the physician-patient-pharmacist relationship, and are prohibited in the proposed legislation.

The Board of Pharmacy, having administered the pharmacy and drug laws since 1886 and having discharged its duties with distinction, is the logical agency to continue effective application of any new laws in this area. We believe that our Board and the M.C.V. School of Pharmacy are instrumental factors in making the profession of pharmacy, as practiced in Virginia, among the most respected in the country. Working with the State Police and federal agencies when necessary, the Board of Pharmacy has and continues to be highly effective. Division of responsibilities in drug control could bring about a less efficient system. We believe that the Board should be strengthened where desirable but should be continued as the agency with prime responsibility for drug control.

The Committee wishes to acknowledge and express its appreciation for the services of staff counsel, David T. Walker; State Board of Pharmacy Secretary, J.B. Carson; M.C.V. School of Pharmacy Dean, Warren E. Weaver; all of whom made invaluable contributions to the work of the Committee. The legal division of the American Pharmaceutical Association is also cited for its research and information as to similar legislation among other states and Congressional activities, past and present.

We hope the proposed legislation included herewith will be favorably received by the Legislature.

We, the Committee, are pleased to have had the honor to serve the Commonwealth in this capacity.

Respectfully submitted,

J. Curtis Nottingham, Chairman

Lloyd C. Bird

William R. Cogar

Charles F. Kingery

Wallace S. Klein, Jr.

Ivan E. Roop, Jr.

R. Maclin Smith

W. Roysmith

Wallace B. Thacker

C. Eugene White