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S., if they violate safety rules, the FDA, DEA, or a State Board of Pharmacy can exercise regulatory, even prosecutorial, authority over the pharmacy operators. That’s not just because of the laws prohibiting Americans from buying Health Canada-approved medicines; it’s because we have never seen a case where the website is shipping all or even most drugs from the Canadian pharmacy. government cannot effectively exercise cross- border jurisdiction to ensure that the drugs shipped into the U. Adding more resources, authorities, and penalties won’t change the fact that international criminals can evade U. law enforcement simply by operating off-shore in jurisdictions that don’t prioritize internet pharmacy crime and/or don’t cooperate with U. Simply put, the FDA and other regulatory boards, including Canadian ones, are rendered impotent to protect the public health as they cannot ensure the medicines supplied from online sellers are actually legitimate. 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