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These sites have no real connection to Canada at all – do not work with a pharmacy or pharmacist licensed by a Canadian province and do not have physical presence in Canada. Indeed, Legit Script has approved a few that are solely targeting Canadian residents and that are operating legally under Canadian laws. Sometimes some of the drugs are, but never all of them. When a pharmacy is physically located in the United States, there is a built-in disincentive against supplying sub-standard drugs to U. residents: the risk of civil or criminal enforcement action. 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. Take, for example, the with smuggling $78 million worth of mislabeled, unapproved and counterfeit cancer drugs into the U. 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