Free pseudoephedrine!
November 27, 2006 10:49 AM   Subscribe

Pseudoephedrine- Why are we taking this laying down?

Lots of people, including me, are more than a little miffed about this pseudoephedrine law. How likely is it that we can get it changed? How organized do we need to be? How many letters and how much money will it take to right this silliness?

What I'm asking is: What do you think it would take to change the law back or at least make it less stupid?
posted by chairface to Law & Government (48 answers total) 3 users marked this as a favorite
What is the matter with the law?
posted by caddis at 10:58 AM on November 27, 2006

What is the matter with the law?

It makes it inconvenient to buy a legitimate product, while doing nothing to solve the Meth problems that it was allegedly designed to help.

It's the textbook example of a law meant to make stupid people feel like their politicians did something for them.

As such, I have almost no hope that it will ever be overturned. Doing so would involve admitting that the law is fundamentally broken.
posted by Tacos Are Pretty Great at 11:01 AM on November 27, 2006

FWIW, the new law was discussed in the blue a while back.
posted by jaimev at 11:02 AM on November 27, 2006

What is the problem? If I understand it all PSE products will not be on open shelves. Rather they will be behind the pharacist wall. That seems fine to me. You can still get the product. You just can't buy a basketfull of them and possibly make an illegal drug from them. Not to say that is what you had in mind. It is just protecting the public from itself. But maybe I miss what you mean in your question. If so, sorry.
posted by JayRwv at 11:02 AM on November 27, 2006

I'd also like some clarification on which law you're referring to, since some states have more restrictive laws than others. My state has per-day limits and requires identification to be shown when making a purchase. Data retained is subject to restrictions and retention policies.

It's less restrictive than making it a prescription-only drug, which would be the next step to control possible abuse. If your issue is with companies who are dropping their pseudoephedrine formulations in order to remain profitable, make it known to them that you are willing to make the trip to the pharmacy counter to get their product.

I still find this a preferable situation to the many drugs that are prescription-only due to issues other than public safety.
posted by mikeh at 11:06 AM on November 27, 2006

JayRwv, the issue is that drug manufacturers do not want their products in the behind-the-counter ghetto (with the cigarettes and enema products) so they change their formulas to remove the pseudoephedrine (the most famous case being NyQuil, IIRC). The brands and medicines that allergy/cold sufferers knew they could trust to clear up their congestion suddenly doesn't work anymore with little-to-no explanation.

I know I'd be pissed. As it is, I know where to get my Sudafed when I need it (which is rarely). And I can deal with the snarky looks from the wage slave behind the counter thinking I'd be using it for Meth.

[Incidentally, I had a friend of mine that worked at RadioShack and every now and again someone would come in asking for, "yanno, those blue batteries, man," looking all kinds of shaky and shady so they could synthesize those into Meth, or something.]
posted by Xoder at 11:13 AM on November 27, 2006

mikeh: In the US the legal landscape is much more uniform than it used to be because the Combat Methamphetamine Epidemic Act of 2005 went into force at the end of September. It has record keeping requirements and monthly limits.

To answer the question, "we" are going along with it because it's about drugs and national drug policy hasn't been rational in a very, very long time (if ever) and pseudeophedrine is being replaced by phenylephrine in many products which works well enough for most people not to notice a difference (but it appears that phenylephrine is not as effective for many people as pseudeophedrine is).
posted by skynxnex at 11:14 AM on November 27, 2006

If you want to change it as being bad law you first have to establish that it is a bad law. It shuts a major source of supply for the raw ingredients for many small meth labs. That is a good thing. It won't slow down large criminal organizations, fine. However, these small labs cause all sorts of problems, fires and environmental pollution among them. The politicians don't really care about your inconvenience. Most of them probably have someone else doing their shopping for them. If you can establish this is bad law, your only real ally in this would be pharmaceutical companies whose sales are impacted and have the ears of the legislators. They have the resources and the clout to make things happen.
posted by caddis at 11:23 AM on November 27, 2006

Best answer: mikeh: Probably a good starting point is the Combat Meth Epidemic Act of 2005, a bit of federal legislation requiring:
  • All Pseudephedrine products behind the counter,
  • Monthly purchase limits,
  • Show ID when purchasing, and
  • Store must "keep records" for 2 years
(From here, the FDA announcement of implementation, referred to in jaimev's blue FPP.)

I don't know about anyone else, but the fourth one is the one that gets me. The fact that I would be listed in a log book, my name and addres subject to further review in case of ... something unspecified at this point, is just totally unacceptable for the purchase of non-prescription medicine. If the logbook and its contents were subject to HIPAA protection with accompanying penalties for wrongful disclosure, that would be a few steps closer to acceptable.

In fact, that might be a good hinge point for reform, chairface: write your congresspeople and urge them to view this mandatory disclosure of medical information to be a serious privacy incursion that fully deserves, even requires, the strong protection usually afforded to such information under HIPAA. Having seen a couple of the logbooks, there is no way they are meeting these kinds of standards now. Imposing this kind of liability on pharmacies would make them change their procedures and subject them to lots of potential liability if they F things up. While this may not address the core of your concern, it is a reasonable request as a private citizen, and if it looks like it's reasonably likely to pass, it could win you the support of a relatively prominent lobby (pharmacy retailers).
posted by rkent at 11:26 AM on November 27, 2006

I think we don't really care that much? Personally, I had stopped using it in favor of newer medications that work just as well.
posted by mzurer at 11:29 AM on November 27, 2006 [1 favorite]

The really irritating effect I've observed in Washington state is that nobody that I've found seems to stock the children's pseudoephedrine decongestants (e.g., Children's Motrin Cold) at all, not even in the pharmacy. Our last bottle ran dry last week, and I sure felt like a druggie draining the last drops into a spoon so I could suck it up with a syringe to get one last dose.

The powers that be (and this may be the state, or just big corporate pharmacies, I don't know) also keep changing the identification check processing. Initially, it was just name, address, drivers license info, date and signature in a special book. Five minutes, in and out, no sweat. The last time I went in, they said I'd have to wait at least 30 minutes so they could enter my information into the computer, and they wouldn't do that until they had a lull in filling prescriptions.

Costco seems to have bailed on the good stuff entirely; they just don't carry any of the pseudoephedrine drugs at all now.

I skimmed through the "Combat Meth Act" link, and didn't see anything about personal limits for importing. Anybody have a reference for what the limit is when bringing pseduoephedrine drugs into the USA in personal quantities (if, e.g., I zip up to Canada for a weekend and buy some)?
posted by doorsnake at 11:34 AM on November 27, 2006

I think we don't really care that much? Personally, I had stopped using it in favor of newer medications that work just as well.

Maybe you don't. The other medications work like crap for me and many other people.

I also have problems with smaller pharmacies (who I'd prefer to support with my business) not carrying anything with pseudoephedrine because they can't absorb the extra paperwork.

Ah, the olden days, when you could buy a little bottle with 50 or 100 sudafed pills. Now you have to shell out considerable cash for what, 20 pills, tops?
posted by desuetude at 11:43 AM on November 27, 2006

Response by poster: I'm reading the comments now but I should clarify what I think is wrong.

The law as it stands is pushing pseudoephedrine behind the counter. Most drug manufacturers are not willing to be in that category so they are both making less effective products for OTC sales and dropping pseudoephedrine formulations completely.

Pseudoephedrine is a time-tested safe and effective drug. Lots people need it to function during allergy or flu attacks. This "pseudoban" affects a huge segment of the population. I would argue it effects almost everyone, though not all at one time.

Is there any tracking or statistics showing this has actually had an effect on meth availability? Is there a plan to drop the restrictions if the change fails to dent meth availability?

In summary:

1) A safe and effective drug was effectively removed from market, affecting huge numbers of people.

2) The near ban will result in a de facto total ban as drug companies react to the restrictions.

3) Meth addicts will still make the stuff, no matter what you do.
posted by chairface at 11:46 AM on November 27, 2006

Response by poster: Whoops. I should have added: I don't really want to discuss the law. I want to know what does it take to change it? How irritated does the populace need to be to actually get something changed?
posted by chairface at 11:49 AM on November 27, 2006

What it would take to change it is a federal law, i.e. somehow getting a majority of Congress and the president to agree with it (to oversimplify.) Which means a whole lot of legislators would have to stand up and say that people's privacy and access to pseudoephedrine, or, maybe, that a sane interpretation of the 10th Amendment, is more important than protecting our children (the inevitable spin, not my position.) Which means a whole lot of voters would have to put a whole lot of pressure on them, when the only concerned parties are allergy-sufferers and privacy activists, or others actually concerned about the principle of the thing.

I don't see it happening.
posted by Zed_Lopez at 11:51 AM on November 27, 2006

I think you think more people care than actually do. Think about the population as a whole: there is a huge group who don't take cold products (for instance, nearly everyone I know), then there are the people who do and don't find the new formulas problematic, then finally there are people who really care. Given that you don't have large numbers or lots of money or lots of power, given that right now all you have a large amount of is irritation, I don't think you are going to get anything changed. If you do want to, you will need lots of connections and lots of work.

Sorry to be a downer, but changing laws is hard, especially in cases like this.
posted by dame at 11:57 AM on November 27, 2006

Is there any tracking or statistics showing this has actually had an effect on meth availability? Is there a plan to drop the restrictions if the change fails to dent meth availability?

The law is not about meth availability, it is about stopping supply of psuedophedrine to small labs, putting those small labs out of business. It appears to have done that. Chairface may not want to discuss the merits of the law, but if the law is indeed doing some good the amount of anger against it will have to be very high. People just do not appear to be annoyed enough to ever get this changed.
posted by caddis at 12:02 PM on November 27, 2006

As for effects, this article (quoted in the blog post of mine I linked to above, but the blog post's link is now dead) about its effect in Oklahoma, which had a similar state law prior to the federal law, indicates that it did nothing to curb meth use -- purer meth from Mexico filled the void immediately.

It did, however, have a large effect in curbing domestic production of meth, so it's still a plus for cops, as busting (and cleaning up after) a meth lab is a dangerous and complicated matter.

I expect to see it becoming a de facto ban first because pharmacy chains will decide selling it's more bother than it's worth and cease carrying it (see here.) Then the manufacturers will stop making it.

To amend my previous posting, a Supreme Court ruling could override it as well as new federal legislation. Then you'd need someone to push a case to that level, for them to hear it, and then for them to go against the long trend of using the commerce clause to legislate anything.
posted by Zed_Lopez at 12:03 PM on November 27, 2006

Laws which inconvenience or otherwise negatively imapact large numbers of people only a little almost never get changed, because no one cares enough to demand the change. Laws which have a substantial negative impact on a small group are far more susceptible to change, because those people will work hard for that change. I certainly regard this law as a nuisance that will make no discernable impact on the meth situation, but I'm unlikely to march on Washington to make my feelings known. Your best bet would have been the drug makers, but I suspect they're far too skittish about being on the "wrong" side of any argument involving illegal drugs.
posted by Horace Rumpole at 12:06 PM on November 27, 2006

I went into an Alabama chain drug store last week and bought a box of generic "Sudafed." Had to present ID and sign a book. Not all that different from getting a Schedule II drug at a pharmacy window. A PITA, but only in comparison to buying other OTC drugs.

I really doubt the manufacturers will stop making it. Phenylephedrine doesn't work for a fairly large percentage of people (including me). That alone should keep pseudoephedrine on the market.

If they really wanted to "fix" the problem, they'd make Sudafed prescription-only... and piss everyone off.
posted by dw at 12:21 PM on November 27, 2006

JayRwv, the problem for me is finding an open pharmacy. The CVSs near me all close their pharmacy windows at 8. Need a (working) decongestant after 8, or on a Sunday? Try again in the morning, sucker.
posted by MrMoonPie at 12:24 PM on November 27, 2006

By the way, cough syrup is probably next, not the stuff with codeine which is available now without a prescription but from behind the counter in some states, but the stuff with plain old dextromethorphan.
posted by caddis at 12:33 PM on November 27, 2006

more here
posted by caddis at 12:33 PM on November 27, 2006

The reasons I find this law irritating are because:

1. The pharmacy is not always open, meaning that just because I'm at the store and needing cold medicine doesn't mean I can always get it without a hassle.

2. I can't just grab a box at the supermarket anymore.

3. I can't grab a box to read the fine print on the back and compare and contrast with the other options (and there are ten million options). I often look at all of the different ingredients and dosages and contents to figure out what I need and what the best bargain is, but that turns into a massive pain in the ass when they're being stored on a shelf way behind the registers and you can't even see how many are per box letalone the fine print.

4. When I have a cold, I don't want to talk to people. I want to grab my medicine, pay for it, go home, and sleep!

So, yeah, it's just inconvenient, and it's annoying. Here is what I would be willing to do, as an annoyed citizen:

- Sign a petition if there were people collecting signatures outside of a supermarket or drugstore.

- Fill out an e-mail form to send to a local congressman if someone set it all up for me (I'm lazy).

- Vote in favor of having it on the shelves again if it was in a bill being voted on during a regular election (e.g. like the wine in supermarkets law Massachusetts just shot down).

I don't think people would rally to protest or do major letter writing campaigns. But what do I know. I just think that the people annoyed by this are probably mostly people who have been inconvenienced like me, and they are thus less likely to want to inconvenience themselves further by writing letters or taking drastic steps to change this.
posted by tastybrains at 1:02 PM on November 27, 2006

I was originally very annoyed by the restrictions placed upon purchases, but after watching the Frontline documentary, I no longer mind it at all -- it was a real eye-opener. I try to remember that feeling when I am affected by this law -- that it's done for a real reason, rather than some stupid knee-jerk lawmaking decision.
posted by theredpen at 1:11 PM on November 27, 2006

I took sudafed every day of my life (pretty much) since I was in second grade or so and diagnoised with severe allergies, until the ban went into place in Wisconsin. I got it behind the counter for a bit, but it wasn't worth it, and I didn't like having my information logged. OUt of principle.

Now I'm congested constantly. My allergy doctor has worked on many alternatives to sudafed for me (including double the dose of nasal steroids) with only limited success. He personally doesn't like sudafed so he'd rather not prescribe it (it can be gotten as part of a few different allgery med combos) but its still damn frustrating that I can't go buy a month's supply in one sitting. But because I'm in the minority, I know the law isn't going to change.

Part of me really wants this to be a brutal cold and flu season just to get more people to notice.
posted by [insert clever name here] at 1:18 PM on November 27, 2006

How about changing the laws so that amphetamines are easier to prescribe? If I recall, meth usage shot up when amphetamines became a big deal and all of a sudden you couldn't get it off the street as easy as it was to make meth. I'd much rather have a small subset of the population using drugs made legally, safely and profitable for companies I hold stock in. I cannot buy small meth labs, I can buy Pfizer. But yes, drug laws suck.

It is incredibly hard to argue against them as they always can appeal to emotions and the irrational. Think average Midwestern mom who is teed off she can't get her cold medicine easily. Then they tell her that it is combating meth, if you aren't making meth it shouldn't bother you. I will admit that it will probably do nothing to solve the meth problem but it will solve small drug labs.
posted by geoff. at 1:47 PM on November 27, 2006

How has this law affected meth labs? My wife works for the state police crime lab as a drug chemist. She analyzes meth labs all the time. But much less than she once did. Here's what she has to say:
Actually, the pseudoephedrine restrictions have cut our meth lab problem by about 80%. We are looking at about 70 meth labs for 2006, down from about 400/year before the pseudo changes. Oregon's law went into effect before the federal law, though, and is a bit different. In Oregon, you now need a prescription to buy pseudoephedrine — it is Schedule III.

We've seen an amazing drop in the number of people making meth in Oregon. But, that doesn't mean the meth has gone away. The supply is still here — mostly up from Mexico, through California. But at least our state doesn't have the clean-up mess and hassles associated with meth cooks in homes, hotels, etc.

I didn't expect it to work, but it did. It's an effective law, and in Oregon it is doing just what the lawmakers hoped it would. IMHO, the minor inconvenience for everyone is well worth the benefit of practically shutting down the small-time meth cooks all over our state. I saw too many meth labs in homes where little kids were living in the room next to the cook. If you have a headcold, you can still get your Sudafed by calling your doctor and getting them to phone a prescription to the pharmacy. Or, better yet, stay home sick, drink your orange juice and have some chicken soup.
So, from one perspective at least — and one close to the source — this law works, and it's worth the bother.
posted by jdroth at 2:02 PM on November 27, 2006 [1 favorite]

you can still get your Sudafed by calling your doctor and getting them to phone a prescription to the pharmacy

What about the uninsured, or those without a PCP?

I come from a country where codeine is OTC, and freely available. I still remember from a few years back the horrified looks from the pharmacist when, dying from coughing fits after fruitlessly scanning the shelves and finding all these lame antitussive substitutes, I asked where the hell was the codeine?

And you know what? In Ireland, with freely available codeine, there does not seem to be a crazy epidemic of codeine abusers. Meth abuse is a disease stemming from social malaise, not from the (former) common availability of precursor chemicals.
posted by meehawl at 2:46 PM on November 27, 2006

When they made emergency contraception OTC in Canada, the Canadian Pharmacists Association created an evaluation form which it recommended pharmacists use to assess why women were using the drug, and to collect their personal information so their use of the drug would be tracked. The woman would be then "counselled" if the pharmacist decided she had used it too much or for the wrong reasons.

Well, the Ontario Privacy Commissioner raised questions immediately, and as a result the Ontario Pharmacists Association will agreed not to use the form. Furthermore they will allow women to refuse to answer questions and to buy anonymously.

I mention this because I think the pseudoephedrine law is a serious violation of privacy and reduces the citizen to a criminal.

Does the US or your state have a privacy commissioner or ombudsperson? Perhaps this is something you could approach them about.

How does the US or state pharmacists' association feel about the law? Maybe they disagree with being made a tool of law enforcement, or object to the privacy issue, and need help organising?
posted by loiseau at 3:18 PM on November 27, 2006

doh. "...the Ontario Pharmacists Association agreed not to use the form."
posted by loiseau at 3:20 PM on November 27, 2006

Anybody have a reference for what the limit is when bringing pseduoephedrine drugs into the USA in personal quantities (if, e.g., I zip up to Canada for a weekend and buy some)?

Good luck—you'll need it. I was really congested, and had just been treated like some sort of suspect for buying pseudoephedrine in New Jersey before my flight from Newark to Toronto, so I decided to look for the non-phenylephrine versions of Sudafed, because it, you know, works, and guess what I discovered?

You apparently can't buy pseudoephedrine off the shelf in Canada (at least in Ontario), and I was too scared to ask the pharmacist about it. It seems that they've decided to declare war on cold sufferers just like the U.S. has.
posted by oaf at 3:43 PM on November 27, 2006

This ban/limit is absolutely no different than what the NORML people and other pro-legalization groups have been complaining about for quite some time. Unfortunately, many people see these groups as existing soley to get high, and many do, but their underlying complaints, suggestions, protests, and methods are spot-on.

If this fight will be won it will be won in the larger context of limiting the war on drugs. Other tactics like suing pharmacies for HIPPA violations will just lead to them dropping the product.

Look, the government could have passed a law just limiting say 5 purchases per person per day, but went all out.

If this makes you an active anti-drug war warrior then so be it.You want better cold medicine, someone out there wants better glaucoma medicine, some religious group wants to take a controlled substance, some guy would rather get stone than drunk, etc. You guys are in the same fight. You can start at places like this or here.
posted by damn dirty ape at 4:01 PM on November 27, 2006

The other ingredients don't work for me at all whereas pseudoephedrine works terrifically. I don't mind the items being sold behind the counter, but I do mind the reformulations that don't work for me.
posted by mintchip at 5:13 PM on November 27, 2006

The issue for me isn't that it's an inconvenience, but rather that the law feels like an invasion of privacy. I don't know how to put it in legal terms, but it doesn't feel right. To me, it's along the same lines as other "war on drugs" privacy-invading laws. For this reason, I feel the law should be of concern to a wider number of people than merely those who don't find the new formulations effective.
posted by treepour at 5:28 PM on November 27, 2006

You apparently can't buy pseudoephedrine off the shelf in Canada (at least in Ontario), and I was too scared to ask the pharmacist about it. It seems that they've decided to declare war on cold sufferers just like the U.S. has.

Bullshit. I've lived in Ontario all my life and it hasn't changed at all.

A pharmacy on my street has a "MethWatch" sticker in their window, but I can still get the stuff. Some places may have restricted it voluntarily but there's no law up here.
posted by GuyZero at 5:28 PM on November 27, 2006

Bullshit. I've lived in Ontario all my life and it hasn't changed at all.

OK, go to the Shoppers Drug Mart in Eaton Centre, or the one on Bloor near Spadina, or the Loblaws at Bayview and Sheppard. You won't find any pseudoephedrine-only products on the shelves, but you'll find plenty of phenylephrine-only products. Even if it's not illegal, it's pretty scarce.
posted by oaf at 5:48 PM on November 27, 2006

By the way, cough syrup is probably next, not the stuff with codeine which is available now without a prescription but from behind the counter in some states, but the stuff with plain old dextromethorphan.

Not everyone knows this, but you can get high off dextromethorphan hydrobromide (aka dxm), so that's probably why. You don't even need a drug lab to convert anything, though of course extracting the pure powder from the syrup makes things a lot handier for ingestion and only requires a few common household chemicals (and nothing that leaves a toxic environment behind)...

One way they combat this is by not carrying the type that has only dxm as the active ingredient. If you take the kind with added acetaminophen or guaifenesin in large enough quantities, it can make you very ill or hurt your kidneys / liver (or both, and possibly other stuff too). I don't know if they do this with codeine-containing formulas or if something similar is possible with pseudephedrine.

At any rate I think this law stinks, and I suppose I will buy some next time I'm at the Walgreens on my block just so I have some on hand.

Good luck, I don't think this is going to change.

For this reason, I feel the law should be of concern to a wider number of people than merely those who don't find the new formulations effective.

I think it sets a scary precedent for requiring logs of purchasers, and will eventually be spread to other products deemed dangerous. Maybe that makes me paranoid, but it just creeps me out and I have this horrible feeling that lists of names like this might end up in the wrong hands if anyone sees they have something to gain by it. Sooner or later, someone probably will.
posted by beth at 6:11 PM on November 27, 2006

I think it's fine to make people jump throught hoops to get a potentially harmful drug, especially one that is used by the small cooks who dump this shit in the rivers and lakes around here every day. I also think theres widespread low level addiction to this stuff. I have taken it a few times and it made me noticably buzzed. I think a lot of people are dependant on it for non medical reason but that's just mho.
posted by fshgrl at 6:15 PM on November 27, 2006

Mark me down as another one who cares. I've taken actifed, then sudafed, first as a prescription drug and then an over the counter drug for over 30 years now.

In Texas, I have a lot of allergy issues, but they get extreme in spring and fall. Having taken most everything out there both OTC and prescription, I can say that nothing works as well for me as pseudophedrine. The new stuff (phenylphedrine?) actually makes me sick.

The problems with the new situation are:

1) During the height of allergy season, my intake (not exceeding package dosage and times) is more than I'm allowed to buy in once location a month. This means I end up going to two or three places (time, fuel, etc.), and passing out my identity in each. I assume that one of these days someone will think to tally all of these up, and the decongestant police will end up on my doorstep.

2) Pharmacies are only open certain hours. If I don't realize I'm running out by 7pm or so, I'll pretty much spend the night awake in a chair trying to breathe. This was never an issue when you could buy it off the shelf in any 24 hour grocery.

3) It's a pain-in-the-ass for the pharmacy workers, and they treat it (and me) as such. The allowed purchase thing is all over the place, most of them will only allow me to purchase two boxes -- regardless of whether they have 24 count or 48 count boxes in stock. And many are no longer stocking the 48 count boxes.

4) I have a problem with the record keeping (as many have said), both in principle, and regarding my concerns mentioned in item 1.

5) My worst fear is that this is the first step to slowly taking it back to prescription (eating another big chunk out of my monthly budget) or off the market entirely.

In any event, it's a major pain in the butt. I'm glad that it's solved some areas lab cleanup problems (although apparently without making a dent in the supply, just moving the lab problem out of our collective backyards), but surely there's a better compromise for not making it available in bulk vs. making it as much of a pain as it is for legitimate purchasers.
posted by nonliteral at 6:31 PM on November 27, 2006

From all I've seen, jdroth is right. I'm in Washington, where there is no prescription requirement as there is in Oregon. I know we're not hearing the reports of meth lab busts we heard a few years ago, though burglaries seem to be up as the meth-heads are trying to get money for imported drug. I'm glad to see fewer labs.

You don't have to go to a pharmacy to get it in Washington. It's carried at Wal-Mart with the cigarettes, for example. I don't think it's a horrible hassle, not nearly as bad as it would be if it was prescription only. I'm glad I don't have the allergies some of you do.
posted by lhauser at 7:03 PM on November 27, 2006

Personally, I had stopped using it in favor of newer medications that work just as well.

/derail ... WHAT new medications that work just as well? Please share with the class!
posted by frogan at 7:05 PM on November 27, 2006

How does the US or state pharmacists' association feel about the law?

I'm in pharmacy school now. I think the laws are stupid. Most pharmacists dislike the paperwork hassle, but not enough to lobby. Many feel that anything that gets people talking to the pharmacist is a good thing, since knowing your pharmacist's name is a good predictor of taking all of your meds as directed.

I wouldn't bet on pharmacy associations taking this one on - though you might be surprised at how politically active pharmacy groups are. The details of Medicare Part D (the prescription drug benefit) are a big focus of pharmacy political activity now.
posted by selfmedicating at 7:06 PM on November 27, 2006

I'm planning on writing and/or calling the companies that manufactured some of the main pseudoephedrine-containing medications - I made the mistake of getting a horrible cold on a Saturday where I needed to go to a meeting very early [before the nearby pharmacies opened], and so I grabbed some of the phenylephrine versions from the nearest convenience store. Big mistake. I spent the entire day annoying the rest of my room with my sneezing and sniffling, and could barely concentrate when I gave my presentation. Lovely. Some of us don't have the option to "stay home sick, drink your orange juice and have some chicken soup," and phenylephrine is, for most of us, not as effective.

Unfortunately, because this is a drug-related law, it's unlikely to be changed [even if I do agree with geoff. that ultimately legalization & control would be a better solution.] These laws treat a symptom [amateur meth labs], but they create more problems [probably increasing gang/drug cartel involvement and related violence, not to mention health-related inconvenience for the rest of us], while not ultimately doing anything to deal with the actual problem: meth abuse.

I suspect that the best we can hope for is pressuring pharmacies to continue stock pseudoephedrine cold medications [albeit behind the counter] and to tell the cold companies that since phenylephrine medications suck, you're willing to go through all the behind-the-counter bullshit to get it.
posted by ubersturm at 7:17 PM on November 27, 2006

For those who are saying it's worthwhile because it's effective, I guess I would concede that having a purchase limit (overrideable by prescription) and stocking behind the counter are probably good ideas, but why keeping the log book? Can anyone even explain exactly what that's for?

Ostensibly, I imagine it's to facilitate keeping a tally of how much you've bought to ensure you're under the limit. But the fact that they're required, not merely allowed but required, to keep it around for 2 years tells me there's something else to it, or at least makes me fear that there is. What's to keep them from going first to the logbooks if they decide to really crack down on local meth production? I mean shit, you know these people have purchased precursors.

If this sounds paranoid, if you think this would never happen, then why not ensure it never happens? Why keep log books? Why not just tell the pharmacies how to detect suspicious purchase patterns and beef up the reporting? I honestly think it would be better if psuedoephedrine were rescheduled to scrip-only; then at least purchasers' personal data would have strong HIPAA protection and they could get the amount they need without being questioned or looked at funny. I have no clue how much PE it takes to make meth, but I imagine it's at least a few grams, which is over 100 adult doses.

There are just more sensical ways to work the tradeoff than the current law, even taking into account the cleanup costs & safety concerns that justify cracking down on the small labs.
posted by rkent at 2:29 PM on November 28, 2006

Late to this discussion, but with an odd story: my state requires that pseudoephedrine be sold from behind the pharmacy counter, with log books, purchase limits, etc. Today I was wandering around looking for things in my grocery store, which plays obnoxious ads in between old songs on the PA system. This time I actually listened to an ad for cold medicine, and the manufacturers, far from ceasing to put pseudoephedrine products on the market, are now using the act that it's kept behind the counter as an advertising point to indicate that it's stronger and more effective.

I found this strangely comforting, as I have allergic asthma and phenylephrine just does not work (although it's quite effective at making my head hurt). I have allergy shots now to keep the allergies under some kind of control, but before that, I lived off Sudafed. I still take it when I need to, just not every day any more, and I prefer it to my regular allergy medicine to clear up any oncoming wheezing, congestion, etc....if I have a mild attack, I can sometimes cut it off with Sudafed and not have to go for the inhaler at all. And I hear much bitching and sniffling in the cold and allergy aisle when I walk through the drug store or grocery store now - many, many people loathe the fact that they can't get effective medication anymore unless the pharmacy is open, so I know I'm not the only one.

I'd like to hear my employer's reaction if I dealt with pollen counts by staying home and drinking orange juice, though. Any hints on how to get them to agree to it?

And in related news: "Jefferson County is on track to break last year's meth house busts. There have been 48 already this year, which is the number for all of 2005." The restrictions on pseudoephedrine went into effect here last year. So it doesn't look like they're cutting much local production with the new law.
posted by dilettante at 6:34 PM on November 29, 2006

Response by poster: Thanks everyone. It's been an interesting chat. I didn't want to discuss the merits or effects of the law largely because it has been hashed over elsewhere but I realize now it isn't really possible to do that. This, like most drug laws, has both emotional and practical issues. And like most drug laws, is just another straw on the camel's back which clearly hasn't broken yet.

I think the camel is starting to look uncomfortable though.
posted by chairface at 12:32 PM on November 30, 2006

Where Have All Our Cold Pills Gone
posted by meehawl at 3:31 PM on December 3, 2006

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