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| The PSE (Meth) Problem Continues!: Rants and Musings of a Retail Pharmacist |
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by The Redheaded Pharmacist - October 17, 2011
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Provided by The Redheaded Pharmacist
It’s that time of year again. The return of cold and cough season means patients will be coming into their local pharmacies in search of some relief to those dreaded cold symptoms. But there are other people coming as well. And they aren’t looking for congestion relief. They want to make illegal drugs.
Cold and cough season means a definite uptick in the sale of the over the counter (in most states) decongestant pseudoephedrine. Pseudoephedrine is the active ingredient in the brand name Sudafed as well as a whole host of other products designed to relieve that nasty head congestion that can accompany a cold or allergies. But pseudoephedrine (or PSE for short) is also the base ingredient for the illegal drug methamphetamine. And there lies the problem.
I’ve talked about the PSE sales dilemma for pharmacies before. On the one hand we’d like to have the product available to legitimate users. But on the other hand the goal is to deny its sale to people who just want to use the product to make illegal drugs. The problem then becomes how do you determine who is who at the pharmacy? And what do you do about it even if you know who is a legitimate user and who is not?
Most states in the U.S. now deal with this sort of transitional classification of PSE that allows for the drug to continue to be sold as an over the counter medication but puts in place some restrictions on it’s sale to the general public. Quantity limits and PSE databases tracking customer purchases are all put in place to monitor PSE sales. But is it working? And if not what else can be done?
I talked about this topic this time last year. It does seem like this issue always pops up in the fall. I contemplated the validity of simply making PSE prescription-only in a previous post. I really thought that was the right answer at the time. After all, look how well the strategy has worked in the two states that have already implemented the PSE as prescription-only status: Oklahoma and Oregon. Methamphetamine producing labs have been dramatically declining in those two states ever since they changed their laws.
So what’s the problem? Sure making PSE Rx-only is a hassle for legitimate cold sufferers and it further limits the access of patients to the drug but it is the price all of us have to pay for the bad behavior of others right? Well, I’m not so sure that the Rx-only approach to the PSE problem is the right way to go now.
Before, I think I was more frustrated with the gatekeeper role that pharmacists now play in relation to the sale of PSE. No matter what your state’s laws and regulations might be you as a pharmacist are tasked with keeping PSE out of the hands of the illegal drug producers. And that to me seems like an unfair burden on a group of healthcare professionals.
So what’s the answer then? How can we stop the demand for PSE simply to be used as a precursor towards the production of illegal drugs? Well, for us to really curb the demand for PSE for illegal drug producing purposes we have to think outside the box and come up with a way to stop the illicit demand for the product.
And I now think that making PSE prescription-only nationwide is not the answer. Why? Because that will just create a market for the illegal distribution of PSE by means of the pill mills that already exist for narcotic prescription-only medications. Making Xanax or Vicodin prescription only (and controlled substances as well) hasn’t curbed their abuse among the general public. Abusers are more than able to find their fix.
I think that making PSE prescription-only unfairly burdens legitimate congestion sufferers. PSE is safe and effective as an over the counter congestion medication and patients shouldn’t be burdened with going to their doctors and getting a prescription for PSE simply because this country has an out of control meth problem that hasn’t been solved.
And I’m not so sure that a nationwide PSE prescription-only restriction would work anyway. The advantage that Oklahoma and Oregon have right now is that the other 48 states don’t have similar rules in place. I’d be curious to see the meth lab data for the states surrounding those two states after they implemented their PSE prescription only laws. My guess is that while the new laws were effective for their individual states the meth problem itself wasn’t solved or reduced but simply displaced to other states with less restrictive PSE laws. If a nationwide PSE prescription-only law was created then meth producers would simply find a way around the new restrictions.
For a real reduction in the production of methamphetamine being produced from PSE, we must somehow reduce the demand for PSE for this purpose. And for me there is only one logical means to reach that goal. We must find a way to manufacture PSE such that it can’t be used to produce meth.
Formulating PSE so that it becomes inactive if heated is one possibility. How about adding a non-toxic ingredient that interferes with the ability to produce methamphetamine from PSE? There has to be a way to produce a PSE product that is still safe and effective for cold and congestion sufferers while at the same time being unable to be converted to the illegal drug methamphetamine. We could be researching this kind of solution right now.
I realize this is a long shot solution. But the current PSE sales restrictions and all of its related hassles for pharmacy personnel and patients alike aren’t working to curb the meth problem. Meth is being made in waves even with PSE sales restrictions in place.
Lets find a way to produce PSE that can’t be made into meth. That way, we could sell it right off the shelf on the over-the-counter aisle. How about this solution to our meth problem? What do you think? Is a new formulation of PSE that can’t be made into meth even possible? If so why aren’t we working on this right now?
The Redheaded Pharmacist
The Redheaded Pharmacist has been working full time in retail pharmacy for more than a decade. He is in his mid 30s, and, yes, he has red hair.
Disclaimer: This blog represents the opinions of the author and the author alone. It does not represent any pharmacy group or organization. I also will leave out or change the names of patients/customers to protect their privacy and comply with government regulations regarding patient privacy rights and personal information.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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