Should OTC Pseudophedrine drugs require a prescription to purchase?

Over the counter cold medicines containing psuedophedrine for years in the US are have been required to be obtained from the pharmacist (without a prescription) with the presentation of a government issued photo ID. Consumers are also limited in the quantity of the OTC drug that can be purchased.

These changes in the US occured in the 2005/2006 time frame, primarily to combat and curb the production of crystal meth. But not as much as many states and the DEA would like. The practice of smurfing, which is purchasers going around town from pharmacy to pharmacy to buy large quantities of the psuedophedrine drugs has resulted in a limited effect on the use of these OTC drugs in the production of crystal meth. Two states, Oregon and Mississippi, now require a doctors prescription to purchase these once OTC medications. Many other states are considering similar legislation that would make the OTC drug, once again a prescription medication. Both Oregon and Mississippi claim that the production of crystal meth has dropped dramatically since the new laws have been enacted.

The upside of the prescription laws: curb the flow of psuedophedrine drugs into the crystal meth production.

The downside of the prescription laws: require someone with a cold to go to the doctor and obtain a prescription. Increase costs. Waste of physician time. Increase medicare costs for an OTC drug.

Supporters of the increased regulation argue that a cold is not life threatening, and there are other OTC medications that will treat your symptoms. So restricted access to pseudophedrine isn’t going to harm anyone. But one more meth lab is definitely harmful to many.

So what does the doper community think?

Some people have reactions to the alternative drugs, or they are not effective. Many people can not afford the money to actually go to a doctor, so you will see an amazing upswing in ER visits that go unpaid, many people adding OTC meds to insurance costs will drive up the cost of insurance to cover OTC meds. Pick your argument.

I swear I feel like going out of country and buying a case sometime and smuggling it in just to be fractious.

I do not like meth labs, but this restriction of OTC meds is fracking stupid. Stop the war on weed and that would be an amazing amount of resources that could be shifted to actual dangerous drugs.

My view as an MD: It’s relatively safe, it’s probably at least a little bit effective. Current restrictions on purchasing it are already reducing its diversion towards illicit use quite significantly.

Therefore, don’t increase my paperwork and schedule burden by requiring patients to see me to get a script for it. I’m already busy with patients who need to see me.

Like Meth?

Qadgop said it all. Prescription drugs should be for those that really need a doctor, because they can easily be dangerous if used incorrectly. Often those are also drugs that can be used illegally, but not always. Pseudoephedrine happens to be a case of a drug that isn’t all that dangerous, but can be used illegally. So the current setep works fine.

I find that pseudophedrine is very effective for me, so I don’t like having to ask for it special at the pharmacy and I don’t like being treated like a meth dealer for wanting more than a weeks supply when I go. If I have to pay $100 to visit a doctor to be allowed to buy $5 worth of pseudophedrine then they should just ban it and save everybody the trouble.

Is there actual evidence that meth manufacturers are getting their ingredients at the local pharmacy or is this just a public display to look like somebody is doing something about a problem? Or do meth dealers just buy ingredients wholesale?

Can’t they just set up a national database and have people register when they buy pseudophedrine? They already make you give ID and sign a form, I wouldn’t think entering your ID into a computer would be that much more of a hassel (certainly less then a doctors appointment). That way you could flag someone that makes more then one purchase a day.

Plus once you had the system in place, you could track frequently abused prescription drugs as well, making it harder for patients to fake doctor scripts or get multiple prescriptions from different doctors.

Yeah – Jacksquatocil, Jacksquatocil PM, cherry-flavored Jacksquatocil…

This Doper thinks that the effects of meth abuse are so obvious and well-known as to make it a nearly Platonic Ideal representation of the concept “evolution in action”.

Minnesota already tracks your purchases. I can’t go to one store, buy my weeks worth, and then drive down the street and get another box.

It really does suck when I get my yearly winter cold, and I can’t buy both a 48 count Pseudophed and a bottle of Nyquil in the same week. All I want is to be able to sleep and breath.

The thing that makes this such a stupid idea in Kentucky is that we already have a system like you describe. It’s nothing at all to add Sudafed to the list of stuff we track, since we already have to check ID’s and stuff.

It’s infuriating. I live on Sudafed during allergy season, and no, the other stuff doesn’t work. (Benadryl works but the side effects are variable. At times, it makes me bounce off the walls. Other times, it knocks me out. Not so useful when you have to go to work.)

Actually, for some people a cold CAN be life-threatening… but they are admittedly the minority.

Frankly a lot of people find those alternatives to be not nearly as effective. Pseudoephedrine has a role in treating sinus congestion, which has causes beyond just colds.

Then there is the very valid issue of the waste of physician time, the people who can’t afford to go to a doctor, possible increased use of the ER, and so forth. I’m sorry, I really think making pseudoephedrine Rx only is entering into the realm of diminishing returns.

Or the alternatives have nasty side effects. A few years back, without realizing it I bought a box of reformulated Sudafed (without pseudoephedrine), took one, and within a couple of hours my pulse and BP had been jacked up 30 points. The pharmacist told me that was a quite common reaction, and part of what caused the switch to pseudoephedrine to begin with.

Like sinus infections, which I used to get all the time, and which sometimes took several weeks and multiple rounds of different antibiotics to get rid of. I am not fond of not being able to breathe properly for several weeks at a stretch.

Consider that multiple studies that have tried to determine if Phenylephrine is any more effective than a placebo. Not if it’s more/as effective as pseudoephedrine, but if it’s better than the power of positive thinking.
I’m not happy that pseudoephedrine is restricted as much as it is, so I sure as hell don’t want it even harder to purchase, especially considering it’s the only thing that keeps my eyes from streaming/burning when a mystery tree in the area pollinates in the spring.

I agree that it is already over restricted. Law abiding citizens should not be inconvenienced because someone else might do something stupid, that really only harms themselves. Besides I am a chemical engineer and if anybody thinks that preventing me from purchasing large quantities of Sudafed would keep me from making meth if I wanted to, they are wrong.

While a prescription campaign of pseudophedrine (meth precursor) may substantially lower production of Meth in the US, it will not reduce the supply which will be supplemented by imported meth from Mexico.

The DOJ estimates that any decline in domestic production of meth can be offset by production in Mexico and then be smuggled into the US.

While meth use contributes to huge costs on our society, I don’t believe making psuedphed a prescription drug will make a substantial impact upon that problem.

Pharmacists have the role of playing gatekeeper to controlled drugs in our society. That role shoudl not be foisted off on Doctors. A doctor’s job/expertise is in diagnosing illness, and detrmining which drugs will work.

Arguments about how bad meth is, and what the benefits of curbing it’s production are, do not equal arguments in support of wasting the time of our already over-stretched doctors.

However, individual states, may consider using prescriptions as a means of shifting the market across state lines. While the problem may not go away, just move it farther away from me…like Oregon and Mississipi have attempted to do.

Explain this to me. I assumed it was required to make meth. So you don’t even NEED it? Why is it such a big deal then? Is it just cheaper or easier?

Oddly pseudoephedrine is completely banned in Mexico.