A Technological Fix for Meth Labs?

Again this year, the cold medicine industry was the number one lobbyist in all the state legislatures that considered making pseudoephedrine-containing products available by prescription only. They won in every state, which is not surprising given that the Citizens United decision makes them even more powerful than they were in prior years. Legislators who wanted to set a prescription requirement to obtain the 15 cold medicines that can be used to make methamphetamine were simply outgunned by the financial might of the industry. Their states will again be ravaged by meth labs this year, and the industry will again pocket hundreds of millions of dollars by selling their products to meth cooks.

However, a new cold medication, trade name Tarex, may change the equation. Tarex contains pseudoephedrine (PSE) but its manufacturer has created a chemical lock that apparently prevents the chemical’s ready removal from the medicine. If the initial test results hold up, state legislatures can make all PSE-containing medications other than Tarex prescription only, giving those consumers who want it a PSE-containing cold medication while also dramatically curtailing meth labs.

Will it work? The history of drug problems does include some notable successes of this sort. The epidemic of temazepam injection in the UK was brought under control by reformulating the medication as a solid tablet rather than as a gel cap. Other “abuse-resistant” medications have bombed however, when creative addicts discovered how to crack the formula and spread the answer to their fellows (the Internet makes this process extraordinarily rapid).

If Tarex does indeed resist the PSE-extraction efforts of meth users, there is some deeply satisfying political theater to come. The cold medicine’s financial interests are not defended only by professional lobbyists. It also funds — and in some cases entirely created — a phalanx of patient advocacy organizations, law enforcement groups and individual experts who give the “disinterested” advice to legislatures that prescription-only PSE is a bad idea. Their public stance is that they just want a reasonable balance struck between relief for allergy sufferers and the fight against meth labs, what could be wrong with that?

Those people are now crapping their pants.

If effective, Tarex would provide exactly what they have been publicly suggesting is the right solution. But the medication’s manufacturer is not among the cold medicine giants who fund all these shills. If legislators take these front groups’ at their word and make Tarex available instead of the current PSE-containing cold medications, the gravy train they have been riding will stop dead. What to do?

My prediction: The shills will continue to express “real concerns” about Tarex. Industry-supported patient advocacy groups will say that Tarex doesn’t give them relief from congestion. Industry-bankrolled law enforcement groups will say that, in their expert judgment, Tarex really can be used to make meth, despite all the evidence to the contrary. This will continue right up to the day when one of the big cold medicine companies buys Tarex’s manufacturer. And then, having thought about it, all those upstanding folks will, doggone it, have a deeply felt change of heart.

Author: Keith Humphreys

Keith Humphreys is the Esther Ting Memorial Professor of Psychiatry at Stanford University and an Honorary Professor of Psychiatry at Kings College London. His research, teaching and writing have focused on addictive disorders, self-help organizations (e.g., breast cancer support groups, Alcoholics Anonymous), evaluation research methods, and public policy related to health care, mental illness, veterans, drugs, crime and correctional systems. Professor Humphreys' over 300 scholarly articles, monographs and books have been cited over thirteen thousand times by scientific colleagues. He is a regular contributor to Washington Post and has also written for the New York Times, Wall Street Journal, Washington Monthly, San Francisco Chronicle, The Guardian (UK), The Telegraph (UK), Times Higher Education (UK), Crossbow (UK) and other media outlets.

48 thoughts on “A Technological Fix for Meth Labs?”

    1. I was thinking the same thing. Even with generics out there (and current non-PSE formulations having generic competitors) the proprietary non-PSE stuff costs roughly 4x straight PSE. Figure 10x for something with no legal competitors. So I would be for Tarex (or something like it) being the only easily-available formulation only the same legislation mandating that also mandates RAND (reasonable and non-dscriminatory) licensing. When a state creates a monopoly, they get to set the rules.

      1. Or just buy the patent outright, have it go straight to generics.
        If you consider the costs of dealing with meth, it would be a giant win for the country.

      2. The company that manufactures Tarex has estimated that it will increase the cost of a box of PSE product by $1. By the way, there is also another small company that has developed similar technology that also appears to hold great promise.

          1. @paul: No, a box of the typical PSE-containing cold medication is 6-12 bucks, depending on where you buy and the type.

  1. If Tarex is under the control of one company, then every other company still wants to have uncontrolled sales of *their* drug.

  2. Yet another problem that would probably to disappear under single-payer health care. Interestingly, one similar argument against such a system would apply here: why should meth addicts keep me from easy access to my cold medicine?

    1. Compassion? Or even self-interest? Meth addiction causes harm not only to the addicts but to their families, communities, and beyond. We’re all paying for it already, to some extent. Does that justifies an allergy-sufferer paying 10x more for a patented gimmick that serves her medical need no better than generic PSE? I don’t know.

    2. Ditto Eli. I wouldn’t mind paying to increase treatment options for addicts. I very much mind having to jump through hoops when I haven’t done anything wrong, to support yet another losing front in the “war” on drugs. We will always have addicts.

        1. Well, apologies, but you say that based on what? I’m all for education and healthcare, which may prevent a lot of bad things. But this whole “war” metaphor, and making more and more things illegal, and hassling innocent people, leaves me cold. It feels unAmerican. I still don’t see any difference with alcohol.

          And no, a drug company didn’t pay me to say that.

          1. I also don’t believe in the “war” metaphor. But I also believe in controlling access to certain legitimate drugs that cause lots of harm when uncontrolled. Otherwise, why not just make a drug like oxycodone over-the-counter? Maybe some would support that. I don’t. Likewise, PSE should never have been made an OTC drug in 1976. It was a big, big, mistake. Not because people get hooked on PSE. But because PSE is the key ingredient necessary to make the most powerful variety of meth, and truly massive amounts of OTC PSE are diverted every day to meth labs in our country. But, as Keith pointed out, the pharmaceutical industry that makes a lot of blood money from that diversion, spends enormous amounts of power, influence, and money to ensure the status quo. That’s what they have been doing for over 30 years. Returning unlocked PSE to a prescription drug is not about meth use or addiction. It is about shutting off the uncontrolled tap of OTC PSE that fuels meth labs in our county. Meth labs that catch fire, explode, and poison homes, the environment, drug endangered children, and more.

          2. hi Rob: I’m responding to your response, b/c the Reply button disappeared for some reason.

            We may be at the end of a useful discussion. I don’t agree that we are *able* to block access, so discussing whether or not it’s a good idea doesn’t seem useful.

            And, again, how is it different from alcohol?

          3. NCG, I’m of the opinion that the fraction of Meth users who self destruct is much higher than the fraction of Alcohol users who do.
            I.e. Meth is inherently more dangerous and destructive than booze. That is a rationale for treating them differently.

            ps – the reply button goes away on deep threads, probably to keep the content from scrolling out of view on narrow displays.

          4. Hi Mobius!

            Well, that may be true, I don’t know. I’m not sure though why we would care about the % of users of something who do bad things, substance v. substance.

            It seems to me that Mark’s HOPE program – about which I really only know what he’s written here, for reasons of time, not a lack of interest — is indifferent to the substance the person abuses. Rather it focuses on getting them to stop using whatever it is, if they are among those users who do bad things as a result of using it.

            While I may or may not think I detect a certain amount of ambivalence on Mark’s part towards alcohol, he does not seem to advocate making it harder to get. Showing i.d. is enough. That’s what I do now to get PSE, and even that annoys me but I can live with it. Getting a prescription is simply out of the question.

          5. NCG, various contributors at this site have commented on harm reduction from booze. From upping the tax, setting minimum pricing, not allowing booze+caffeine pre-mixed drinks, and so on.

            Also, the point about the tech fix is to _allow_ OTC sale of PSE products, just ones that (allegedly) are no good for Meth production.

          6. Yes, meaning that at the same time, they would put the other PSE versions behind a prescription wall. (And it really is a wall for some of us.)

            Meanwhile, it would remain to be seen if the new drug worked the same. Maybe it will, maybe it won’t. I hear plenty of complaints about generics, so, that’s not a slam dunk.

            If it worked the same, I suppose it won’t be a huge big deal to me to lose the other option. But you can’t expect me to get excited about it either.

          7. Regarding HOPE: It works. Some time ago I started the first one in Oregon. HOPE saves lives and families, saves taxpayer money from avoided repeated imprisonment of repeat property offenders, reduces crime by removing the motivation to commit more property crimes, and gets property crime victims the restitution to which they are entitled and deserve. That being said, I’ve never had (or needed to use) HOPE for someone committing property crimes due to alcohol addiction. Abuse of meth, heroin, and prescription opiates is what we see going into HOPE, and I suspect you will find the same in other HOPE programs. I’m not saying that alcohol abuse isn’t a contributing factor to lots of crime. It is. Big time. But addiction cycles and brain chemistry for various drugs of abuse (of which alcohol is one) vary from drug to drug, and their connection to types of crime also varies. Domestic violence and alcohol? You bet. Property crime and alcohol? Not so much.

        2. “But we don’t have to always have meth labs.”

          No, that’s true, you could cause them to switch to an even worse synthetic… Designer drugs are, after all, a result of crackdowns on prior drugs.

      1. NGC, it isn’t a position I actually take. If it truly meant a reduction in meth use, I would gladly suffer inconvenience. My guess is that it could. But I would also guess a system could be arranged whereby one doesn’t actually have to see a doctor to get Nyquil, and instead present some form of ID, etc. to a pharmacist. Meth is the most devastatingly evil drugs out there.

        1. Ah, I see. We already have such a system where I live.

          I’m not so sure I would give up access to PSE based on a mere reduction in harm to other people. That probably sounds awful. If it meant a complete end to meth abuse, then yes. But a “reduction?” When we have so many other ways to try to help people? I don’t think so.

          1. I think you may be underestimating your own empathy NCG. In the meth belt, most burn unit care is meth lab related. I think you or anyone who spent a day in a burn unit and saw what people go through, would indeed be very happy if you could cut such human misery by even 10%.

          2. Keith, I’m curious: Do you consider Arkansas part of the meth belt? I ask because I’m going for another visit this weekend to a friend in the only burn unit in Arkansas (grease fire, in his case). I’m curious to ask the folks who work there what they see.

            JOHN –REPLYING IN YOUR COMMENT BECAUSE THERE IS NO MORE SPACE, YES ARKANSAS HAS A SERIOUS METH PROBLEM, THOUGH PROBABLY NOT AS BAD AS TENNESSEE AND KENTUCKY. KEITH

          3. Thanks, Keith. I knew we had a serious meth problem, but wasn’t sure how serious it was, relatively speaking. I’ll be curious to hear what the staff at Children’s says.

          4. Hi Keith: sorry to sound like a crazy libertarian here — which I would normally really, really like to avoid! — but banning the stuff isn’t the only way to prevent fires.

            For one thing, the government could make it, safely, and give it away. If fire prevention is the point, I mean.

            I find the causation story a little bit too attenuated, this idea that my being able to buy allergy medicine causes someone to be burned. Which, you are correct, I would give up if I agreed with the story. I just don’t think I do agree with it.

  3. The “law of unintended consequences,” and the coevolutionary process of each side alternatively upping the ante in the “drug war,” suggest that even if Tarex replaces currently available PSE medications it will not be long before a new (potentially worse) process or new (potentially worse) substance appears on the scene. The lack of PSE to the meth labs is unlikely to lead to those folks just tossing in the towel. I think it is more likely to strengthen the grip of Mexican cartels on the meth market, a definite harm on both sides of the border.

    It is more likely that domestic meth producers they will either develop a process to “break” the Tarex and that the new process could be even more fraught with harm and danger than the current ones, or they will develop a new and equally harmful “recreational” drug will take meth’s place. This is always the problem of attacking dangerous drugs from the supply side. I don’t seem much more than an incremental reduction in domestic meth labs happening with Tarex, as compared to what would be accomplished if all states had ID requirements and registries for purchases of PSE-containing compounds, and this reduction would easily be exploited by cross-border meth suppliers.

    At some point (and I am not holding my breath) this country would do well to put serious focus on what kind of quiet desperation and anomie leads people into meth-land: it seems to be worst in those places that have the least opportunity and the greatest boredom, and without relieving those factors, I think little will change. So much of our current society brings to mind Vonnegut’s “Piano Player” and the directionless “underclass” and their self-destructive pursuits. People need work and they need challenge and focus and they need to feel useful and needed, or they will seek relief of a sort in harmful mind-altering substances. Take away one substance and they will soon find another.

    1. I agree with much of what you’re saying, especially about isolation and boredom and despair. I think a lot of people probably feel that the world doesn’t need them and doesn’t care about them, because in our society now, that is true. We have built an economy that is unjust. Sticking more and more people in jail isn’t right.

    2. As a chemistry professional who has been of occasional use to the DEA, let me assure you that you have vastly overestimated the chemical abilities of these meth “cookers.” They will not be creating a work around for Tarex, nor will they develop any new drugs.

      New drugs are developed by people such as Alexander Shulgin (he has since stopped). When “new” drugs appear on the street, they are usually new production of Shulgin’s prior discoveries.

      1. Who developed the new meth processes that were developed in response to certain chemicals being made controlled substances? Was that Shulgin? Or was it rogue chemists (who undoubtedly contribute to the manufacture of all manner of illicit substances)?

        Even if we could cease all domestic meth production, the fact remains that Mexican cartels have taken up the industry, with gusto, and will both profit from that circumstance and create more of the kind of mayhem they’re already creating, with a vengeance. Where there’s a market, there’s a way.

      2. I read up a bit on Tarex.

        A key to meth-making is crystallization. Emilie Dolan of Highland Pharmaceuticals said Tarex interrupts the process because rather than crystallizing when heated with the chemicals, it results in a gooey substance.

        “Especially with the shake-and-bake method, you can’t get meth out of it,” Dolan said. “It kind of gunks up.”

        If meth-heads can get high smoking the gunk, this isn’t going to make much difference.

        1. Recrystallization is a technique to purify the product you want and leave the impurities behind in the solvent. If at some point you have gunk instead of nice crystals, then the synthesis might not work at all, or it could be so impure that you can’t actually sell it.

          (My opinion is based on a chemistry B.Sc., not any knowledge about production of meth.)

          1. Thanks for that insight, Odm. My limited experience is having known a couple of meth heads decades ago. I sure hope the gunk won’t do the trick because I can practically guarantee you these guys will try it. The thought of someone smoking all that impurity and solvent is pretty horrifying.

  4. “Even if we could cease all domestic meth production . . .”

    That is exactly the point.

    As to your historical question about domestic meth production, I wrote a law review article about it some time ago:
    http://www.oregondec.org/IN/Tab15.pdf
    The “new” one-pot method is just a variation on lithium-ammonia reduction of PSE to d-meth.

    By the way, Mexico has banned PSE entirely, forcing the cartels to switch to more complicated processes that produces weaker (less potent) meth.

    1. Kathleen,

      Yep, “Player Piano” holds a lot of insight for the current situation.

      Gotta wonder why folks don’t talk about this prescient book more.

      So it goes.

  5. I stopped using Nyquil once the behind-the-counter regime went into effect, because the PSE substitute that’s used in Nyquil now a) doesn’t relieve my congestion and b) makes me nauseous (there’s also the fact that acetaminophen does nothing for my body aches). A roll-my-own of a shot of dextromethorphan, a PSE, an ibuprofen, and a shot of my favorite whiskey works much better.

    Now, I’m guessing in a regime of prescription PSE, doctors would be under pressure not to over-prescribe PSE, meaning every time I have a cold or flu-like virus I’d have to visit my PCP (or whichever doctor is available on short notice), pay up another office-visit co-pay, and put off obtaining relief from the congestion for 12-24 hours. Thanks, guys.

    A version of PSE that can’t be used as a precursor to Meth can’t happen soon enough to suit me.

    1. Don K: Now, I’m guessing in a regime of prescription PSE, doctors would be under pressure not to over-prescribe PSE, meaning every time I have a cold or flu-like virus I’d have to visit my PCP (or whichever doctor is available on short notice), pay up another office-visit co-pay, and put off obtaining relief from the congestion for 12-24 hours. Thanks, guys.

      We don’t have to guess, we have real data from states where this policy is in place…and they simply don’t support your speculation.

  6. @MobiusKlein:

    >NCG, I’m of the opinion that the fraction of Meth users who self destruct is much higher than the fraction of Alcohol users who do.
    I.e. Meth is inherently more dangerous and destructive than booze.

    That’s a non sequitur. Percentage of users who are self-destructive is not a good metric of the inherent dangerousness of a drug, because the groups are self-selecting.

    If it’s true that “the fraction of Meth users who self destruct is much higher” than that of alcohol users (and I think it probably is), an alternative explanation is that in our society, methamphetamine is considered to be a much more “hard core” drug than alcohol (whose use is normative), and therefore attracts people who are by nature self-destructive.

    Comparing two groups, meth users and alcohol users, is problematic. The vast majority of meth users also use alcohol, but the vast majority of alcohol users never use meth. So you’re looking at two groups, one of which uses both drugs and the other of which uses only one drug. Is it any surprise that the group that uses both drugs is in worse shape? In order to be fair about comparing the two groups of drug users, you’d need to have one group that uses alcohol but not meth and another that uses meth but not alcohol. In fact, the second group is pretty small. The two drugs are often used in combination — somebody will snort up some crank to stay awake while drinking, or he’ll drink to take the edge off the speed. (I’m not sure that these two behaviors are mutually exclusive.) Because the two drugs counteract each other, a person who uses both is likely to use more of both than he would were he using only one by itself.

    A 2010 study in the Lancet, by David Nutt and his colleagues, attempted to rank the various intoxicating substances in order of harmfulness, giving each drug a number. Alcohol was at the very top of the list (most dangerous), and meth was in position #4. Among the factors weighed was the destructive impact each drug had on society, where alcohol was far and ahead of every competitor, being involved in accidents and violent crime. I’m not going to claim that Nutt’s findings are definitive, but any ranking will put alcohol, heroin, cocaine, and crystal meth up near the top. Which one is the “most dangerous” depends on how you weight the factors.

    1. Weighing factors is tough. I readily agree that total damage from Alcohol is higher, likely under any sane metric.
      What I want to gauge is how intense the damage is per person. My anecdotal view is Meth is more dangerous, and less prevalent. This is actually helpful for harm reduction, since it’s a smaller market to control, and the benefits are more focused. Hence my rationale for having one be legal, the other not.

      1. Although meth may be “a smaller market to control” the fact remains (as rachelrachel points out) that meth “attracts people who are by nature self-destructive” and therein lies the conundrum. Take the meth away and you are likely just driving a migration to some other self-destructive practice such as crack cocaine or some “designer” drug. I seriously think that anyone choosing to do meth has a lot more problems than just the meth itself, and like whack-a-mole, those problems will manifest in other ways in the absence of meth.

        Having grown up in a rampant drug culture (HS in Berkeley late 1960s) it was recognized by most of the kids I knew that some drugs were worse than others, and most of us understood intuitively the unacceptable hazards associated with meth, heroin, and barbituates; this is not new information to the culture at large. Those who choose to proceed with such drugs anyway have a lot more in terms of pathology than their meth habits. I am glad to have escaped unscathed, as did everyone else I knew who limited their experimentation to marijuana and psychedelics; I know a lot more became alcoholics than were taken over by such things as meth.

        There is a core difference between alcohol-users and meth-users, just as there is in people for whom marijuana functions as a “gateway drug” and those for whom marijuana is the end-point of drug use. Expecting to moderate the behavior of everyone by prohibition of one substance or another is, historically, unlikely to have much effect. The ideal would be to have harmless psychoactive substances available, but even then, some people would seek out meth and heroin. Solve that and you will have performed a miracle.

  7. Again this year, the cold medicine industry was the number one lobbyist in all the state legislatures that considered making pseudoephedrine-containing products available by prescription only. They won in every state, which is not surprising given that the Citizens United decision makes them even more powerful than they were in prior years.

    Keith, there’s an alternative explanation. It is already too difficult for American citizens with allergies to get the medication they need. Prescription requirements will make the problem even worse.

    What we should do is make PSE products freely available again, so that people can treat their allergies and recreational meth users have the ability to engage in pleasurable activity. If you are afraid of problems involving meth labs, make the substance commercially available so that it can be safely manufactured.

    It’s a win-win. Prescription requirements punish law abiding citizens with allergies as well as stripping the freedoms of recreational drug users.

    1. Dilan Esper: It’s a win-win.

      I doubt the children of people addicted to meth would agree with you on that.

  8. I took the liberty of tracking down some information (such as there is) on this “Tarex” and am calling bullsh*t on the claim that it’s some kind of permanent win against PSE diversion to meth production. Tarex is just a substrate, and while I can believe that it’s resistant to the kinds of extraction methods it’s makers thought to try, their incentives are not the same as those of the meth cookers. The Bobs is just talking nonsense above when he implies that there will be no more creative underground chemistry now that Shulgin retired.

    I mean really, the PSE has to come out of the Tarex to be effective in your body: if it perfectly encapsulated the PSE so that no one could get it out, that would defeat the purpose. Someone will be able to use this fact to devise an extraction method, and while it will surely be more expensive than crushing up Psuedofeds that does not make a huge win.

    1. I agree with Aardvark on this…. I also call BS on the effectiveness of the “Tarex” technology.

      “A key to meth-making is crystallization. Highland Pharmaceuticals says that rather than crystallizing when heated with chemicals used in meth-making, Tarex results in a gooey substance.”

      What is the chemistry process they are talking about? Heat is not used in the shake and bake method? If you heat this reaction it will explode? Also, the “crystallization process” is the last step of the reaction. Again, heat is not used. The info that is out there says the dosage form is a lipid base. The solvents used by Meth cooks will chew right through a matrix like this.

      I am all for an improved dosage form, but something seems really fishy to me…

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