Cold Medicine Sales Tracking to Reduce Meth Labs: Worthless and Effective

Methamphetamine cooks cannot operate their labs without easy access to the cold medicines that contain pseudoephedrine (PSE). This has resulted in a long-running political battle across the U.S. Many state legislators want to make PSE-containing medicines prescription-only, which as the Oregon and Mississippi experience shows, virtually eliminates a state’s meth labs. On the other side, the cold medicine industry, which makes hundreds of millions of dollars a year selling PSE to meth cooks, opposes such a restriction.

The industry’s response has been to propose an electronic cold medicine purchasing system called NPLEx. The idea is that if someone tries to buy too much PSE-containing cold medicine, the system would notice and block the sale.

From the point of view of stopping meth labs, the system is worthless. South Carolina put it in last year rather than create a prescription-only requirement, and saw meth lab incidents increase by 65%. Kentucky, where the NPLEx system was invented, has had it in place statewide since 2007 and seen meth lab incidents increase by 500%. Meth cooks easily thwart the system by using false ID or by hiring people to buy the cold medicine. The NPLEx system is thus worthless from the point of view of actual effectiveness.

But it is incredibly effective politically and financially. When legislators in states battered by meth have considered creating a prescription-only requirement for PSE-containing medicines, the NPLEx system has given the appearance of being an effective policy alternative. State Senator Mike Fair of South Carolina is one of many sincere legislators who now realize that they were suckered by NPLEx. The industry has fooled people in state after state with their worthless system and continues to make huge profits from supplying meth cooks; in that sense NPLEx is enormously effective.

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.

69 thoughts on “Cold Medicine Sales Tracking to Reduce Meth Labs: Worthless and Effective”

  1. the NPLEx system has given the appearance of being an effective policy alternative

    How so? What statistics are the proponents advertising?

    1. The industry generally touts how many PSE purchases the NPLEx system stops. They claim that serves as evidence of how much meth manufacturing they’ve stopped. But those of us who work in this area know that is simply evidence of pervasive group smurfing of PSE. NPLEx actually facilitates PSE smurfing and a PSE black market by ensuring that no individual smurfer goes above legal limits. Smurfers don’t even have to keep of log of their PSE purchases any more to ensure they don’t go above the legal limit. The NPLEx system does it for them.

      1. Smurfing must then result in an increase in the median and modal amount purchased by consumers and an increase in the prevalence of “cold sufferers”. Do the NPLEx data show that?

        1. NPLEx is bought and paid for by the industry. When confronted with that precise demand for information by the Mississippi legislature in 2010, the industry balked and claimed it was “proprietary.” You draw your own conclusion.

  2. So, in other words, restrictions on the purchase of medicines containing pseudoephedrine haven’t made a dent in the production of Methamphetamine. Criminals either circumvent the laws using straw buyers, purchase the substance somewhere else or produce the meth using a phenylacetone process which doesn’t require using pseudoephedrine. Not to mention simply gangs that simply import the meth itself from Mexico or elsewhere where there are no such restrictions.

    The solution is therefore even more restrictions on the purchase of these products, making life even difficult for the vast majority of people who need and buy these products for their intended uses. Yes, that makes perfect sense.

    1. I’m sorry, you seem not to have read the post. The post asserts that once the sale of pseudepinephrine is strongly regulated, Meth production is “virtually eliminated”. It’s a showy veneer of ineffective regulation that has no impact or even a negative one.

      I’m not sure I support the proposed prescription-only regulation – the idea that the people most in need of cold medication (low-status workers unable to simply decide not to go into work because they need to nurse a cold) should have to somehow get a prescription for cold medication seems to betray a gross ignorance of our society and medical access in it. And I’d like to know what happened to Meth prices in Oregon and Mississippi once domestic production fell. But you really need to respond to the claims made in the post, not to about half of it read via your prejudices.

    2. Warren is correct. Returning PSE to a prescription drug, as it was prior to 1976, is highly effective at eliminating PSE smurfing and driving down domestic meth production, on a sustained basis. Other efforts at lesser regulation of PSE over the last 30 years have either provided temporary benefits, or no benefits at all. As for meth prices, that is a longer story and involves purity, potency, and availability of meth supplied by the DTO’s based in Mexico and Central California, which supply most of the meth in America, and have for quite some time. But that’s a longer story than I should squeeze into this reply. As for Oregon, combining the results of returning PSE to a prescription drug in 2006, with Mexico banning PSE entirely a few years back (and the resulting drop in potency), Oregon has seen a dramatic and sustained positive impact on meth abuse.

    1. Actually, the interests of people with colds have entered heavily into this policy decision. Policy makers have to weigh costs and benefits. However, from my perspective, two things can and should weigh heavily:
      1. Based on the pharmacology of PSE, as a powerful vasoconstrictor in a class of drugs of drugs know as sympathomimetic amines (and thus contraindicated for million of Americans with hypertension and a variety of other health issues), it is my opinion that the FDA should never have made PSE a non-prescription drug in 1976, even aside from the whole meth issue.
      2. There are only 15 products remaining (and their generics) that contain PSE. Even the industry admits that most consumers simply purchase non-PSE products that line the shelves.
      You also might want to check out these recent documents:

      1. Yes, but of course, the industry also basically admits that–unlike pseudoephedrine–the products that line the shelves don’t actually do anything, and people are purchasing them under the mistaken impression that they contain the decongestant that they have been using for years. Then they wonder why their sinus infection isn’t getting better.

        1. Megan has it exactly right. I can buy a product called Nyquil today — and be surprised that it doesn’t seem to work as well as I remembered it working. But it takes a substantially higher level of sophistication to know why it isn’t working as well and to figure out what the rigamarole is to go through in my particular state to get to a product that DOES work as well as I remember such products working.

          To argue that “most consumers simply purchase non-PSE products that line the shelves” means anything significant is ridiculous — the sort of logic one expects from a six year old.

          1. No, Ms. McArdle and Mr. Handley both have it wrong. Phenylephrine HCl is actually more effective than PSE and doesn’t give you the jitters or keep you awake at night, or have the effects on blood pressure. A better alternative in every way. And this is from someone who loved her Sudafed once upon a time.

            As for Nyquil — right, it doesn’t have the PSE in it. So buy a box of Phenylephrine HCl and take it with the Nyquil. Same effect. Done.

          2. I’m confused: assuming Betsy’s not wildly off base regardng its effectiveness, why doesn’t reformulated Nyquil already have Phenylephrine HCl in it?

            Looking at the active ingredients on Wikipedia, I see that Nyquil sells one formula with Phenylephrine, and another (their main brand) with Doxylamine; the latter contains Dextromorphan (an over-the-counter cough suppressant that worked wonders for me in generic form a couple years back when I had the flu from hell), but they don’t sell one with Phenylephrine and Dextromorphan. Is there a reason for that?

        2. Megan states:
          “the industry also basically admits that “unlike pseudoephedrine” the products that line the shelves don’t actually do anything, and people are purchasing them under the mistaken impression that they contain the decongestant that they have been using for years. Then they wonder why their sinus infection isn’t getting better.”
          Since this web site is framed on Senator Moynihan’s notion that “everyone is entitled to his own opinion, but not his own facts,” can Megan provide any facts or evidence that support her assertion that the industry basically admits that?

          1. This was basically the standard line from the industry until they realized that consumers didn’t know that the new product didn’t work, and would continue to buy whatever was on the shelves, at which point they got kind of quiet. But I’ve never heard a chemist–in the industry or out of it–defend the switch as neutral for consumers.

            Just to be clear, are you arguing that phenylephrine is not metabolized in the gut, and is just as effective a nasal decongestant as pseudoephedrine? Or are you just quibbling with whether industry has admitted that fact? I’ve certainly heard it straight from the horse’s mouth, but I don’t know what their on the record position is, since I never actually reported the PDE story directly, so fair enough, strike that line.

            The point remains that the reason people are buying stuff on the shelves is not that they are indifferent, but that they don’t know that the formula has changed, and that in oral/combination formulations, does not seem to do a very good job of decongesting people. If this were true of any other product besides PDE, would you be celebrating that companies had managed to gull consumers into choosing a less effective reformulated product?

          2. Megan McArdle and Brett Bellmore are right.

            For some people, psuedoephedrine works. I know one such person, and this person has had health scares when an allergy attack hit at night when no psuedoephedrine was available or when the month’s allotment was used up and the person could not buy it.

            I am going to state flatly that the potential for NON-MEDICAL users to abuse a substance should not even be considered in restricting the availability of a substance. If the cost of ensuring that someone who needs psuedoephedrine is that some other people engage in recreational activities that the federal government doesn’t approve of, fine, that’s the cost. The health of legitimate medical users of psuedoephedrine is not a “cost” to be traded off against some public policy goal; it should be considered a fundamental right to be able to be able to take medicine that treats your illnesses.

        3. Ephedrine isn’t an antibiotic. But then, what do you expect from someone who believes meat was unavailable in 1990s London?

  3. A prescription requirement would be harsh indeed for the rest of us – especially those without health insurance. Also, as far as I know, many meth addicts will smoke anything, bypassing pseudoephedrine, as chuchundra notes.

    1. I’m not sure what you mean by bypassing PSE. PSE is the key ingredient necessary to make the powerful variety of meth (d-methamphetamine) in small user labs, as well as the super labs of the DTO’s in Central California. The sustained Oregon experience demonstrates that when you effectively control PSE to preclude both domestic small user labs and internationally to shut down most PSE-based meth production in Mexico, you get significant and sustained declines in meth abuse.

  4. Keith, you write that a prescription requirement “virtually eliminates a state’s meth labs”, but even taking your graph at face value (and it would be nice to see the graphs for more than two states) what it shows is that a prescription requirement in a small number of states eliminates those states’s labs. However, Oregon and Mississippi aren’t surrounded by impenetrable walls, so if the production all got pushed into California or Missouri, that’s hardly a virtue. I don’t think it’s at all obvious that a prescription requirement everywhere would have the impact you suggest, rather than having people find another synthetic route.

    Moreover, I find myself agreeing with Brett here: this post (and the attitude it reflects) seems totally devoid of any cost/benefit analysis of the impact of depriving people who have colds of an effective decongestant (and no, phenylephrine is not an adequate substitute).

    1. As it turns out, Oregon and Mississippi have seen a lot less interstate PSE smurfing than you might suspect. There are likely a number of reasons for this, but one in particular stands out: Group smurfing doesn’t pencil out for individual smurfers if you have to travel very far.

  5. I have to be suspicious of the graph that seems to indicate zero meth labs in Oregon. I still see tweakers on a regular basis here, and I still see news reports about lab busts. I also hear frustrating stories of parents trying to buy cold medicine for their sick families, (there’s a nasty strain of crud going around right now) and getting hassled by the pharmacist or cops for daring to buy medicine for their kids.

    1. Oregon isn’t down to zero. We finished last year with nine meth lab incidents, mostly dump sites and remnants. In 2010 it was 13, as was 2009. Where we can trace the PSE, it traces to interstate smurfing. Also, PSE is contraindicated for young children. Finally, returning PSE to a prescription drug isn’t about getting rid of meth, it’s about getting rid of domestic meth labs.

  6. I too have to agree with Brett. I get colds, and like to have some real Sudafed or the like on hand. It beats going out to get it when I have a cold. So do I have to get an anticipatory prescription?

    Also, I have a question about the numbers. Even if NPLEx is useless at preventing meth labs from getting the products, it’s hard to see how it can lead to an increase in purchases. Why would that happen? Surely something else must explain the increases you describe in KY and SC.

    Looking at KY, there was actually a drop from 2005 levels until 2009, when the big jump started. Could that have more to do with economic conditions than NPLEx?

    1. As I explained above, NPLEx actually facilitates smurfing and a PSE black market. As to meth lab numbers, the entire nation experienced a big decline during the years mentioned, following the implementation of the federal Combat Meth Epidemic Act (CMEA), which moved all PSE products behind the counter with logging, ID, limits, etc. But those of us who understood PSE smurfing as it had developed in West Coast urban areas told them it would only be temporary. NPLEx is merely a highly advanced method of trying to enhance the CMEA. In other words, compounding a failure.

  7. All: How heavily the interests of people with chronic colds and sinus infections (a group which includes me) should be weighed can be debated in good faith. However you feel about that, NPLEx doesn’t work at all and it would not be reality-based to argue otherwise. That is the point of the post. What is happening is not that people are saying “I am choosing this ineffective system in order to make a principled stand on the rights of people with colds”; people are pushing it as a solution and voting for it as a solution to meth labs and it doesn’t work. I assumed in posting that libertarians about cold medicine still have the integrity to call a lie in this arena a lie, yes?

    Regarding Artor’s comment that there is still meth in Oregon is correct. PSE restrictions are to target labs, there will still be use (albeit about 1/3 less) from importation.

    Byomtov: NPLEx doesn’t cause an increase, it doesn’t make any difference one way or the other. Meth labs have been going up in many.
    localities, labs generate more customers which generates more need for labs etc.

    Last for PSE takers, just FYI: If you have high blood pressure or diabetes the medication can be dangerous for you, so ought to consult a medical professional whether meth is a concern where you live or not.

    1. Keith, you seem a decent fellow, but forgive me if I don’t give much credence to stats from the pro-drug war side of the fence. As a famous man once said, “Fool me once, shame on you. Fool me twice…you can’t get fooled again.”

      I have no idea what a “Meth lab incident” is how the data is collected and classified. It’s more than a little suspicious that you use a stat like that instead of something more concrete like arrests or hospital admissions for OD or such. Moreover, historical data from one state, or comparing two states, without accounting for other possible factors, proves absolutely nothing. I think you’ll agree that Kentucky and Oregon are fairly different and that there may some issues in comparing the two, especially over the last ten years.

      Lastly, your hyperbolic criticism of drug companies does your argument no favors. The idea that drug companies are making “big profits” selling off-patent cold medicine is dubious. The assertion that these drug companies are seeing significant revenue from meth labs buying cheap pseudo is ridiculous.

      1. This last I would definitely agree with. Pseudepinephrine is off-patent, and the only way a drug company could make “huge profits” off of it is if they were to find a way to exploit its contraband status by selling at an appropriately inflated price. I’m sure there are people doing exactly this, but I would be very surprised to learn that the companies that manufacture and package pseudepinephrine are among them.

    2. Going a step beyond, PSE raises blood pressure and heart-rate as side-effects. If your blood pressure is on the high-side of normal, you should not use it routinely.

      Speaking as another allergy/cold/sinusitis sufferer, I was able to stop using PSE entirely when I adopted a netti pot regimen to rinse things out.

      1. As one neti pot user to another, be sure to check out this link (if you’ve not already heard about neti pots and brain eating (well, neuron eating) amoebae)).

      2. Wonderful. I can exchange my PSE-induced jitters for either a placebo or for brain-eating bacteria

  8. Really, “I assumed in posting that libertarians about cold medicine still have the integrity to call a lie in this arena a lie, yes?” is rather disingenuous. As I observed above, you’re completely ignoring the possibility that prescription-only requirements ALSO won’t work in the general equilibrium case. I would suggest you go and reread your post and ask whether it doesn’t come off as an endorsement of prescription-only policies, which is what makes these issues relevant.

  9. “A prescription requirement would be harsh indeed for the rest of us – especially those without health insurance. ”

    Exactly. Your snarky, attitude, Keith, strongly suggests that you don’t see taking a few hours off to see a doctor — to ABSOLUTELY NO PURPOSE except to get a prescription — along with the $100 or so this “consultation” will cost as a problem. Not to mention the time issues here. A cold is something that lasts a few days — by the time you have managed to get your appointment and your prescription, you hardly need the medicine.

    I appreciate there is a real problem here on the meth side, but simply throwing out “well, force every one to get a prescription” without a single acknowledgement as to the realities — how long it takes to get an appointment, the time it takes to go through the appointment, the cost of the appointment — shows a breathtaking lack of concern with real America, every bit the equivalent of amazement at supermarket scanners.

    1. I’ve never had much use for George Herbert Walker Bush (though heaven knows his son made him seem like statesmanship incarnate by comparison), but the supermarket scanner story was a canard. Bush was attending a trade fair – not a supermarket checkout – where the very latest technology in supermarket scanners was being demonstrated; rather than merely note the price it displayed the name of the product and various other information. As is appropriate at a trade fair, Bush made comments praising what he was being shown; this was then reported as him never having seen a supermarket check-out scanner before.

      Given that he’d spend the previous decade surrounded by the secret service, and spent his entire adult life with a housewife who employed domestic staff, he might genuinely not have seen a checkout scanner before – but the incident cited to demonstrate this really doesn’t offer any such evidence.

    2. Oh, gosh, when will you conservative elitists get a clue about real America? The communities I work in are devastated by your anti-American policies. Meth labs thrive where Republican ignorance and anti-education policies and corporate idolatry in service of the conservative global corporate class have driven Real Americans into joblessness and despair.

      There were no meth labs just a few short decades ago, yet PSE was widely available. What’s changed is outsourcing and the shredding of public education and the rise of corporatism.

      Why do you hate America?

  10. “On the other side, the cold medicine industry, which makes hundreds of millions of dollars a year selling PSE to meth cooks, opposes such a restriction.”

    What an unbelievably nasty smear. First, you provide no evidence whatsoever that the cold medicine industry makes “hundreds of millions of dollars a year” selling PSE to meth cooks. To back that statement up, one would presumably need to know the per-unit profit margin to the manufacturers on PSE based cold medicines (which is likely not that high given the fact that its an off-patent medicine with low end-consumer unit costs and both wholesale and retail distributors standing between the manufacturers and the end consumers taking their own cut) AND the units consumed by meth labs.

    But perhaps you have facts to back this statement up that you’re not sharing here. So let’s set that aside.

    Its still a incredibly heinous charge to suggest, as you clearly do, that manufacturers of PSE based medicines oppose laws to make such medicines prescription-only BECAUSE there enjoy making money off of supplying meth labs. Such manufacturers make money off of supplying people with runny noses too. It would be perfectly legitimate for them to oppose such laws because such laws threaten their perfectly legitimate business of selling effective medicines to people who are helped by them. Indeed one could argue that the manufacturers of cold medicine have a legitimate beef against law enforcement agencies that can’t seem to get the meth epidemic under control and thus target what they can police effectively – the sale of Sudafed to old ladies with the sniffles.

    Another way to curb meth production would be to ban the teaching of chemistry in high schools and colleges. Presumably if some benighted legislator somewhere proposed such a law in would be opposed by administrators of high schools and colleges. And it may be technically correct to say “high schools and colleges, which make hundreds of millions of dollars in tuition income from teaching basic chemical technique to meth cooks, oppose the law.” But it would be a vicious and indefensible statement nonetheless.

    1. By the industry’s own admissions to Congress last year, they sell $600,000,000 worth of PSE products each year. I believe that number excludes Wal Mart, and possibly others, so I believe the number is actually closer to 1 billion each year. But the excellent fact checkers at the New York Times made me establish every assertion in my Op Ed some time ago:
      so I used the $600,000,000 number.

      1. Let’s use your high-end number of $1B. If indeed $1B worth of PSE products are sold annually, then its probably a decent assumption that manufacturers only take in $500M of that (the retailer and, if applicable, wholesale distributor can be expected to take a cut and 50% total mark-up is a good ballpark assumption for the magnitude thereof).

        So if manufacturers generate $500M in sales of PSE products, we need to know that profit margin on those sales. Absent access to inside information that’s a difficult number to get, but I would be VERY surprised if the fully loaded unit margins on off-patent pills were higher than 20%. That would get us to a $100M TOTAL profit pool on PSE products. Assuming that some portion of the volume of cold medicine is consumed by people with, um, colds – its hard to justify the statement that the industry “makes hundreds of millions of dollars a year selling PSE to meth cooks.”

        To do so we’d need to posit a world in which, mysteriously, manufacturers capture well over 50% of the revenue generated by sales of these products (a neat trick indeed given that most makers of fast moving consumer goods don’t), or that the unit contribution margins on such products is well over 20% (again – hard to believe; there are after all plenty of generics in the category) or that somehow meth cooks snap up the vast majority of unit volume.

        1. sd, then you might be surprised. The cost of bulk wholesale PSE from India and China is, relatively speaking, cheap, as compared to what the industry charges retailers for PSE products. Coupled together with LE estimates of 70 to 80 percent rates of retail PSE diversion to make meth, you have you numbers. Also, just as food for thought, with PSE products (legally and theoretically) harder to acquire in America since enactment of the CMEA, why have bulk PSE imports into America by the industry gone up 43 percent in the last few years?

  11. The problem would go away if there were better treatments than Sudafed. (I write as someone whose asthma seems to be triggered by rhinoviruses). Although the genomes of rhinoviruses havge been decoded, the common cold is very probably under-researched because pharma does not see it as a profitable target.

    Any cure has to be cheap – a one-off vaccine or simple pill. It’s an ideal testbed for the alternative approaches to the current and near-broken model of pharma research, like large prizes and open-source research. Anybody know a billionaire with a bad snuffle?

    1. The problem with rhinovirus as a drug target is that it doesn’t kill people, and most people cope without medication of any sort. Those calculations affect its profit potential, of course, but they affect other motivational calculations as well. If I heard of a truly impressive effort, well-resourced and run by brilliant researchers, that targeted rhinovirus I’d think it a pity, on the grounds that there were far worse maladies they could be targeting.

    2. The reason that pharma doesn’t spend much time on colds–at least as narrated to me by pharma researchers–is first, that viruses are really, really hard to target because they don’t do much, which means relatively few lines of attack; second, that there are about a zillion cold strains out there; third, that it’s very hard to kill a short-term virus like a cold faster than your body does; and fourth, that the hurdle for approval on a non-fatal condition is very, very high. You have to have great safety and efficacy, which means long testing times and big test groups, which means short patent lives. Unfortunately, people won’t pay $300 for a somewhat more effective cold treatment.

    3. I’d second the brief duration that Megan mentioned, and add that it’s episodic. If a lot of people had persistent cold-like symptoms, even if they weren’t crippling, the market would be there; chronic complaints where the person takes a pill every day for the rest of their lives are money spinners. That’s why there are drugs developed for hay fever, but not for the common cold.

    4. Anybody know a billionaire with a bad snuffle?

      Well, Sheldon Adelson definitely has some sort of nasal problem. He can’t even tell what a stinker Gingrich is.

  12. I’m sure that this is just my lack of experience in drug policy talking, but really, be honest, look deep into your heart and ask yourself this question: would we be seeing this ravaging meth epidemic all across the USA if marijuana were fully legalized?

    1. Yes, I believe so. In my neck of the woods, marijuana is readily available, much more so than meth. I also don’t know any current of former meth abusers who have said they wouldn’t have used (or abused) meth if they just had better (and legal) access to marijuana. Meth is a completely different drug than marijuana, and it has been my experience that, in many if not most cases, meth abusers use meth for different reasons than most folks use marijuana.

    2. I’m sorry but this makes no sense to me.
      What is your mental model here? Tweakers want to get high, and would use marijuana if they could, but it’s not available so they use meth instead?
      Is this even close to reality?
      (a) I’d imagine it’s a strange US city indeed where meth is easier to find than marijuana.
      (b) If these people are so happy just switching one drug for another, why not take the even simpler route of going to the local liquor store and buying a case of rotgut?

  13. Now that I think about it, if NPLEx is “enormously ineffective”, doesn’t this apply that the less strict CMEA is also ineffective, and therefore that all the inconveniences sudafed purchasers have had to accept for the past two years are basically a complete waste of time? Surely any “reality-based” argument should start from that premise.

    1. That is, in fact, true. Subtitle A of the CMEA (domestic PSE controls) was simply the latest in a very long and tragic line of ineffective PSE controls promoted by the industry. For those that desire some late night put-you-to-sleep reading, I wrote a law review article some years ago about that history:

  14. Keith, is there any research towards a technological solution? You can imagine the invention of a non-meth-lab-compatible “denatured Sudafed”. Find some harmless chemical compound which, if subjected to the not-too-selective meth-lab chemical processes, produces an unpleasant, unsmokeable/unsnortable byproduct. I’m sure a real chemist could get around this sort of thing, but if you could kill off the shake-and-bake synthesis, it would be worth something.

    1. You really want something added to your Robitussin that serves no positive purpose but when inappropriately treated is toxic or noxious? I don’t see the upside for the manufacturer, and the potential liability is gobsmacking – not only should the ingredient become activated somehow without the user deliberately interfering with the product, but in theory a drug user could even sue for damage caused by an ingredient whose only reason for inclusion was vindictiveness.

      1. This approach isn’t without precedent. Thousands were blinded and killed from drinking denatured alcohol.

        1. I’m sorry, you’re wrong. You can’t get rid of the last bit of water from ethanol by distillation, so it’s extracted with solvents to remove the water. This leaves contaminants making the product unsafe for human consumption. The contaminants aren’t specially added to deter consumption.

          1. During prohibition, manufacturers were required to add methanol to ethanol resulting in estimates of 10,000 or more deaths. Less lethal substances are still added to ethanol.

            Alcohol Poisoning

          2. I didn’t realize that poisonous additives were still in use; I’m a bit amazed. My experience is with ethanol in the lab; when I started working in labs as a minor, I was told for reasons of safety that if I were to steal and drink some of the ethanol from the 20-liter carboys we had on hand for histology, I should take from the 95%, not the 100%, because of contaminants – not additives – in the 100% (not that I would have done, it was the standard spiel for kids too young or poor to buy booze, just in case). You wouldn’t put up with additives in a laboratory setting, but you still shouldn’t drink the stuff.

          3. Labs and industry that require pure ethanol have to have a BATF permit. I suspect this also requires use and inventory record keeping that’s open to inspection. Pure ethanol can be purchased without a permit with the payment of a $13.50 per proof gallon tax (200 proof: $27.00 per gallon).

    2. There are currently two small pharmaceutical companies with industry expatriates working on ways to chemically preclude the use of retail PSE products to make meth. One is focusing on inert polymers, the other inert lipids. I am doing my best to help both, but history and science suggests that they face an uphill battle to achieve their goals. I wouldn’t ask anyone to hold their breath, but we will keep plugging away at that possibility.

  15. So how long, after a prescription system goes into place on a broad scale, before some subset of physicians decides to become overnight millionaires by offering a streamlined prescription process? Or is sudafed going to become scheduled as well as prescription-only?

    I wonder how much of the perceived effectiveness of pseudoephedrine comes from the blood pressure and cardiac effects. You can tell it’s working. (It’s also my impression that it dries out troublesome sinuses much more drastically than the pseudo-pseudoephedrine formulations, which may not be good for morbidity but once again provides proof of efficacy to the user.)

    1. paul asked: “So how long, after a prescription system goes into place on a broad scale, before some subset of physicians decides to become overnight millionaires by offering a streamlined prescription process?”

      It’s been almost six years in Oregon, and no such thing has occurred. I doubt it ever will: For a number of reasons, the dynamics of PSE and smurfing are not like pain meds, where pill mills pop up to fill the demand by pain med abusers.

      paul also asked: “Or is sudafed going to become scheduled as well as prescription-only?”

      PSE is a Schedule III controlled substance (and a prescription drug) in both Oregon and Mississippi. BTW, in Oregon and other places, long ago PSE was a Schedule II controlled substance, based on its pharmacology, and only went OTC by exception after the FDA monograph came out.

  16. You can’t get rid of the last bit of water from ethanol by distillation, so it’s extracted with solvents to remove the water. This leaves contaminants making the product unsafe for human consumption.

    For the most part you’re correct regarding the ethanol/water azeotrope (95% EtOH). The addition of a small amount of benzene was used to break the azeotrope, resulting in an anhydrous distillate containing residual benzene at ppm levels. For the most part, cyclohexane has replaced benzene for that purpose, due to the latter’s high toxicity.

  17. As somebody who has suffered from allergies for most of my life, I know how valuable pseudoephedrine is for a healthy lifestyle. Thanks to our government overlords I have suffered from recurring problems because of my lack of access to the drug. I know it’s impossible for people to imagine how such a simple drug can mean that much but it does and these increasingly restrictive laws have made my and a whole lot more allergy and cold sufferers suffer just a little bit (sometimes a lot) more.

    I don’t want people to do meth but I don’t want a perfectly safe medicine restricted from my usage either. When is the government going to stop trying to save us from ourselves?

  18. Blindingly obvious point here: just make it trivially easy to see a doctor (or better, a practice nurse) with your sniffle. Then make PSE prescription-only. Yr swamp, I haz drained it, without even charging for the use of the Caterpillar D-6 or my time as consulting engineer.

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