Pharma and the Damage Done
September 24, 2013 10:43 AM   Subscribe

 
I've only skimmed the article so far, but is the article advocating a return of pseudoephedrine to prescription-only status? Because that would be a terrible idea, and a huge pain to any of us with legitimate congestion problems.

Look, meth is bad, and the pharmaceutical industry is probably pretty bad in a lot of ways, but "Screw you, jerks with allergies!" isn't going to fix either of those problems.
posted by infinitywaltz at 10:48 AM on September 24, 2013 [6 favorites]


You could always tell that Elliot and Gretchen were the really bad guys.
posted by colie at 10:51 AM on September 24, 2013 [11 favorites]


more than 100 cold and allergy drugs made without pseudoephedrine, such as Sudafed PE, would have remained over the counter. And for those who didn't like those alternatives, doctors could renew prescriptions by phone.
Spoken like someone who's never actually tried Sudafed PE, or who has been congested at 7:05 on a Thursday night. Or who, you know, doesn't have an existing prescription.
posted by MrMoonPie at 10:54 AM on September 24, 2013 [13 favorites]


I mean, the author makes good points, but he undermines his argument. What else is he being all hand-wavey about, I wonder.
posted by MrMoonPie at 10:55 AM on September 24, 2013 [1 favorite]


I may be jaded, but I'll take legitimate businesses trying to protect their operations over the mendacious Drugs War rhetoric any day. I see from the article that social workers are having to take hundreds of kids into care: oh, that would be the Crack Babies argument, which we now know to be false - is it right this time? I see that we're talking about "commonsense legislation": sadly, in the Drugs War, there is no such thing as common sense, because making easily-obtained drugs illegal makes no sense. I see that we need to choke off the supply lines: yeah, that's worked swimmingly for other narcotics, putting profitable trade into the hands of criminal gangs that will kill and destroy governments and harm users to protect their profit margins - not perfectly-legally lobby politicians.

Add in that it's become easier and easier to create "designer" drugs from common materials at home, making it a game of whack-a-mole to make more and more substances illegal - except the fabulously lethal and violence-inducing poison alcohol, of course! - and I despair.

The correct policy response to drug abuse is harm reduction. How can we make sure that people making drugs do it safely and with minimum toxic side effects? How can we identify and help people to manage their drug use? How can we assist families dealing with addiction and self-destructive behaviour? But this response is nuanced, and difficult, and unfamiliar. So we take up the usual cudgels, even though they have failed time and again.
posted by alasdair at 10:56 AM on September 24, 2013 [19 favorites]


The callers were angry. If her bill passed, they said, they would have to go to the doctor each time they were congested. It wasn't true—more than 100 cold and allergy drugs made without pseudoephedrine, such as Sudafed PE, would have remained over the counter.

Or they could buy a Harry Potter wand and cast a magic spell against allergies! That would be just as effective as the entirely useless pseudoephedrine-free "medications" mentioned. Screw this article.
posted by enn at 10:56 AM on September 24, 2013 [22 favorites]


Spoken like someone who's never actually tried Sudafed PE,

Seriously. There's pseudoephedrine and then there's bullshit. Nothing else works.
posted by Bulgaroktonos at 10:57 AM on September 24, 2013 [15 favorites]


I just want to know why the hell I have to hand over my ID every time if it evidently isn't stopping people from getting enough to do this. It's like the TSA has moved into CVS.
posted by Sequence at 10:58 AM on September 24, 2013 [8 favorites]


Gutierrez also notes that having to get a prescription makes pseudoephedrine drugs more expensive to consumers, and that most meth in the United States still comes from Mexico. (Drug enforcement officials confirmed this, though none could give me an estimate of how much meth is domestically produced; some noted that locally cooked meth is often dominant in rural areas.)

Yeah, this is the main point right here as far as I'm concerned.

That said, it's got to be frustrating as hell to be in an area that's been hit bad by meth and have to listen to people from elsewhere griping about their allergy symptoms like that somehow carries equal moral weight.

I don't want to make pseudoephedrine prescription-only — because I don't think it'll be effective. But I totally empathize with the anger about it.
posted by Now there are two. There are two _______. at 11:00 AM on September 24, 2013 [4 favorites]


I see from the article that social workers are having to take hundreds of kids into care: oh, that would be the Crack Babies argument, which we now know to be false - is it right this time?

The "crack babies argument" was that the kids were brain damaged, not that they needed to be taken into care.

The former was proved false. The latter was very much true - they did mostly wind up in foster care.
As do meth babies.

And putting pseudoephedrine behind the counter means less running around with SWAT teams catching the people who buy it and cook it. Sorry. I don't enjoy being congested either when the wrong plants are having sex in my sinuses.
posted by ocschwar at 11:00 AM on September 24, 2013 [2 favorites]


Drugs, man, drugs.
posted by Mister_A at 11:04 AM on September 24, 2013


The net effect is strengthening organized crime. Small scale cooks became a problem after increasing regulation and reducing availability of pseudoephedrine. The medium scale local producers were mostly displaced by large scale importers, not tweakers in pickup trucks. As far as I can tell the meth problem is only worse and my sudafed is more expensive. Doubling down seems unlikely to fix the problem, only strengthening the business of cartels with functioning supply chains (who can acquire bulk precursors on the international market).
posted by polyhedron at 11:06 AM on September 24, 2013 [1 favorite]


Now there are two. There are two _______.: You want to talk about moral weight? My take-home pay is about $1200 a month and it costs me $75 to see the doctor right now. I could very well lose my job if I show up at work a snotty mess or just plain can't work. There are millions of people who live like this, which is many times the number of people who are currently meth addicts. I'm not saying that meth isn't a huge problem, but there's serious ethical issues with this solution, not just logistical ones.
posted by Sequence at 11:07 AM on September 24, 2013 [13 favorites]


And putting pseudoephedrine behind the counter means less running around with SWAT teams catching the people who buy it and cook it. Sorry. I don't enjoy being congested either when the wrong plants are having sex in my sinuses.

Only your stuffed nose can curb the police state!
posted by srboisvert at 11:13 AM on September 24, 2013


Any other guys had that seriously strange side-effect from pseudoephedrine where you go for a piss but semen comes out instead?

I nearly called a SWAT team myself.
posted by colie at 11:17 AM on September 24, 2013


I just want to know why the hell I have to hand over my ID every time if it evidently isn't stopping people from getting enough to do this. It's like the TSA has moved into CVS.

Check your receipt. It will have two lines on it that state how much psuedoephidrine you have bought this quarter.

My wife was denied cough medicine purchases in the U.S. for about a year after she bought some in Las Vegas to take back to the UK, where we were living at the time. Her guess is that the sketchy guy hanging around the counter ran through an even larger purchase on her ID with cashier assistance after she left. This must have taken her over some allowed purchase amount.
posted by srboisvert at 11:20 AM on September 24, 2013 [1 favorite]


Yes, let's deny people legitimate effective medicine so the phony "War on Drugs" can appear to be doing something. Excellent public policy, there!
posted by Mental Wimp at 11:21 AM on September 24, 2013 [3 favorites]


I could never figure out why High Times used to have all those adverts for bulk quantities of Ephedrine and Pseudoephedrine tablets back in the 80's.

The quantities did seem to be rather a lot for someone dealing with congestion, and none of the articles ever alluded to their use.
posted by PeterMcDermott at 11:22 AM on September 24, 2013 [1 favorite]


Oh my god I would be so fucked if I couldn't buy real pseudoephedrine at the store without a RX. My congestion gets so bad that I feel like I'm drowning and choking, throwing me into horrid panic attacks in the middle of the night and making me unfit for life during the day; NOTHING else works at clearing it up but pseudoephedrine.
posted by joan_holloway at 11:22 AM on September 24, 2013 [1 favorite]


Like everyone else says, Sudafed PE is a joke - simply does not work. And I'm not neccessarily a fan of making it prescription only. The hoops required to jump through to obtain the pills when you need them seem too onerous for law-abiding citizens.

What I'm wondering though, is the middle ground that we find ourselves at, with the pills behind the counter and purchasing limits - why isn't that working? What is broken about NPLEx? How is it not working (or alternatively, why does smurfing keep working?) Are the purchasing limits & time-frame so high or short that you can basically go buy another box the next day? Or is there no system that connects the pharmacies, so you can just go to all the CVS/Walgreens/Rite-Aids in town in a single day and buy a single box? What are cooks doing to get around NPLEx and what could we do to improve that system?
posted by ish__ at 11:24 AM on September 24, 2013 [2 favorites]


The "crack babies argument" was that the kids were brain damaged, not that they needed to be taken into care.

The former was proved false. The latter was very much true - they did mostly wind up in foster care.
As do meth babies.


And so, these hundreds of babies, how do they compare with the problem of children of alcoholics being tossed into foster care? Or should I not ask that question?
posted by Mental Wimp at 11:25 AM on September 24, 2013 [3 favorites]


with the pills behind the counter and purchasing limits - why isn't that working? What is broken about NPLEx?

A lot of meth is made in Mexico now so purchasing barriers in the US don't matter much.
posted by Bulgaroktonos at 11:26 AM on September 24, 2013 [1 favorite]


Ok, so we all agree that the meth addicts have ruined it for the rest of us. How about doing something about the meth addicts, then?
posted by Melismata at 11:26 AM on September 24, 2013 [2 favorites]


with the pills behind the counter and purchasing limits - why isn't that working? What is broken about NPLEx?

A lot of meth is made in Mexico now so purchasing barriers in the US don't matter much.


Then how would making psuedo prescription-only fix that? Or do script-only proponents disagree that the meth is coming from Mexico?
posted by ish__ at 11:27 AM on September 24, 2013


I tend to think easy availability of confidential drug treatment programs combined with aggressive harm reduction strategies would be more effective than the police state.
posted by polyhedron at 11:31 AM on September 24, 2013 [8 favorites]


Or they could buy a Harry Potter wand and cast a magic spell against allergies!

enn, I would like to buy your wand.
posted by Senor Cardgage at 11:34 AM on September 24, 2013 [3 favorites]


Then how would making psuedo prescription-only fix that?

Calvinist policies help politicians get re-elected, by getting tough on innocent people.
posted by Blazecock Pileon at 11:42 AM on September 24, 2013 [7 favorites]


Putting it behind the counter and limiting purchases isn't working because the people manufacturing meth have figured out how to work the system. I've talked about it with my pharmacist - they know exactly who the makers are, because they see them all the time. I don't know how they're working the system and I haven't asked because frankly, I'm afraid they'll think I'm doing research, but I'm guessing it's a system of fake IDs, using others to purchase their supplies, and carefully keeping track of which stores plug into a larger (national) database and which don't (because otherwise you could just go buy as much as was allowed at 20 different stores).

I'll start by saying, as with everything else, this is an attempt to address the symptoms without addressing the problem, but that's the way we do things. My thought is that the product we use (Zyrtec-D) used to be prescription only, and it wasn't any more of a pain to procure than it is now; less in some ways, because we could get a full month's supply, and it was always in stock. Now I might stand in line for 20 minutes only to find out they're out (unless I sneak up to the front of the line to look and see before waiting, which I've started to do, much to the annoyance of those in line). Also, if it were prescription, I could get it through my mail-order pharmacy like I do everything else and avoid the annoying line in the first place.

But like I said, this is treating the symptom, not the problem. The problem is people make meth; making the components harder to acquire obviously hasn't worked, so maybe it's time to try something else. I just don't know what that is, other than the obvious answer of ending the less-than-successful War on Drugs and thinking about options that might make Nancy Reagan a little uncomfortable.
posted by jennaratrix at 11:47 AM on September 24, 2013 [2 favorites]


From what I hear, most of the really good meth isn't coming from home cooks, anyway. Apparently it's mostly all coming from this one guy, and neither the DEA nor the Mexican cartels seem to be able to break his stranglehold on the market.
posted by infinitywaltz at 11:54 AM on September 24, 2013 [1 favorite]


Seriously. There's pseudoephedrine and then there's bullshit. Nothing else works.

Ephedrine works. It's sold behind the counter as Bronkaid. It just stimulates your central nervous system more. But yes, phenylephrine has been clinically proven to be placebo shit and is still advertised as "Pseudoephedrine Free!" as if it's a miraculous development that will shield all of the allergy and cold sufferers from that horrible meth gateway drug.
posted by WhitenoisE at 12:03 PM on September 24, 2013 [1 favorite]


Speaking as someone who lives in Mississippi, a prescription for Sudafed or whatever it used to be called is a Major League PITA. Imagine my surprise one day, when I really need some, and I only buy this stuff once or twice a year, and I can't find it on the shelves anywhere.

Me: (sniffling) "Where is the Sudafed?".
Pharmacist: "Oh you need a prescription now."
Me: "What?"
Pharmacist: "Blame the druggies and the gov't."
Me: "I have to go to the doctor to get Sudafed now?"
Pharmacist: "Or drive to Tennessee. Try this PseudoSudaFed".
Me (pondering the logic of having it prescription only here, but OTC 70 miles away): "Does it work?"
Pharmacist: "You can try it."
Me: "Umm..Nevermind"

*Also, for someone who tries to keep up with current events, I don't really know how I missed knowing about the "prescription" law here altogether. **I find it hard to believe the number of meth labs have dropped that much here.
posted by bellastarr at 12:04 PM on September 24, 2013 [1 favorite]


Apparently it's mostly all coming from this one guy....

You know, the thing is, I could be that one guy (I just get a kick out of working with people who have most of their teeth and whose idea of a doublecross is to take the last cup of coffee and not make more). Only I wouldn't start out with pseudoephedrine. That's the big myth of this front of the war on drugs - that you can't get there from any other widely available carbon containing compound (my choice would be toluene). And it's not like this shit isn't widely known (a casual Google for my intermediary of choice put me at erowid.org ("Documenting the complex relationship between humans and psychoactives") which gave me complete instructions for building a pretty impressive reactor. And surely there's at least one chemistry major out there who doesn't care about his coworkers' dentition.
posted by Kid Charlemagne at 12:14 PM on September 24, 2013


Putting pseudoephedrine behind the counter not only made it inconvenient to buy (perhaps you stop at the drugstore when the pharmacy counter's not open, or they're taking a lunch break, or there's simply a long line of people with complicated prescriptions ahead of you), it drove up the prices and reduced availability of some formulations and dosages.

I can't take the 120mg "extended release" formulation (which means none of the antihistamine combo versions work for me), and I'm cheap, so I probably get the stink-eye for asking for my drugs-that-let-me-breathe-and-keep-my-eardrums-from-bursting with "what's the largest box of 30mg generic that you stock?" This is generally a box of 96 tablets in blister packaging, for which I pay about $10.

If you have access to a college/university pharmacy, I advise stocking up there -- I used to pay $1.59 for a convenient bottle of 100 tablets. I would just buy a bottle every time I passed by on principle -- great bargain, and I never want to run out.

I don't even have especially strong allergies, but life without ready access to the holy antihistamine/decongestant/expectorant trinity is not something I want to contemplate. Breathing is super awesome.
posted by asperity at 12:15 PM on September 24, 2013


Hey all you whiners. You know what's done wonders for my allergy symptoms?

Meth.
posted by R. Schlock at 12:22 PM on September 24, 2013 [8 favorites]


That's the big myth of this front of the war on drugs - that you can't get there from any other widely available carbon containing compound (my choice would be toluene).

Or methylamine.
posted by infinitywaltz at 12:25 PM on September 24, 2013


The peril of getting your information from the wiki page for a TV show is that it doesn't mention that using methylamine as a precursor in real life is going to result in racemic methamphetamine, which is basically like cutting the good stuff in a one-to-one ratio with nasal decongestant (Vicks calls it levmetamfetamine on their packaging to avoid the stigma of the name).
posted by invitapriore at 12:41 PM on September 24, 2013 [2 favorites]


Party at invitapriore's house!
posted by cjorgensen at 12:43 PM on September 24, 2013 [3 favorites]


Hey guys I have another idea for curbing the negative and criminal effects of methamphetamine production in the United States. Can you guess what it is? Here's a hint: It worked with alcohol.

Making pseudoephedrine prescription only is bullshit. If I get a cold I need sudafed NOW. Not in a fucking week after I get an appointment. I might as well just wait it out at that point. And I'd rather buy some street meth and use that to clear my sinuses than the PE shit, at least the street meth actually works.

It may be apparent this topic makes me angry. You drug warriors have inflicted more suffering on the populace than anyone else in the last 30 years.
posted by Justinian at 12:49 PM on September 24, 2013 [1 favorite]


The peril of getting your information from the wiki page for a TV show is that it doesn't mention that using methylamine as a precursor in real life is going to result in racemic methamphetamine, which is basically like cutting the good stuff in a one-to-one ratio with nasal decongestant (Vicks calls it levmetamfetamine on their packaging to avoid the stigma of the name).

Or I could be a DEA agent masquerading as a "Breaking Bad" fan, and I just smoked you out. invitapriore is Heisenberg, folks! We got him!
posted by infinitywaltz at 12:52 PM on September 24, 2013 [2 favorites]


There's also, for some sufferers, relief provided by an OTC antitussin sold at many many stores and shops. *Note, this is not a substitute for Meth, meth is bad. This is for people coughing out lunghfuls of mucus.
posted by tilde at 12:52 PM on September 24, 2013


Responding to joan_holloway, "... throwing me into horrid panic attacks in the middle of the night..."

This reminded me of why I stopped taking pseudoephedrine. During one particularly strong allergy season, I found myself waking up in the middle of the night in blind panic, heart racing. It was so bad I went to the emergency room.

After a few more episodes, I tracked the attacks to days when I had taken sudafed*. I stopped the Sudafed, and I haven't had an attack since (though I do get some adrenaline elevation after two consecutive days of Claritin.

Probably totally unrelated to what you're experiencing, but I wanted to throw it out there for anyone with uncharacteristic panic attacks, fwiw.

For the great google data-machine, I'll also state for cross reference that I have a strong sensitivity to chocolate, keeps me awake for hours, in case that's relevant.


* And once with a Guaifenesin formulation that contained probably contained pseudoephedrine.
posted by chromecow at 12:52 PM on September 24, 2013 [1 favorite]


cjorgensen: "Party at invitapriore's house!"

infinitywaltz: "Or I could be a DEA agent masquerading as a "Breaking Bad" fan, and I just smoked you out. invitapriore is Heisenberg, folks! We got him!"

Unfortunately, they keep all the glassware and whatnot pretty well locked away from all us computer dorks where I work, so I won't be snatching a round bottom flask from the back room any time soon. It's probably for the best.

Now that I'm thinking about it, there's probably a way to isolate enantiomers from a racemic mixture like that, but I know shit all about it, since I'm not really a chemist. I just simulate the things.

Seriously. Not a chemist. NSA? Can you hear me
posted by invitapriore at 12:54 PM on September 24, 2013


I don't know, "Not a chemist" sounds like something a chemist would say. You better call Saul.
posted by infinitywaltz at 12:55 PM on September 24, 2013




I'm only part of the way through this article and already I'm gripped with terror that someone is going to take away my Advil Cold & Sinus.

Nothing else works for a sinus headache or a sinus infection. Nothing. I have tried everything else.

Before I had sinus surgery, I took that stuff constantly, because there were days I could barely function without it. I always used to joke that I was definitely on some list and going to get arrested for buying too much one day when I had a sinus infection....I guess I should be thankful I don't live in Indiana?
posted by inertia at 12:59 PM on September 24, 2013


asperity: "so I probably get the stink-eye for asking for my drugs-that-let-me-breathe-and-keep-my-eardrums-from-bursting with "what's the largest box of 30mg generic that you stock?""

Naw, I always say to the pharmacist, "Can I get some sudafed?" "Which one would you like?" "Um ... biggest box of the plain generic stuff I can legally buy?" "Sure, no problem!" I get the impression this is a pretty common request. I've also asked the pharmacist, "I bought a box of sudafed two weeks ago and then my husband used it all and I don't know if I'm allowed to buy it again yet? But I have a bad cold and my husband's out of town so I can't make him go get it for me." They can look and tell you how much you can buy (usually a lot).

I was like, "Sorry, now I sound like a meth-head," and the pharmacist was like, "Oh, no, if you were a meth-head we'd see you every three days, you'd never pick up other prescriptions, and you'd know exactly how much you were allowed to buy. If you're always in here picking up antibiotics for your kids and birth control and antacids, and you happen to hit the sudafed ceiling, we'll just tell you that and ask if you want us to call your doctor for a prescription. It's not a big deal. Just the fact that you fill prescriptions here pretty regularly means you're probably not shopping here for meth ingredients."

I was like, wow, this conversation has taken a weird turn, but GOOD INFO.
posted by Eyebrows McGee at 1:16 PM on September 24, 2013 [7 favorites]


(Also, it turns out that I am COMPLETELY WILLING to give up my privacy and live in a "papers, please" society to get some sudafed. Those who would trade liberty for security deserve neither, but what if I just want to trade liberty for some cold medicine? Is that okay???? I NEED MY SUDAFED.)
posted by Eyebrows McGee at 1:19 PM on September 24, 2013 [3 favorites]


Good news everyone! (I'm wayyy too tweaked to find the relevant MeFi FPP on this, but it has been done!) Since Sudafed is nearly impossible to find without filling out a ream of paperwork in triplicate, and Crystal Meth is widely available with no need to show ID across the street from almost every middle school, some kindly scientists have published the formula for how to synthesize Sudafed from Crystal Meth! Good luck! Ahhhhhhh-spiders.....
posted by Cookiebastard at 1:21 PM on September 24, 2013 [13 favorites]


...the pharmacist was like, "Oh, no, if you were a meth-head we'd see you every three days, you'd never pick up other prescriptions, and you'd know exactly how much you were allowed to buy. If you're always in here picking up antibiotics for your kids and birth control and antacids, and you happen to hit the sudafed ceiling, we'll just tell you that and ask if you want us to call your doctor for a prescription. It's not a big deal. Just the fact that you fill prescriptions here pretty regularly means you're probably not shopping here for meth ingredients."

Nooooooo! Do not introduce your impurities into MethaFilter's blue, 97% pure mix of self-righteousness, privileged victimhood and anecdata.

We need that shit, man. It keeps us tight.
posted by R. Schlock at 1:25 PM on September 24, 2013 [3 favorites]


I'm sympathetic to allergy sufferers, but I'm also floored by this line from the article: Since the bill became law in 2006, the number of meth labs found in Oregon has fallen 96 percent.

That is a dramatic decrease, but what I don't know is if the supply has ultimately changed. Does this mean that organize crime has filled the gap? If so then it doesn't matter much that people aren't running small time labs.
posted by dgran at 1:32 PM on September 24, 2013 [5 favorites]


Now that I'm thinking about it, there's probably a way to isolate enantiomers from a racemic mixture like that

If you can crystallize it, you can do it with a pair of tweezers. Otherwise, there is always chiral chromatography.
posted by Kid Charlemagne at 1:38 PM on September 24, 2013 [1 favorite]


It should be noted that benzadrine was a racemic mixture and nobody seemed to care too much.
posted by Kid Charlemagne at 1:39 PM on September 24, 2013 [1 favorite]


Yeah, I mean, I doubt your average buyer on the street is going to show up at the customer service desk complaining about the preponderance of levorotary methamphetamine in their crank, but surely from the producer's perspective, with all other things being equal you'd want to maximize yield on the active ingredient, no?
posted by invitapriore at 1:44 PM on September 24, 2013


dgran: "I'm sympathetic to allergy sufferers, but I'm also floored by this line from the article: Since the bill became law in 2006, the number of meth labs found in Oregon has fallen 96 percent.

That is a dramatic decrease, but what I don't know is if the supply has ultimately changed. Does this mean that organize crime has filled the gap? If so then it doesn't matter much that people aren't running small time labs.
"

Lots of little labs means lots of cleanups/fires/injuries/deaths. At least with one big lab, you've contained the risk to one place.
posted by double block and bleed at 2:24 PM on September 24, 2013 [1 favorite]


I'm not one for War on Drug theatre either, but I see a lot of tweakers here in Indiana. Meth does terrible damage to their bodies like no other drug. It's creepy when women in their early 20s who look like they're in their late 50s shake me down for drug money every time I walk into or out of the gas station.

I'm sorry that you can't live without your precious sudafed or that it would be a terrible inconvenience for you to have to see your doctor. There really are a lot of people ruining their fucking lives out here in the land you only see from your airplane window. Taking away easy access might not help those who are already hooked, but it will definitely cut down on the next batch of suckers.
posted by double block and bleed at 2:35 PM on September 24, 2013 [2 favorites]


Because oxycodone being prescription-only sure has cut down on addiction to THAT drug!
posted by joan_holloway at 2:41 PM on September 24, 2013 [3 favorites]


There really are a lot of people ruining their fucking lives out here in the land you only see from your airplane window.

I'm sure their lives will be immeasurably improved when their meth is the stuff produced in Mexican pharmaceutical labs by murderous drug cartels instead of locally sourced bathtub gin meth.
posted by Justinian at 2:45 PM on September 24, 2013 [4 favorites]


Yeah, I mean, I doubt your average buyer on the street is going to show up at the customer service desk complaining about the preponderance of levorotary methamphetamine in their crank

Yep, greater than 95% pure:
This may be accomplished by precipitating the amphetamine from ... which ... yields N-methylamphetamine, 1. In the majority of the samples obtained for this study, 1 was greater than 95% enantiomerically pure, with the S enantiomer being the major isomer present. This is consistent with reduction of commercially available ephedrine or pseudoephedrine is the origin of the casually procured material used in this study
posted by ambrosen at 3:21 PM on September 24, 2013


I'm sorry that you can't live without your precious sudafed or that it would be a terrible inconvenience for you to have to see your doctor.

Pennies a dose to breathe, or $80 for an office visit to breathe. Not breathing isn't much of an option, but I'd like to keep it to a manageable cost. I don't want to diminish the problems of addiction, but the heartbreak of a deviated septum is real, too. There has to be a solution that doesn't lay the costs disproportionately on those of us for whom "mouthbreather" as an insult kinda stings.
posted by asperity at 3:58 PM on September 24, 2013 [4 favorites]


All the blame here lies squarely on the drug warrior fuckwits. We'd push the tweakers onto doing another less harmful drug if any recreational drugs besides alcohol, nicotine, and caffeine were legal.
posted by jeffburdges at 4:39 PM on September 24, 2013 [1 favorite]


I think we're all overlooking one very important thing:
Any other guys had that seriously strange side-effect from pseudoephedrine where you go for a piss but semen comes out instead?
...
posted by colie at 2:17 PM on September 24 [+] [!]


OHMYGOD.WHAT.ICAN'TEVEN.
Is this a British English thing?
posted by mean square error at 5:54 PM on September 24, 2013 [1 favorite]


Easy solution: pass a law mandating that all pseudoephedrine products must contain a deadly poison, thereby making them useless to meth producers.

Problem solved. U.S. government, I am available for consultations at an exorbitant fee.
posted by kyrademon at 6:04 PM on September 24, 2013 [1 favorite]


mean square error, that is actually a not-unheard-of side effect of many stimulants. Do a Google search with your choice of prescription stimulant and you'll find people on health forums asking about it.
posted by invitapriore at 6:08 PM on September 24, 2013


There really are a lot of people ruining their fucking lives out here in the land you only see from your airplane window

Keep voting republican flyover country, it seems to be working out methtastic for you!
posted by any major dude at 6:20 PM on September 24, 2013


I'm not saying that you'd have to be on meth to vote republican... But some of the candidates they are fielding these days...
posted by el io at 6:23 PM on September 24, 2013


I was uninsured from 4 to 26, and I would have drowned in my own snot if Sudafed had been a prescription drug. Even once I had some kind of insurance through my first job that had benefits, I still couldn't necessarily get time off to go to the doctor.

And the PE does nothing except make my head hurt, which is not an improvement.
posted by dilettante at 7:47 PM on September 24, 2013 [1 favorite]


Some sort of universal healthcare system would no doubt be of great benefit in this situation. I can go to any walk in clinic and usually from about 20 minutes to 60 minutes later walk out with free samples or prescriptions for Cetrizine (known as Reactine in Canada) and Fluticasone (Avyms, though again, U.S. names may vary) to alleviate my allergies to common grass and ragweed, not to mention Hydroxyzine for post nasal drip and colds. I don't have to pay for the visit directly (taxes do that) and because I have no drug plan I often get samples and always get generics (when possible) at Costco. I haven't been prescribed anything with Pseudoephedrine in it for years but I do realize that different things either work or do not work depending on the person. I'm sure a prescription to Sudafed or something similar is easy to get.

When the allergy season starts I pop in, say I need something for the upcoming season, and I'm done.

I'm astounded at how difficult and costly visiting a doctor and getting a prescription can be in the States. What kind of country has jobs where you can't take a sick day or go to the Doctor's? Nasty environment to say the least.
posted by juiceCake at 8:34 PM on September 24, 2013 [2 favorites]


I'm astounded at how difficult and costly visiting a doctor and getting a prescription can be in the States. What kind of country has jobs where you can't take a sick day or go to the Doctor's? Nasty environment to say the least.

Yep.
posted by infinitywaltz at 8:43 PM on September 24, 2013


Sadly, they don't even sell the right dosage of pseudoephedrine at Costco. 120mg only, no 30mg tablets. Lack of access to health care really sucks. And then Costco compounds it with their "no sudafed unless you wanna bounce off the walls all night" policy.

At least they have stupidly cheap antihistamines. 365 tablets of generic Claritin for like $13. Living in the future, yo.
posted by asperity at 8:44 PM on September 24, 2013


Have you tried fluticasone? I know everyone is different but it works a treat for me. I can't take sudaphed because of a weird side effect. It makes me high as a kite.
posted by double block and bleed at 9:27 PM on September 24, 2013


Seriously. There's pseudoephedrine and then there's bullshit. Nothing else works.

Phenylpropanolamine worked pretty good and didn't have as strong a stimulant edge as pseudoephedrine, but there was that little problem of making women's brains explode.
posted by ROU_Xenophobe at 9:33 PM on September 24, 2013 [1 favorite]


PeterMcDermott: "I could never figure out why High Times used to have all those adverts for bulk quantities of Ephedrine and Pseudoephedrine tablets back in the 80's.

The quantities did seem to be rather a lot for someone dealing with congestion, and none of the articles ever alluded to their use.
"

Well, ummmm, in a prior job with bad hours, I used to keep, ummmm, a bottle of tablets of Psuedo/Ephedrine on hand. Not for cooking, but for keeping me awake.
posted by Samizdata at 9:37 PM on September 24, 2013 [1 favorite]


> There really are a lot of people ruining their fucking lives

Because they're caught making meth or because they're becoming addicted to meth?

If it's the latter, shake & bake might not be a big factor. The Oregonian's research, covered by Frontline:
when the purity of a drug goes down, use declines as well. People are less interested in using a drug. People who tried for the first time when it's weaker are much less likely to become addicted
If you look at the number of rehab patients vs. purity and diversion legislation, restricting ephedrine caused a steeper decrease in patient population than pseudoephedrine.

There's another chart with a longer timeline and more notes on the history of precursor control.

When my kid was younger & suffered more congestion and I ran up against store-imposed product-per-week limits (before California legislation those limits were lower) because I was also buying for myself and sometimes my wife, I thought it was so much ineffective bullshit. And it might be, but
In 2008, Oregon experienced the largest drop in violent-crime rates in the country. By 2009, property crime rates fell to their lowest in 43 years. That year, overall crime in Oregon reached a 40-year low. The state's Criminal Justice Commission credited the pseudoephedrine prescription bill, along with declining meth use, as key factors.
[from the Mother Jones article, emphasis added]

That's pretty dramatic and has me rethinking my grar. On the gripping hand, maybe the news about how fucked up meth addiction is has gotten out and scared people off.
posted by morganw at 10:21 PM on September 24, 2013


Justinian: "There really are a lot of people ruining their fucking lives out here in the land you only see from your airplane window.

I'm sure their lives will be immeasurably improved when their meth is the stuff produced in Mexican pharmaceutical labs by murderous drug cartels instead of locally sourced bathtub gin meth.
"

Sorry, you all. When it comes to meth, I am a locovore and I only want my crank artisanal...
posted by Samizdata at 1:00 AM on September 25, 2013


mean square error, that is actually a not-unheard-of side effect of many stimulants. Do a Google search with your choice of prescription stimulant and you'll find people on health forums asking about it.

Yeah, I began looking into it [in part because my wife and I are TTC and my breathing is dependent on pseudoephedrine, so I was worried]. Oddly, I am finding reports of pseudoephedrine both as a cause and as a treatment for that problem. I guess since I don't actually have that particular problem, I will not worry too much about it.
posted by mean square error at 3:02 AM on September 25, 2013


Have you tried fluticasone? I know everyone is different but it works a treat for me.

Sure, but it's a steroid, not a decongestant, and as such the effects are different. Nasal sprays are less useful if you have less-than-functional nostrils. Also, requires a prescription. Overall: potential alternative, not a substitute.

I imagine that many people with this kind of breathing problem as a long-term thing, rather than as something that you deal with once in a while with a cold or specific seasonal allergen, are pretty familiar with the options they have and know when and how to use each. We could certainly use more public education on the uses and effects of OTC drugs, and better packaging that makes it clearer what a given ingredient does and what conditions it's likely to treat.

FWIW, I get by on small doses of pseudoephedrine, taken early in the day as needed (wouldn't do to set myself up for a rebound effect). This isn't really possible with the combo drugs that include it plus an antihistamine, analgesic, expectorant, or whatever else, since pretty much all of those give you a larger dose than the (unfortunately) meth-making-friendly 30mg tablets.
posted by asperity at 8:14 AM on September 25, 2013


Fluticasone is for allergic rhinitis, not infections like a cold. Don't take steroids to treat infections!

see for example this study.
CONCLUSION: FP treatment does not have any marked effects on the symptoms of the common cold. FP treatment induced prolonged shedding of viable rhinoviruses. Some symptoms of the common cold were significantly more severe in subjects with pathogenic bacteria in the nasopharynx.
posted by Justinian at 10:56 AM on September 25, 2013


Another problem with fluticasone, for me at least: even though I have insurance, the copay for a month's supply is still $60.
posted by inertia at 11:00 AM on September 25, 2013 [1 favorite]


I can't imagine doctors wanting this go to Rx-only, because they would be stuck seeing patients for office visits so they could get some Sudafed, or calling in prescriptions to pharmacies for their patients.

And then inevitably, some super great awesome health insurance company like mine, would decide that they won't cover pseudoephedrine without prior authorization, or unless the patient had tried some other cheaper, useless medication like Sudafed PE, causing doctors and their staff to have to spend even more time on the phone with insurance companies arguing for COLD MEDICINE.
posted by inertia at 11:11 AM on September 25, 2013


1. Offer freely dispensed meth heroin cocaine and other drugs with strong propensity for tragic addiction to residents living in the mothballed but ready to roll KBR internment camps. (stay as long as you like, have all the drugs you want, just can't take the drugs out of the camps. Aim for 1-2 star accommodation level-your own tent but communal bathrooms) Offer gov't paid transportation to the camps from all points in the US
2. Give KBR a gov't contract to build rehab facilities accross the street from each camp. rehabs will be staffed and run by by religious/non profit orgs. You can cross the street as often as you like.
3. rid the streets of hard core addicts, and slash the WOD budget by 90+ percent. Transfer all DEA agents to the SEC where agents compete for 6-figure bounties for all fin-crimes successfully prosecuted
posted by Fupped Duck at 1:14 PM on September 25, 2013 [1 favorite]


1. Offer freely dispensed meth heroin cocaine and other drugs with strong propensity for tragic addiction to residents living in the mothballed but ready to roll KBR internment camps. (stay as long as you like, have all the drugs you want, just can't take the drugs out of the camps. Aim for 1-2 star accommodation level-your own tent but communal bathrooms) Offer gov't paid transportation to the camps from all points in the US

This is essentially the function of many parts of big cities these days. Bunny's remake of Hamsterdam on The Wire was essentially this idea.

The problem I have with it is that the majority of users of meth/cocaine/heroin/other drugs are otherwise law-abiding citizens who don't create a problem for society, just as the majority of drinkers are. This WOD-driven vilification of anyone who uses drugs seems to have crept into your solution. This myth is the largest impediment to rationally discussing drug policy.
posted by Mental Wimp at 8:57 AM on September 26, 2013 [1 favorite]


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