New Law Puts Pseudoephedrine Behind Counter


Over-the-counter drugs containing pseudoephedrine will go behind the counter beginning in late September under a new law passed by Congress and signed by President Bush.

The Combat Methamphetamine Epidemic Act of 2005—passed as part of the reauthorization of the Uniting and Strengthening America by Providing Appropriate Tools Required to Intercept and Obstruct Terrorism (USA PATRIOT) Improvement and Reauthorization Act of 2005—requires consumers who wish to purchase pseudoephedrine-containing over-the-counter medicines to show photo identification and sign a log book. It also limits the amount of pseudoephedrine-containing products that can be purchased to 3.6 g per day and 9 g within a 30-day period.

Rep. Roy Blunt (R-Mo.), one of the supporters of the legislation, said the new law will help combat methamphetamine abuse. “Easy access to common cold medicine is a meth cook's dream come true,” Rep. Blunt said in a statement. “The most effective way to fight the meth epidemic is to make it harder for criminals to get the key ingredient in the production of this deadly drug.”

Dr. Punyamurtula S. Kishore, an addiction medicine specialist in Chestnut Hill, Mass., agreed, although he noted that it wouldn't solve the problem completely. “[Pseudoephedrine] is the chief ingredient in the whole cooking process,” said Dr. Kishore. “Any controls are good controls.”

Dr. Maurice Ramirez, an emergency physician in Orlando, Fla., and a drug-testing professional for the Nuclear Regulatory Commission regulated industries, said that one reason cold medicines are being put behind the counter is to reduce the number of addicts who buy raw materials for their suppliers. “When you're taking meth, you look like you have a cold anyway, so the addicts buy a cartload of cold medicines and credit it against their account at the pusher,” he said. “It's foolish for [manufacturers] to go to the store and get their own pseudoephedrine, because they know that's where people are watching.”

Dr. Ramirez noted that the law also applies to sales of cold medicines on the Internet, which is one way many suppliers get them. “Many can just buy it over the Internet in large bulk amounts if they have a solid address and can generate the appropriate fake paperwork. It's harder to get the ammonia you need than it is to get cold medicine components. That part [of the law] is to counter crime and I think that's appropriate,” although it doesn't solve the problem of demand for meth.

Not everyone was as supportive. “This will not solve the problem,” said Dr. Akikur R. Mohammad of the psychiatry and behavioral sciences department at the University of Southern California, in Los Angeles. “It's easier to make meth with ephedrine and pseudoephedrine; if you take those medicines off the shelf, it makes [addicts'] lives harder but it doesn't mean they can't make it.”

Instead, said Dr. Mohammad, who is also medical director of Malibu Horizon, a residential substance abuse treatment facility, “We have to educate people that addiction is a disease, that it can cause problems with health. And when people are addicted, we have to aggressively treat them.”

Bill Piper, director of national affairs for the Drug Policy Alliance, a Washington-based group that emphasizes treatment over criminal prosecution for drug addicts, agreed. “I don't think it's going to have any impact,” he said. “It's not going to reduce the availability of methamphetamine, nor is it going to reduce the number of people addicted to meth. At the most, all it's going to do is reduce homemade meth.”

Laws similar to the Combat Methamphetamine Epidemic Act have previously been enacted in several states. In response to the reduction in available homemade methamphetamine, “Mexican-based drug cartels moved in,” Mr. Piper added. “As long as demand is there, there is going to be a supply.”

If addicts don't buy the meth directly from a cartel, there are ways to cook it without using cold medicines, although it is more complicated without the ephedrine or pseudoephedrine, Dr. Mohammad said. “Now they will have to turn to people who are more educated and have more knowledge in chemistry.”

The Combat Methamphetamine Epidemic Act also included other provisions related to helping meth addicts and their families. Mr. Piper pointed to one provision sponsored by Rep. Sheila Jackson Lee (D-Tex.) that creates grant programs to establish treatment centers for parenting and pregnant women.

“Generally speaking, most drug users tend to be men, but when it comes to meth, about 50% are women,” he said. “There is a huge lack of resources for drug treatment for women, especially women with children. If you are [being treated] in-house, you can't bring your child with you, and if you are an outpatient and you don't have child care, it's much more difficult.”

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