Your Intrepid Pharmacist is back after a much needed break and ready to hit the ground running. First up is a check in on Tennessee’s number one problem (of many): methamphetamine production. In 2010 Tennessee had the dubious honor of having more meth lab busts than any other state in nation (nearly 2,100 busts in 365 days or roughly 5.5 labs per day) and the most in the state’s history.
Readers of my previous columns (see recommended columns on this page) and those in the Tennessee Pharmacists Association (TPA) know that I have written previously about the dangers and costs of meth production via its base component pseudoephedrine and even successfully had a proposal brought before the TPA in early 2010 encouraging pharmacists as group to support making pseudoephedrine prescription only. Sadly for your Intrepid Pharmacist, the proposal failed as many in the TPA felt in spite of current conditions a better solution existed. (Spoiler alert: it does and you are going to read about it below).
While Mississippi followed Oregon’s lead and made pseudoephedrine prescription only in mid-2010, most southern states had not done anything of significance on the matter besides debate and argue. The record number of lab busts in Tennessee brought a good deal of debate within the 2011 Tennessee legislature, but we must thank the federal government for forcing real and significant action on the matter.
In late February 2011 the federal government, who had previously picked up most to all of the costs for meth lab cleanups decreed they would no longer pay for it. For those who have missed my previous columns on meth lab dangers (like exploding hotel rooms) and clean up costs that run between $5,000 and $20,000 per lab (depending lab on size and location), this is a significant amount of money the state would suddenly have spend. If we assume a low end figure of $5,000 per lab that means last year Tennessee would have spent (at minimum!) some ten million dollars on lab cleanup alone (that’s $5,000 by 2,100 labs). And in a time of fiscal shortfalls, such expenditures cannot be afforded. Put another way, that same sum would pay for 250 teachers at a pay rate of $40,000 annual salary. For those not sure no just how toxic the byproducts of meth production are to the real estate in which is it made can read an excellent summary here by the nice folks in Wisconsin.
Meanwhile, Georgia passed their own solution to the problem and made pseudoephedrine a class five controlled substance that can only be dispensed by the pharmacist in a pharmacy (not a technician, not a store manager, only a pharmacist). Tennessee decided for a different, and your Intrepid Pharmacist must say, a far more practical solution. Following heavy lobbying by the drug makers with a “stop meth not meds” campaign (catchy slogan, no?) the legislature passed unanimously SB1265/HB1051. This law, dubbed the I Hate Meth Act, will bring a live real time multi state database into the state’s pharmacies starting January 1, 2012. The database is the National Precursor Log Exchange (NPLEx for short), which has been in effect in Kentucky since 2005.
The elegance of this solution is that people who really need to buy pseudoephedrine for sinus problems will still have access to the medication with a valid state license. More good news: the aforementioned drug companies will be paying for the costs, so the state and its taxpayers do not have to spend limited dollars on it. The bad news is reserved for those who are hopping from pharmacy to pharmacy buying single boxes of pseudoephedrine for they will no longer be able to do so.
The database is a live real time system. So, if a smurf (those are the methlab foot soldiers who buy the base product, pseudoephedrine) goes into Rite Aid and buys a box of pseudoephedrine the sale will go through with no problem. Then, if they head across the street to Walgreens or CVS or stop in at a Bi-Lo or a local independent pharmacy and attempt to buy another box as they have been able to in times past, two things will happen. First, the live database will indicate that a purchase has already been made and block additional sale of the product and second, it will notify law enforcement of such a purchase attempt. Bearing in mind that smurfs are not the brightest pills in the bottle, they will no doubt make several same day or multiday attempts at obtaining the drug and these repeated attempts will establish a pattern for law enforcement to see the first alert was not an accident.
For once, Tennessee may see a happy ending to part of the drug abuse problems that plague this state, a happy ending that allows patients continued over-the-counter access to pseudoephedrine, blocks illicit purchase on a multi-location, multi-state level and does not cost the taxpayers additional money.