The meth makers: a prescription for pseudoephedrine abuse

The patient approaches. You see him coming and know what he wants before he opens his mouth. He arrives with cash in hand, driver’s license or state ID at the ready, scruffy t-shirt and jeans that look as unwashed as the wearer. The purchase is made. Five minutes later, the next person comes, another five minutes and the next, and the next. They travel in groups, these smurfs, sharing the same car, moving from pharmacy to pharmacy in search of single boxes of pseudoephedrine.

Some pharmacies, like that of your Intrepid Pharmacist’s are electronically linked so it is possible to see the individual’s purchasing habits within the same company. Hixson five days ago, Athens two days ago—a total of 24 days of drug. And here they are, still under the national legal limit, but with some three weeks of drug dose remaining. seeking more of that magical meth maker, pseudoephedrine. At, this point, your Intrepid Pharmacist (or a member of the staff) turns down the purchase request. A refusal that is always met with the same I-had-no-idea-I had-purchased-all-that expression of surprise. Five minutes later, the next one receives the same refusal for the same reason. (And they nearly always have state ID’s. Why is that? Who actually drove the vehicle?)

For many in Tennessee and the nation, methamphetamine is a relatively new entity, which most only became of aware of when they had to start showing their driver’s license and signing for the box of Sudafed, Claritin-D, or the like. A decade ago in Tennessee pharmacies, people would come in and clear the shelves of Sudafed. Some would purchase all they could—usually eight or nine boxes— while others would buy some and steal the rest. By 2003 a number of the state’s counties, such as Cumberland County (Crossville) already had required Sudafed to be moved behind the counter and had limited the number of boxes that could be purchased. That same year, and the next two, over 800 labs were seized per year, just in Tennessee. Your Intrepid Pharmacist was always amused when need called for a visit to the Cumberland Country courthouse back in those days. Notices from the head judge were plastered in the windows as you entered, requiring proper dress in the court room, and a shower to remove the “meth smell,” a scent that can only be described as citrus mixed with cat urine. The entrepreneurs among you may want to market this as a new perfume/cologne scent aimed at partiers who want to smell the part and “fit in” without actually having to ingest any drug.

Then, in 2005, the nation’s legislators, suddenly realizing the national epidemic facing America had nothing to do with testosterone use by athletes, stopped holding useless showy inquiries featuring big name ball players and enacted pseudoephedrine laws similar to those already in place in many Tennessee counties. The laws limited the amount of pseudoephedrine one could purchase within a 30 day span. They also required drug makers to bring an alternative meth-proof decongestant (phenylephrine) to the over-the-counter market. The result was an immediate decrease in the number of lab seizures, some of which were discovered once they caught fire or exploded (see video below). No longer could one purchase or steal the vast amounts of pseudoephedrine needed to make methamphetamine. These laws were challenged by attorneys, but upheld by the legal system.

Not willing to give up the lucrative, albeit dangerous and toxic home chemistry that is meth making, the home lab process evolved. (You can search for lists of quarantined meth lab homes here. Your Intrepid Pharmacist recommends sorting by county.) Groups of people, smurfs, were sent out to area pharmacies to make single purchases of pseudoephedrine. These faithful foot soldiers then pooled their boxes and took them back to the Papa Smurf, who did the meth making. As law enforcement cracked down further on home labs, the smurfs began to work out of hotel rooms and car trunks. Eventually, the process refined to a single serving “shake and bake” form, requiring only an empty sports drink bottle and small amounts of pseudoephedrine, but whose result could either be meth…or a rather spectacular explosion (see video below). The costs of treatment of such are beyond the time and scope of this column, but they do exist as do the costs of lab and home cleanup by hazardous waste teams (your Intrepid Pharmacist wasn’t being dramatic; it really is a toxic process). The new production formula has put the state on track for doubling the number of lab seizures made in 2008. And the parade of the prosecuted continues into September 2009. The issue and number have become so great, in fact, there is actually a meth offender database and whole websites devoted the dangers of the drug.

With meth labs in Tennessee again on the rise the question must arise: why is pseudoephedrine still available without a prescription? Some moves in this direction have been made in states like Oregon (2005) and a city in meth ridden Missouri, but, nationally, this product remains a constant problem. There is a proposed national bill, but little seems to have happened with it. And if such a law can work successfully in Oregon where meth lab seizures have dropped from the upper 400’s down to the teens, why haven’t Tennessee legislators enacted similar legislation?

Clearly the time has come for pseudoephedrine sales to be limited to prescription only. Hell, the time has passed. Are you listening legislators? You can always have the publicity garnering big name ball players back in time for next election season.