Drug Policy

Where Have All Our Cold Pills Gone?

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For years I've been fascinated (and frustrated) by the intricacies of state liquor laws, which vary widely in their dictates concerning what may be sold, when, by whom, and where. Now, thanks to the methamphetamine "epidemic," I have a new area of picayune regulations to study: state cold medicine laws. Yesterday the Office of National Drug Control Policy issued a report that details every state's restrictions on the sale of medicine containing pseudoephedrine, a cheap and effective decongestant that has the misfortune of also being a methamphetamine precursor. In an effort to curtail meth production by mom-and-pop labs, various state legislatures decided to start treating all pseudoephedrine users like criminals. Naturally, Congress copied the idea.

The federal law, which took full effect on September 30, requires retailers to keep cold and allergy remedies containing pseudoephedrine behind the counter or in a locked cabinet, forces buyers to show ID and sign a logbook, and limits them to no more than 3.6 grams a day and nine grams a month. Some states have no laws of their own, while others have laws that are more lenient or stricter in certain respects. The stricter rules always prevail, of course. In Arkansas, Indiana, Kansas, Kentucky, Maine, Minnesota, Missouri, New Mexico, North Carolina, Oklahoma, Oregon, Tennessee, and Wisconsin, for example, only pharmacies are allowed to sell pseudoephedrine, so if you have a runny nose when CVS is closed, you just have to suck it up.  Some states have especially strict quantity limits. The generous 3.6-gram-per-day federal limit allows people to purchase up to 10 12-packs of a daytime cold remedy similar to the old Vicks Dayquil, for example, while Alabama and Illinois insist that two packages are plenty.

The ONDCP cites declines in meth lab seizures as evidence that the peudoephedrine restrictions are working. But as state officials have acknowledged (and as anyone who was paying attention could have predicted), the decline in local production has not reduced the overall supply of meth, because the vast majority of it comes from Mexican traffickers who are not affected by the Dayquil crackdown and who were happy to pick up any slack. There is no evidence that forcing cold and allergy sufferers to register as suspected meth manufacturers has had any impact on meth consumption. The workplace drug testing data from Quest Diagnostics that the ONDCP includes in its report show no consistent pattern: In some states, amphetamine positives went up after pseudoephedrine was restricted, while in others they went down. Likewise for states that never had restrictions of their own. In Massachusetts, for instance, residents (and even visitors) were allowed to obtain congestion relief whenever they wanted, no questions asked, until the federal law took effect. Yet amphetamine positives in that state fell by 18 percent (from 0.33 percent to 0.27 percent) between 2005 and 2006. Since the Massachusetts approach seemed to work, I say the whole country should adopt it.

[Thanks to the Drug Policy Alliance's Bill Piper for the tip.]

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  1. BTW, yesterday was National Methamphetamine Awareness Day.

    I’ve got to say, that is one SERIOUSLY aware day.

  2. On the local news yesterday, there was a story about why people now have to show ID to buy any pseudo-ephedrine product. They showed some crank head testifying about the horrors of meth before the state assembly, and closed with scourge of home meth labs.

    During that last portion they gave the public a tip on how to identify a meth lab in your neighborhood. “There will be a strong smell of ammonia present”. I giggled to my girlfriend about how we’ll need to find something else to wash the floors with, before some busybody has the police kicking our doors in.

  3. This regulation also applies to PediaCare decongestants and cold remedies for small children. Try explaining this to a 2-year old (or their frustrated parents as well).

  4. they gave the public a tip on how to identify a meth lab in your neighborhood. “There will be a strong smell of ammonia present”.

    Well, either a meth lab or a crazy old lady hoarding cats.

  5. During that last portion they gave the public a tip on how to identify a meth lab in your neighborhood. “There will be a strong smell of ammonia present”.

    If they’re using the Nazi method (sodium/ammonia reduction). If they’re doing “red, white, blue” (iodine/phosphorus reduction) then it’ll smell totally different.

  6. I giggled to my girlfriend about how we’ll need to find something else to wash the floors with, before some busybody has the police kicking our doors in.

    I don’t think giggling is the correct response. It’s going to happen to people, someone innocent will get blown away by the local, state or federal storm troopers. Sorry, it just isn’t funny to me.

  7. About a month or 2 ago, here in Illinois, I went to buy DayQuil at the local Walgreens. Normally I buy the Walgreens brand generic version of Dayquil (its usually about 2-3 dollars cheaper).

    I had to go to the pharmacy desk, show id and have him log my name/address in some log book. That odd thing was that I only had to do that for the generic version. The actual DayQuil was just sitting on the shelves and could have been purchased without going through all that.

    When I asked the pharma assistant why I had to sign for the generic and but not the name brand he had no idea.

    I thought that was rather odd….(unless I suppose DayQuil removed the pseudoephedrine)

  8. joe’s comment made me lol!

  9. The only good thing (yes, good) about this mom&pop crackdown is the shifting of the waste byproducts from my backyard to south of the border.
    Of course, if amphetamines and analogs were still legally available at the drug store, Bayer or Merck or some large company would be producing them and dumping wouldn’t be an issue, either due to legal or tort imposed restrictions.

  10. ChicagoTom,
    Yeah, DayQuill is now formulated with Phenylephrine which SUCKS!!! I remember reading a study a while back regarding the properties of market available decongestants. It basically said that phenylephrine was not a market viable drug in light of its slow activity and higher dosages when compared to other faster acting and cheaper to produce decongestants. Sad how times have changed.

  11. So you’re a family of four with chronic allergy/sinus symptoms. That equates to 120# Claritin D 24hour a month or 240 # twice a day meds. You can purchase 10 days of meds at a time or 10 Claritin D 24 hour 0or 20 # of the 2 x a day meds. Your spouse has to do the same and you can’t get meds for your kids, they have to show up at the pharmacy window and need photo ID also. The law also states you have broken the law if you buy more than the allowed amount even if the meds are for your spouse, kids, sick parents, a sick friend. remember you have a maximum daily, and monthly allowance or you’ve broken a federal law (part of the Patriot Act actually, so you can be prosecuted as a “terrorist”). If your kids don’t have photo ID. if you visit multiple stores on th same day, Gitmo. This supposed family of four needs to physically go together to the pharmacy 3 times a month to get enough meds for their allergies. And of course you can only do that during normal working hours, so pull those kids out of school, spouse and you have to get off work 3 times a month forever.

  12. The Frontline documentary on meth gave some good insight into what the DEA is thinking with these restrictions on pseudoephedrine.

    It started with quaaludes which the DEA was able to effectively stamp out by banning the manufacture of methaqualone. Methaqualone was only manufactured in a handful of places around the world, so it was fairly easy to get those factories to stop.

    The feds actually tried to ban ephedrine and pseudoephedrine but this time the drug companies balked and was able to kill the legislation at that time.

    Here’s a partial transcript of the interview with Gene Haislip

  13. My dad, no fun-loving hippie, recently lost an employee to the state on a meth plea bargain. The employee was turned in on a tip from neighbors for having frequent visitors (since when is having a social life a crime); cops searched the house, found all the common household products needed to make meth, and arrested him. The “slam-dunk” evidence that forced him to take a plea bargain was that he had marijuana seeds in his trash can. The prosecutor gets another “meth-lab” in his column…..another productive member of society shipped off to the slammer. Meth laws suck, and I still have a runny nose.

  14. The DEA has done nothing to stop or even significantly reduce the drug problem in this country in it’s entire existence oh these 30+ years. If I had guys working for me that consistently failed at their jobs for thirty years, I’d find a new set of guys with better ideas not encourage the same idiots to keep making the same mistakes over and over.

  15. Chicken soup; get yerselves some chicken soup.

  16. Go with Zicam, it works fine and makes your cold lots shorter, if a cold is what it is.

    The Feds have been banning everything that works for years, my own complaint being DES and phenylpropanolomine, both of which stop incontenence in female dogs. PPA used to be a penny a pill in lots of a thousand, making it the most cost effective medication that ever existed, in fact.

  17. On the local news yesterday, there was a story about why people now have to show ID to buy any pseudo-ephedrine product. They showed some crank head testifying about the horrors of meth before the state assembly, and closed with scourge of home meth labs.

    It seems like the media got their marching orders. On my local news last night (KYW-3, Philadelphia) there was an under cover I-Team “investigation” about local pharmacies “breaking the law”. In one case the hidden video showed the clerk ringing up back to back sales of pseudoephedrine to defeat the programming in the cash register to limit sales of the drug.

    There was also lots of b-roll footage of SWAT Teams and their “dynamic entries”. An interview with a sad sack who had his life “ruined my meth” not “he ruined his life with meth”. And a 3 second obligatory soundbite from the other side: a gal complaining about the inconvenience.

    The segment ended with the reported urging viewers to check the stations’s website to learn more about the law so they can see if they have inadvertently broken the law by buyin too much snot medicine.

  18. “Well, either a meth lab or a crazy old lady hoarding cats.”

    Either way, isn’t it about time some cops break down their doors and start shooting? We can’t be too careful!

  19. y’all know that no cold medicine has ever been shown to reduce the duration or severity of a cold, don’t ya? Moving this useless crap behind the counter will, at worst, save some suckers a little money.

    If you want your cold to go away, stay in bed for 24 hours at the earliest onset of symptoms.

    If you don’t want to get a cold, keep your immune system healthy and liberally utilize Purell.

  20. y’all know that no cold medicine has ever been shown to reduce the duration or severity of a cold, don’t ya? Moving this useless crap behind the counter will, at worst, save some suckers a little money.

    They do reduce the impact of cold symptoms though, so they’re not useless crap to some people.

  21. It seems like the media got their marching orders.

    Yep, this shit always happens in sweeps months. Thank God it’s finally December.

  22. “y’all know that no cold medicine has ever been shown to reduce the duration or severity of a cold, don’t ya? Moving this useless crap behind the counter will, at worst, save some suckers a little money.”

    And this whole statement is completely untrue. Combination cold meds DO decrease the severity of upper respiratory infections allowing people to be at least functional, which saves the country billions in lost earnings potential. People can actually go to work, earn money, turn aout a product with no down time and they “feel” better. So no the whole statement is in error.

  23. If you want your cold to go away, stay in bed for 24 hours at the earliest onset of symptoms.

    If you don’t want to get a cold, keep your immune system healthy and liberally utilize Purell.

    Both wives tales. Washing your hands under running water alone (without Purell or soap) will decrease transmission of upper respiratory viruses, Purell when double blind tested does nothing significant, and unless you’re an AIDS patient you have a fully functional “immune” system and don’t need anything else to “keep” your immune system healthy.

  24. If you want your cold to go away, stay in bed for 24 hours at the earliest onset of symptoms.

    We’re not taking the meds to make the cold go away ya asshole, we’re trying to make the symptoms more bearable so we can do our jobs and pay our bills. Spend a little money to earn even more money. It’s called “economics”.

  25. Mr Oomigmak, if my wife followed your advice, she’d soon be out of a job (she’s a preschool teacher. Sometimes one wants or needs to reduce the symptoms, and who are you to call them “suckers” and to say they shouldn’t be allowed to?

    But hey, your folksy language is quite charming, so I’ll give you a pass.

  26. I find it really quite shocking that people get so upset and defensive when you question their basic beliefs and behaviors. Yes, quite shocking.

    Anywho, take a little time and do some research on Google Scholar. These medicines you’re wasting your money on aren’t doing one iota of good.

    Nothing I say or do is ever based on conventional wisdom or old wive’s tales. I live my life based on scientific evidence.

  27. Oomigmak – your “scientific evidence” is crap then. If you can’t see millions upon millions of people over 60+ years of sudafed use “feel” better than you need to open your eyes. “Cause that’s how long and how many people have been using and bought sudafed products. And you deny the physicians who routinely porescribe sudafed products to millions upon millions of patient everyday worldwide. So unless you’re right, every doc in the western world, and millions upon millions of people are wrong, ….then you have an ego problem….

  28. CVS closes now? When I was living in the US they were open 24 hours.

    Anyway, this sucks. I sure hope for you guys’ sake that things don’t go the way they are here in Germany. Here you can’t buy any drugs outside of a pharmacy. Not even a freakin’ aspirin.

  29. “porescribe” should be prescribe… and everything you have listed is an old wives tale….

  30. Over-the-counter cough syrups and drops do little to help recovery and could actually harm children, a US specialists group has said.

    The American College of Chest Physicians says the popular medicines have little impact on the underlying cause of coughing.

    “There is no clinical evidence that over-the-counter cough expectorants or suppressants actually relieve cough,” Dr Richard Irwin of the University of Massachusetts Medical School said.

  31. Hey Jose, use some common sense, your doctor prescribes these products daily, and cough suppresants are not sudafed, totally different medication.

  32. I don’t think giggling is the correct response. It’s going to happen to people, someone innocent will get blown away by the local, state or federal storm troopers. Sorry, it just isn’t funny to me.

    It was a contemptuous giggle.

  33. Bones – the question isn’t whether or not they “feel” better. It is whether or not they would have felt just as well without sudafed, especially if they thought there were taking sudafed. If you could find me one independent journal article that supports the conclusion that sudafed reduces the severity, duration, or symptoms of rhinovirus, then I will change my mind. I just haven’t seen it, and I’ve looked.

    Also, doctors recommend/prescribe medicines all the time just to appease their patients. Witness all the needless antibiotics presciptions written each year for the cold.

    Also, I do have an enormous ego, but that simply comes from being smarter than pretty much everyone else.

  34. Oomigak – again you’re wrong. I can go one better right now. Look at the OTC sales of sudafed, billions of dollars. It works for people and they buy it repeatedly BECAUSE it works, so there’s your evidence. And again you’re wrong, sudafed is a “symptomatic” medication, fixes nothing, so you aren’t going to study what it fixes just if it relieves “symptoms”, and the OTC sales are prima fascia evidence (for 60 years) that it works to relieve people’s symptoms.

  35. Nothing I say or do is ever based on conventional wisdom or old wive’s tales. I live my life based on scientific evidence.

    Hey, me too! That’s why I know that when I take psuedoephedrine, it displaces noradrenaline from storage vessels in my presynaptic neurons, and the displaced noradrenaline is released into the neuronal synapse where it is free to activate the aforementioned postsynaptic adrenergic receptors. This shrinks swollen nasal mucous membranes, reduces tissue hyperaemia, oedema, and nasal congestion, leaving me free to go about my life in the very likely circumstance that washing my hands like a normal person and not like Jack Nicholson in “As Good as it Gets” causes me to get a cold once a year or so.

  36. It was a contemptuous giggle.

    Cue Emily Litella, Never miiind!

  37. Oh and Oomigmak just for fun

    HAY FEVER

    Over-the-counter Sudafed works just as well as prescription Singulair in relieving nasal congestion caused by hay fever.

    The question: Allergic rhinitis, or hay fever, affects more than 40 million people in the U.S. each year. It’s caused by substances called allergens airborne pollens and mold spores that commonly trigger symptoms during the spring, summer and fall. Typical symptoms include runny nose, watery eyes and sneezing. Another symptom, nasal congestion, has been shown to be the hardest to control. Would a prescription medication be better at controlling multiple symptoms than an over-the-counter drug without causing unwanted side effects such as insomnia or anxiety?

    The findings: This randomized study involved almost 60 adults with ragweed allergy who took either over-the-counter Sudafed or prescription Singulair for two weeks to control their symptoms. Patients kept a diary to rate their symptoms daily during the study. Both Sudafed and Singulair were equally effective in controlling nasal congestion, sneezing and itching. In addition, patients took Sudafed in the morning and didn’t report an inability to sleep at night.

    Who’s affected: People with seasonal allergies.

    Caveats: Some of the researchers received sponsorship from Singulair manufacturer Merck. In addition, the company provided some funding for the study and contributed editorial suggestions during the preparation of the journal article.

    Take-home message: Patients who don’t get relief from over-the- counter medications should contact their physicians to figure out how to best treat their hay fever symptoms.

    More information: Visit the Web site for the Archives of Otolaryngology-Head and Neck Surgery at http://www.archoto.com; for more information on allergic rhinitis, visit http://www.aaaai.org.

  38. So, Bones, the fact that people buy sudafed is supposed to be proof that it works? Really? Is that your argument? Well, people have been using ground tiger penis in China for millenia to cure impotence or to produce a male child. I guess that must work, too. And bleedings, those work, too, right? Tons of people buy echinacea, so that must work, too, correct?

  39. Oomigmak – when you’re hungry you buy food right? Does it work? People buy everything, but (a) you’ve got to have the ability to buy the product, and in Imperial China you couldn’t buy sudafed, (b) unless you’re stupid you don’t buy something unless it works multiple times, (c) placebo accounts for 20% of any drug effectiveness, so even ineffective (tiger penis and echinacea) work 20% of the time, (d) sudafed went thru FDA testing and had to be better than 20% placebo effective to pass for salke in this country.

  40. And Oomigmak don’t address the Singulair article above or Shannon Chamberlain above, keep putting up strawman arguements for the sake of arguing.

  41. Oomigmak,
    You have just blown your statement completly out of the water.

    From your first link:
    “Symptomatic treatment with analgesics, decongestants, antihistamines, and antitussives is currently the mainstay of therapy.”
    and
    “Drug Category: Decongestants — These agents relieve congestion of nasal passages or sinuses.
    Drug Name: Pseudoephedrine (Sudafed) — Stimulates vasoconstriction by directly activating alpha-adrenergic receptors of respiratory mucosa. Also induces bronchial relaxation and increases heart rate and contractility by stimulating beta-adrenergic receptors.”

    While sudafed does not cure you of Rhinovirus it relieves the symptoms of it allowing you to function.

  42. When you are sick and go to any Western doc and have nasal congestion you probably will receive a prescription form of sudafed, when you have chronic allergies and go to any Western doc you will receive an antihistamine and it will probably be mixed with prescription form of sudafed. Now unless every Western doc is prescribing millions of doses of sudafed because it’s ineffective and they have some dark evil meth addiction plan – then almost every Western doc must think it works too…..unless you know better than all the medical schools, doctors, and the general population of the western world…..

  43. Oomigmak, Just some friendly advice, in this forum, you should get your ducks in a row or be prepared to post a Mea Culpa.

  44. My doctor used to assert that over-the-counter cough medicine was useless. Bottom line, he said, if it doesn’t have codiene you’re wasting your money. I’m a fan of Sudafed, though. I often have sinus problems and it makes the day bearable.

    Regarding the actual post, it’s an amazing coincidence that I read essentially the same story in the today’s paper: meth labs busts are way down, but meth possession and hospital admittances have stayed the same, due to the influx of cheap Mexican meth that is, regrettably, more potent than that produced by Yankee ingenuity.

    Minnesota prosecutors, however, have recently come out against longer sentences. From their official statement: “We’re not going to incarcerate our way out of this.” Of course, plenty of experts have been saying this for decades, and politicians have yet to take note, but it was nice to read a tiny bit of common sense in the paper for a change.

  45. unless you’re an AIDS patient you have a fully functional “immune” system and don’t need anything else to “keep” your immune system healthy.

    Bullshit, dipshit. If you think someone who works out 5 times a week, doesn’t smoke, always eats properly, gets enough rest and avoids stress has the same immune capacity as your average fatass, smoking, lazy, stressed-out alcoholic insomniac I have some ocean front property in Arizona to sell you.

  46. Bullshit, dipshit. If you think someone who works out 5 times a week, doesn’t smoke, always eats properly, gets enough rest and avoids stress has the same immune capacity as your average fatass, smoking, lazy, stressed-out alcoholic insomniac I have some ocean front property in Arizona to sell you.

    Ok Andy, where’s the property? The only dipshit is you.

  47. Kids:

    Here is our lesson on “investing.” Go to the drug store and say, “mommy’s real sick” and buy as much pseudofed as you can. Keep this up for as long as you can. When you can’t store the stuff any longer, locate your local meth lab, and make a hugely profitable sale. Your local kingpin will give you the respect you deserve, plus you’ll have made a nice little return.

  48. Correct me if I’m wrong. Once upon a time, circa 1965, amphetamines were routinely prescribed for weight loss, depression and othe maladies. No drug problems or crime problem caused by this admittedly overprescribed class of drugs were observed at the time. We have big problems now that require the citzenry to give up rights and conveniences.

    I’m Sooooo confused.

  49. You want to hear something crazy? I actually WROTE TO MY SENATOR (Feinstein) about this bill when it was proposed, asking her to please reconsider her sponsorship — something about punishing millions of law-abiding sick people in order to prevent a few dozen meth labs from using Walgreens as their safety stock (since their regular stock is already coming from illegal sources).

    I have no idea what came over me… I wasn’t hopped up on sudafed or anything. The response was as expected: a form letter thanking me for my support.

  50. Lamar: this would be a good cash job for illegal aliens!

  51. Correct me if I’m wrong. Once upon a time, circa 1965, amphetamines were routinely prescribed for weight loss, depression and othe maladies.

    Methamphetamine is still available as a prescription drug (Desoxyn) for weight loss and ADD-type behaviors. The only difference is that the prescription dosage is about 1/10 the street dosage, so if used properly you won’t get the same buzz or run the same risks of addiction.

  52. Captain Holly, It goes to show what I don’t know about speed. But at 5’11” 145 lbs, I figgered out that diet pills were not a good idea a LONG time ago.

  53. I gave cough medicine to my daughter when she was so young she could not possibly have known it was medicine. It worked. CASE CLOSED.

  54. J sub D | December 1, 2006, 4:26pm | #
    Correct me if I’m wrong. Once upon a time, circa 1965, amphetamines were routinely prescribed for weight loss, depression and othe maladies. No drug problems or crime problem caused by this admittedly overprescribed class of drugs were observed at the time.
    ===

    I actually remember those years, and I do recall demagoguery from politicians and others in the media. “Uppers,” “bennies,” “dexies,” etc., were seen as presenting important addiction problems (in much the same way as, for instance, Oxycontin is seen today), but not NEARLY the scourge upon the land as pot, heroin, and LSD, which were publicized as being the drugs of choice of the dreaded “flower power” and “antiestablishment” countercultures.

    Absent the ensuing drug prohibition against those “scourges,” we might not have seen the rise of crystal meth operations, which in turn sparked an authoritarian crackdown, which left us with this silly cold-remedy issue.

    Incidentally, in my household, we also found sudafed to be good for keeping congestion and related issues from blooming into full-scale sinus infections. Maybe it was just placebo effect, but I have to admit that the new stuff doesn’t seem to do as good a job.

  55. If you’re sincerely looking for the best cold remedy ever, check out Cold F/X. Currently available in the U.S. and Canada only.

  56. I get incredible thundering sinus headaches when the weather changes and a front comes through. Now, I can’t get the meds I need without being in some government database. These are meds taken since childhood, I’m not in a 40 year old trailer making meth, yet the political hysteria of the week means millions of us suffer.

  57. Phenylephrine just doesn’t work, on me at any rate. Or my son. This is one of the silliest things I’ve seen in years – Nyquil now doesn’t even contain a decongestant! (which makes it approximately as effective as if they had substituted phenylephrine for the pseudoephedrine.)

    Are there any efforts to roll this silliness back?

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