A Prescription Should Be Required for Sudafed Because It Doesn't Cure the Common Cold


State and federal restrictions on the sale of cold and allergy medications containing pseudoephedrine, aimed at curtailing production of methamphetamine, have not had a noticeable impact on illegal consumption of the drug, which has been declining since the late 1990s. But by forcing cold and allergy sufferers to ask pharmacists for products they used to get off the shelf, making them sign logs so police can keep track of how much pseudoephedrine they are buying, and arresting them now and then when they accidentally exceed the government's arbitrary limit, these laws have at least wiped out all those nasty mom-and-pop labs, replacing them with professional, efficient cartels. Well, not quite. The Wall Street Journal reports that "a nationwide resurgence in illegal methamphetamine labs" has caused state and federal legislators to re-examine the effectiveness of the Sudafed crackdown. They plan to do what prohibitionists always do in the face of failure: double down—in this case by requiring prescriptions for a cheap, safe, effective decongestant that not long ago was readily available in convenience stores across the land. That requirement will force doctors to police Americans' pseudoephedrine consumption, encouraging them to treat every patient with a stuffy nose as a potential crank kingpin.

Jim Beilsmith, eastern director of the Missouri Narcotic Officers Association, thinks this is a swell idea. Bravely opposing "the pharmaceutical companies that make more than a billion dollars a year from cold relief medicines containing pseudoephedrine," Beilsmith offers several reasons why a prescription requirement is bound to succeed where quantity limits failed:

1) "Pseudoephedrine is the one ingredient that you must have no matter what method is used to produce [methamphetamine]."

2) "This is a fight that we can win."

3) "The cost associated with fighting the ongoing meth problem in money and human damage is far higher than any that can be associated with this legislation."

The first claim is simply not true, as I noted several years ago in Reason. In any case, the Mexican traffickers who supply the vast majority of the illicit meth consumed by Americans do not buy their pseudoephedrine at the drugstore, and they won't be begging their doctors for prescriptions either. These are strong reasons to doubt the second claim. The third claim is literally true, because the total costs of enforcing the laws restricting access to methamphetamine do outweigh the cost of this particular mandate. But I don't think that's what Beilsmith meant. Probably he meant that the harm caused by methamphetamine use outweighs the harm caused by requiring a prescription for pseudoephedrine, which would be relevant only if his first two claims were true (and if you accept his unspoken utilitarian and paternalistic moral premises). If, despite all these difficulties, Beilsmith still thinks this policy is worth a shot, perhaps that's because he assigns zero weight to the costs it imposes on consumers:  

The only thing pseudoephedrine does is keep your nose from running for in most cases about four hours that is all. It has no curative properties as most of the other ingredients in cold relief medicines.

And what's the value of that? As Beilsmith himself inadvertently points out, it's "more than a billion dollars a year."

More on pseudoephedrine restrictions here.

[Thanks to Mark Lambert for the tip.]