Just a few short years ago, the title of this article would have seemed absurd. Why would the government want to restrict the sale of OTC medications that are used by millions of people to relieve sinus and cold symptoms?
Recently the Illinois state legislature passed a bill, which the governor signed, to limit the sale of cold medicines containing ephedrine or pseudoephedrine to 2 packages at a time. In addition, adult cold medications that contain the drugs as their sole active ingredient must be kept behind the counter or in a locked case.
This legislation was not enacted because of a concern for ephedrine overdose deaths, but because of an epidemic of clandestine methamphetamine production in the United States. Ephedrine and pseudoephedrine are key ingredients for manufacturing methamphetamine, along with such common household products as starting fluid, lithium batteries, and coffee filters. Farm fertilizer, like anhydrous ammonia or red phosphorous, also usually is needed to complete the recipe.
Methamphetamine is the fastest growing illegal drug in the United States, and it is the most addictive drug I have seen in almost 37 years of law enforcement. Crimes commonly associated with the abuse of this drug include domestic violence, child endangerment and abuse, and other violent felonies committed by paranoid offenders due to their abuse of methamphetamine.
Illinois reported 1099 clandestine laboratories in 2003, with the numbers increasing by well over 600% from 1994 to 2003. Missouri has seen more than 2000 of these labs in just the past year, and the epidemic continues to spread eastward in the United States. My state, Ohio, is very close to having 300 methamphetamine labs reported this year, a 500% jump from just a few years ago.
In Ohio, we in law enforcement thought that we were somewhat prepared, as we attended regional seminars in Illinois and tried to learn from the experiences of law enforcement agencies that had this problem. I testified on behalf of new legislation for stricter laws dealing with methamphetamine production, and we have all promoted extensive public education on methamphetamine abuse. Without these advance tactics, I am sure that the problem would be much worse. The issue of restricting cold medicines in Ohio is currently being discussed and may become reality in 2005.
Pharmacies have become the target of a new drug abuser, who does not want your controlled substances but wants to steal your cold medications. Although some abusers purchase these medications, I feel strongly that many of them steal the products. Typical methamphetamine "cooks" live for the high they get with this drug, and they do not have the income to support buying these products.
Once again, law enforcement needs the help of pharmacists. It is important that pharmacists report suspicious activity, which may mean only providing the license number of a person buying excessive amounts of cold medications. Such information has proven to be very valuable for law enforcement in the past and is part of the key to reducing methamphetamine production.
The restriction of the sale of these medications will likely put a new burden on pharmacies, because employees will be required to assist customers when they need these common OTC medications. The abuse committed by relatively few people negatively affects the majority of the population?but that is nothing new.
John Burke, director of the Warren County, Ohio, drug task force and retired commander of the Cincinnati Police Pharmaceutical Diversion Squad, is a 32-year veteran of law enforcement. For information, he can be reached by e-mail at firstname.lastname@example.org, via the Web site www.rxdiversion.com, or by phone at 513-336-0070.