Just a few short years ago, the title of this article wouldhave seemed absurd. Why would the government wantto restrict the sale of OTC medications that are used by millionsof people to relieve sinus and cold symptoms?
Recently the Illinois state legislature passed a bill, whichthe governor signed, to limit the sale of cold medicines containingephedrine or pseudoephedrine to 2 packages at atime. In addition, adult cold medications that contain thedrugs as their sole active ingredient must be kept behind thecounter or in a locked case.
This legislation was not enacted because of a concern forephedrine overdose deaths, but because of an epidemic ofclandestine methamphetamine production in the UnitedStates. Ephedrine and pseudoephedrine are key ingredientsfor manufacturing methamphetamine, along with suchcommon household products as starting fluid, lithium batteries,and coffee filters. Farm fertilizer, like anhydrousammonia or red phosphorous, also usually is needed tocomplete the recipe.
Methamphetamine is the fastest growing illegal drug inthe United States, and it is the most addictive drug I haveseen in almost 37 years of law enforcement. Crimes commonlyassociated with the abuse of this drug include domesticviolence, child endangerment and abuse, and other violentfelonies committed by paranoid offenders due to theirabuse of methamphetamine.
Illinois reported 1099 clandestine laboratories in 2003,with the numbers increasing by well over 600% from 1994to 2003. Missouri has seen more than 2000 of these labs injust the past year, and the epidemic continues to spreadeastward in the United States. My state, Ohio, is very closeto having 300 methamphetamine labs reported this year, a500% jump from just a few years ago.
In Ohio, we in law enforcement thought that we weresomewhat prepared, as we attended regional seminars in Illinoisand tried to learn from the experiences of law enforcementagencies that had this problem. I testified on behalf ofnew legislation for stricter laws dealing with methamphetamineproduction, and we have all promoted extensive publiceducation on methamphetamine abuse. Without theseadvance tactics, I am sure that the problem would be muchworse. The issue of restricting cold medicines in Ohio is currentlybeing 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 tosteal your cold medications. Although some abusers purchasethese medications, I feel strongly that many of themsteal the products. Typical methamphetamine "cooks" livefor the high they get with this drug, and they do not havethe income to support buying these products.
Once again, law enforcement needs the help of pharmacists.It is important that pharmacists report suspiciousactivity, which may mean only providing the license numberof a person buying excessive amounts of cold medications.Such information has proven to be very valuable forlaw enforcement in the past and is part of the key to reducingmethamphetamine production.
The restriction of the sale of these medications will likely puta new burden on pharmacies, because employees will berequired to assist customers when they need these commonOTC medications. The abuse committed by relatively few peoplenegatively affects the majority of the population?but thatis nothing new.
John Burke, director of the Warren County, Ohio,drug task force and retired commander of the CincinnatiPolice Pharmaceutical Diversion Squad, is a 32-year veteran of law enforcement. For information, hecan be reached by e-mail at email@example.com, viathe Web site www.rxdiversion.com, or by phone at513-336-0070.