OPINION: Evidence backs making pseudoephedrine prescription-only to curb meth lab epidemic
Some folks may recall when pseudoephedrine (PSE) could only be obtained by prescription before 1976. Two things were missing back then: millions of office visits to obtain PSE prescriptions and the methamphetamine lab epidemic. Two states took advantage of this historical truth and returned PSE to prescription-only. The results? Not surprisingly, astonishing drops in meth labs and no strong objection from consumers.
Prescription laws target only the small number of PSE-containing decongestants that are located "behind the counter." Nothing "on the shelf" is affected. PSE is not in any pediatric formulas and is not ideal for seniors because it elevates heart rates. Current law limits and logs PSE sales to each consumer because PSE is the essential ingredient needed to make D-methamphetamine, a highly addictive version of meth often made in a 2-liter soda bottle that generates hazardous fumes, toxic waste and sometimes explodes.
After Oregon and Mississippi returned PSE to a prescription there was little to no public outcry because pharmacists and physicians coordinated the transition well for allergy sufferers, and cold sufferers never lost any options "on the shelf."
Prescriptions for allergy sufferers were called in to pharmacies or rolled into the next office visit and 6-month refills were offered for convenience. Co-pays made the drug even cheaper for those with insurance and the retail price - $6 - didn't change for those who did not. Based on Oregon Medicaid stats, extra office visits were rare.
In Oregon, the total annual cost increase to Medicaid was less than $8,000. Compare this to the millions of dollars for meth lab clean-up, police response, court costs, rehab, incarceration, child protective services, and follow-up social services that Michigan taxpayers absorb. Add to this property damage and the costs to regional transferring hospitals, fire departments, emergency medical services and the millions in meth lab burn care each year. Meth labs not only drive up the cost of health care, they clearly drive up taxpayer burden. Returning PSE to prescription status will alleviate much of this expense for Michigan, as it has for Oregon and Mississippi.
Since enacting the law in 2006, Oregon's taxpayers have enjoyed a sustained dramatic decline in meth labs and property crime rates plummeted to a 50-year-low. Similarly, Mississippi has enjoyed a 67 percent decrease in meth labs since enacting their prescription law last summer. The law's ability to curb meth labs is limited only by surrounding states that still offer over-the-counter PSE. This obviously makes a compelling case for the entire nation to return PSE to a prescription. It has also prompted drug companies to go on the offensive.
To prevent a major dent in profits, drug lobbyists distract lawmakers from PSE prescription legislation with electronic tracking systems like NPLEx/MethCheck that block excessive PSE sales by linking pharmacies in a database system. These systems force meth cooks to hire a workforce to buy legal limits of PSE. The buyers are often paid in meth, making more addicts, more cooks, and still more meth labs.
After implementing electronic-tracking legislation, meth labs increased 34 percent in Arkansas, 164 percent in Oklahoma and Tennessee led the nation with a record 2,082 labs. Kentucky has seen their meth lab incidents skyrocket by 248 percent since implementing MethCheck.
Despite the obvious failure of electronic tracking, drug company lobbyists have been successful at steamrolling MethCheck into law in several states over the protests of public servants who are left to clean up more meth labs with less money. Several states have recently enacted this disastrous legislation but have yet to implement it. State Sen. John Proos just introduced a bill that would mandate MethCheck in Michigan.
Sadly, meth labs have become an accepted norm in Michigan. In five minutes a meth cook can walk into a store and buy everything he needs to destroy himself, his family and neighbors. Meth labs have burned down homes and apartment buildings, blown up in hotels, and littered Michigan's roadsides and woodlands for years.
The fingers of the meth lab epidemic have extended from the southwest to Traverse City, Bay City, Jackson, Lansing and even the Upper Peninsula. This increasing public health threat requires effective evidence-based legislation rather than politics, and the research is in: the prescription law works. It always did.
Dawn Johnston lives in Kalamazoo and is a flight nurse.