CHARLESTON, WV -- Supporters of a bill that would require a prescription for allergy medicine containing pseudoephedrine want consumers to know the law would not cause inconvenience.Instead, law enforcement officials say the law would lead to a dramatic decrease in meth labs across the state."We can't keep up with the meth lab crisis," said Detective Clark Green with the Kanawha County Metro Drug Unit. "If all it takes to help us with this problem is to put pseudoephedrine behind the counter, we need to do it."Supporters of making pseudoephedrine available by prescription only met with members of the Daily Mail editorial board
. The newspaper's editorial page has been reluctant to support that change.
Legislation has been introduced in both the West Virginia Senate and House of Delegates. Previous legislation has not passed, but Dr. Dan Foster, chairman of the Kanawha County Substance Abuse Task Force, said the bill introduced this session is different."It exempts products that have a minimal capability of being converted into meth," Foster said. "There are two now that are marketed here in local stores and available just about everywhere I think that have been shown to be effective . . . but have limited capability of being made into meth and are not desirable at all by those folks who purchase pseudoephedrine to make meth."The two medications exempt from the legislation are Nexafed and Zephrex D. Foster said those drugs have been chemically engineered so that, using current technology, only a fraction of the methamphetamine that can be made from traditional pseudoephedrine products can be made from the "tamper-resistant" products. As a result, those drugs yield only 5 to 30 percent of the meth that other products may yield, making it financially unsustainable for meth cooks to use.Although the bill is controversial and lobbyists representing the pharmaceutical industry have spoken out against Senate Bill 6 and House Bill 4170, Foster said two other states have passed prescription-only laws, as have other counties and municipalities in states across the country.
"There are two states in this country that have laws like this," Foster said. "They don't have the exemption because they were put into place before these products (Nexafed and Zephrex D) were marketed. Oregon was the first one in 2006, I believe, and then Mississippi passed their legislation in 2010 and was implemented in 2011."Counties in Missouri and Tennessee passed ordinances at the local level to require prescriptions for pseudoephedrine. Those measures have wide support, Foster said."I'm not aware in any of those jurisdictions where there has been any significant movement to undo it," Foster said. "It has been universally well received."Dr. Brad Henry, a physician in Charleston, called pseudoephedrine a "symptomatic drug," meaning it doesn't cure any illness and helps symptoms only minimally.
"It's an oral decongestant that provides maybe a 4 to 6 percent decrease in nasal congestion," Henry said.Henry is part of a two-person practice that treats about 4,000 patients, many of whom seem to have no problem with requiring a prescription for the drug."I'm a proponent of it being prescription-only," he said. "I have yet to have a patient in my office to really have a concern about that. It makes me wonder if this is the public outcry that's painted as more of a mirage. I'm not seeing it in my practice with the patients I discuss it with."
Henry corrected a common misconception with the legislation. One argument he hears often is that a patient must visit a doctor to get a prescription for pseudoephedrine, but that's not necessarily true. A patient with cold symptoms could call a doctor and ask the physician to call in a prescription to the pharmacy."The only products you can't call in are Schedule II products, which are your highly addictive medications and highly abused medications," Henry said.Another argument Foster said he hears often is about the NPLEx system, which monitors patients buying pseudoephedrine to ensure they stay within the legal limit. Foster said meth cooks find loopholes in that system and, once they reach their legal limit of pseudoephedrine, will find other people to purchase it for them — a technique called "smurfing.""NPLEx is the logging system . . . but it doesn't work because you're limited to an amount and have other people purchase it," Foster said. "If you look at Walmart figures that showed last February 600 transactions that month to 1800 in August, it went up almost on a linear basis. When they stopped selling the two most popular brands, Sudafed 12 and Sudafed 24, the transactions dropped to 200 the next month. That doesn't mean all of that was being diverted, but it's very suspicious."Lt. Eric Johnson with the Metro Drug Unit said law enforcement isn't trying to stand in the way of patients getting needed medications. But, he said, pseudoephedrine is one of the most common meth-making ingredients, and regulating it could help ease the problem in a variety of ways."I can't speak for all law enforcement, but I have yet to find a task force commander or police officer who would want to keep a necessary prescription medication away from anyone who needs it to ease pain or suffering," he said. "With the pseudoephedrine problem the way it is — the effects on the economy, effects on families, whether it is residential or in hotels — we have yet to see the adverse effects on our economy from the use of methamphetamine, and that's just financial."
The officers pointed out the legislation wouldn't make the meth problem go away entirely. Rather, it would decrease the number of mom-and-pop meth labs, which produced only about 1 percent of the meth seized by the Metro Drug Unit last year, so officials can concentrate on intercepting crystal meth being shipped from Mexico."You're going to have a meth problem, period," Johnson said. "You cannot force someone to stop being a meth addict. That being said, if we're getting Mexican crystal meth here and all the mom-and-pop labs go away due to making pseudoephedrine prescription only, our economy is better, our children are healthier. We do not have houses that are condemned and torn down, same with hotels and motels. There is less cost incurred to clean up those areas, the ones that can be salvaged. Our community is healthier overall."Green said a box or two of pseudoephedrine will yield only one to two grams of meth, which will "last a hardcore meth addict maybe a day.""They buy a little bit, the cook it up, they basically destroy whatever environment they're in at the time, they use it and by the time law enforcement is typically involved, there is no product left," Johnson said. "It's sold off or used almost immediately as it's made."