Just as allergy season revs up, a bill before the Colorado Senate would make pseudoephedrine commonly sold as Sudafed a prescription drug, to make it less available to meth cooks.
The cold medication used to be available on open shelves in pharmacies and grocery stores, near Benadryl, aspirin and vitamin C. Because it is used in making methamphetamine, its sale was restricted by law. The pills were pulled behind pharmacy counters, where purchasers must show identification and sign a log to obtain it. Those logs helped merchants and police differentiate between a person manufacturing meth and one simply suffering from a stuffy nose.
The measure, along with strict enforcement, worked. Almost all the meth found in Colorado now is imported from Mexico.
Because that country, also in an effort to crack down on meth, made pseodoephedrine available only by prescription, now the Mexican drug industry looks toward the United States for its supply. Procurers, called smurfers, cruise stores, buying small amounts in each one and hoping to escape notice. Those small amounts add up, though, and contribute to the flow of meth into the United States.
That is not, however, sufficient reason to severely limit access to a medication that so many use and so few abuse.
Pseudoephedrine has been judged by the FDA to be appropriate for over-the-counter sales. It treats a symptom most often associated with colds and allergies that dont require medical attention. The OTC substitute thats now available in its place doesnt work as well. Theres no medical reason that a person with congested sinuses needs to visit a physician just to get that prescription.
There are many reasons not to require an doctor visit. Physician time is a scarce resource, and this is a waste of it. In Cortez, its almost impossible for a new resident to find a doctor accepting new patients, and even those with a patient-provider relationship cant schedule an appointment quickly. The expense is substantial. Prescription fraud is a problem. And physicians arent necessarily the strictest gatekeepers: Witness the number of medical marijuana cards issued in Colorado.
Paying a pharmacist to fill a prescription for a drug anyone used to be able to grab off the shelf is expensive and wasteful as well, but its the pharmacist component that makes this idea tempting to legislators. Meth requires various components, most of them far easier to acquire than cold medicine, but the prescription system already exists and is available to be utilized by regulators. That doesnt mean that use is appropriate. After all, no one is considering making ice cream salt or nailpolish remover prescription-only.
Colorado is not a border state. No doubt some pseudoephedrine flows from here to Mexico; after all, a whole lot of drugs of abuse make the same trip in reverse. The more Texas, New Mexico, Arizona and California restrict pseudoephedrine, the more demand states farther north will see. Meth labs are becoming more prevalent in the Midwest.
Still, this law would restrict access by innocent people to a medication that, on its own, is innocuous. It would be interesting to learn what percentage of pseudoephedrine purchased in Colorado is used for its designated purpose vs. how much contributes to the states meth problem, which is undeniably severe.
Lets utilize the sign-out system more effectively before we involve physicians and pharmacists and make one more aspect of health care far more expensive and unwieldy than it needs to be.