Methamphetamine: Prescription-only or e-tracking systems?

June 15, 2010

Oregon's law requiring prescriptions for pseudoephedrine products practically eliminated its illicit methamphetamine problem. But some pharmacists, consumer groups, and the drug industry say that it will increase healthcare costs and inconvenience consumers. They think electronic sales-tracking systems would be a better approach.

Key Points

Oregon was in the midst of a methamphetamine war during the early part of this decade, with hazardous meth labs springing up in basements, garages, and kitchens across the state. By 2003, Oregon law enforcement officials were encountering, on average, 39 meth labs each month.

To restrict the illegal sales of products containing pseudoephedrine (PSE), the main ingredient needed to produce illegal methamphetamine, Oregon became the first state to pass a law requiring prescriptions for PSE products such as Sudafed and Claritin-D. The result? In a 3-year period following the rule, Oregon reported only 46 meth-lab incidents.

Real solution or quick fix?

"[Pseudoephedrine] is a valuable drug. You shouldn't have to call your doctor, wait two weeks for an appointment, then take off a couple of hours from work to get a prescription," said Fred Mayer, RPh, MPH, a Drug Topics editorial board member and president of Pharmacists Planning Service Inc., a consumer, public health, and pharmacy-education foundation in San Rafael, Calif.

Many but not all law enforcement agencies disagree. Some say that prescription-only laws are the only way to dismantle the illegal methamphetamine trade, as was demonstrated in Oregon.

The battle moves to Washington

The contentious debate over prescription-only versus electronic sales recently reached Washington, D.C., where members of the U.S. Senate Caucus on International Narcotics Control heard testimony for and against adding a prescription-only element to the federal Combat Methamphetamine Epidemic Act (CMEA) of 2005. The April 13, 2010, hearing co-chaired by Sens. Dianne Feinstein (D-Calif.) and Charles Grassley (R-Iowa) included testimony from pharmacists, consumer groups, and law enforcement officials.

Since 2006, CMEA has required states to regulate over-the-counter sales of pseudoephedrine and ephedrine products. It set daily limits on the purchase of these products and required pharmacies to place the products out of customer reach, to maintain sales logbooks, and to verify customer identification.

Smurfers muddy the waters

That approach worked until meth cookers began using "smurfers," criminals who go to pharmacies and retailers and use fake identification to buy illegal quantities of PSE products. Police say that using the log system mandated by CMEA to catch the smurfers is like searching for a needle in a haystack.

Using the information provided by e-tracking systems is not much better, they say, because the criminals don't use their real names. "In some states, such as California and Arizona, smurfing is well organized and has progressed into its own black-market industry," stated a 2009 position paper from the Advisory Board of the National Methamphetamine and Pharmaceuticals Initiative (NMPI), a group of federal, state, and local law enforcement officials and prosecutors with the mission of reducing methamphetamine crimes. According to the position paper, prescription control is "the only effective means to prevent illicit methamphetamine labs in the United States."