OTCs in Action 17: Outwitting meth manufacturers


A few weeks ago, I was not allowed to purchase my tried-and-true pseudoephedrine cold & sinus medication because I did not have my new driver’s licence with me for identification. Surprised by the firm “no” given to the just-expired card still in my wallet, I meekly went back to the OTC shelves and chose an alternative.

PSE products were restricted to behind the pharmacy counter with ID required for purchase several years ago to reduce the OTC’s conversion into methamphetamine for illicit drug use. A couple of states have gone so far as to make PSE sales by prescription only. But two OTC manufacturers, Westport Pharmaceuticals and Acura Pharmaceuticals, are using science to make PSE safer. Their PSE OTCs, Zephrex-D and Nexafed, respectively, feature formulations that hamper the conversion of PSE into methamphetamine. Last week, Acura launched Nexafed Sinus Pressure + Pain (pseudoephedrine and acetaminophen), to give consumers the first combination remedy using this technology. This is important because, in some areas, meth-resistant are the only pseudoephedrine products permitted to be sold. “When Nexafed replaces traditional, non-meth-resistant PSE products in pharmacies, patients get the same relief they expect, but meth cooks have to look elsewhere for the older products they prefer,” Acura president Bob Jones said. “This has led to a significant reduction in local meth labs as documented by state and county officials in 2014.”

An article in Pharmacy Times this month supports Jones’ claim:

“After Nexafed became the only form of PSE available in the local pharmacies of 2 counties in Tennessee, law enforcement officials reported an 88% reduction in meth production labs in Campbell County and 90% fewer labs in Scott County. Similar findings were reported in West Virginia, where a 40% reduction in meth lab seizures was reported after a substantial number of retailers replaced conventional PSE product formulations with tamper-resistant products such as Nexafed.”

That said, the DEA’s National Drug Threat Assessment Summary 2013 indicates that methamphetamine abuse is stable – “amphetamine-related treatment admissions arw slowly but steadily declining. The number of new methamphetamine abusers (“past year initiates”) fluctuated but remained statistically similar from 2008 to 2011. The number of current users increased from 2010 to 2011, but also remained statistically similar and did not exceed the number reported in 2009.”

The disparity between local meth lab declines and stable usage rates is likely owing to increasing production in Mexico — the primary foreign source for the US market — and ongoing small-scale domestic production, according to the DEA. Methamphetamine prices decreased more than 70% between the third quarter of 2007 and the second quarter of 2012; during that time, methamphetamine purity increased almost 130%.

Obviously a problem of this magnitude will not be solved by a few OTC reformulations … but fewer meth labs as a result of behind-the-counter distribution and meth-resistant products is a start.

To see the original DEA report and the Pharmacy Times article, click on the links below: