Should pseudoephedrine be by prescription only in Oklahoma?

[Conan71]

Guys, don't get upset with me.  I'm simply stating the reality that the days of pseudo is numbered.  The next big winner in the pill pushing game would be the company who figures out another med with identical results which can't be synthesized into something else.

The social costs of meth are mounting.

[heironymouspasparagus]

Maybe what is needed is a new recipe that uses sodium cyanide as an ingredient.  The issue will become self limiting.

[nathanm]

You still have to run a cost-benefits analysis of some sort with the issue. As Conan says, on balance the cost is greater to do nothing.

And we could stop the clandestine manufacture of meth tomorrow if we wanted to, but we'd rather spend money on prisons than drug treatment clinics.

[Conan71]

And we could stop the clandestine manufacture of meth tomorrow if we wanted to, but we'd rather spend money on prisons than drug treatment clinics.

How would you stop it tomorrow without getting rid of the precursor?  Drug and alcohol treatment is only effective on people who are truly ready to quit.

[nathanm]

How would you stop it tomorrow without getting rid of the precursor?  Drug and alcohol treatment is only effective on people who are truly ready to quit.

Maintenance is also treatment. Give them the drugs they're addicted to and they'll function better until they're ready to finally kick the habit.

[AquaMan]

Maintenance is also treatment. Give them the drugs they're addicted to and they'll function better until they're ready to finally kick the habit.

Just give them their Meth and wait for them to get better? That's the self limiting option mentioned above.

[Conan71]

Maintenance is also treatment. Give them the drugs they're addicted to and they'll function better until they're ready to finally kick the habit.

So your need for allergy relief trumps the need of someone needing life-saving burn treatment which may no longer be available near their home?

[nathanm]

Just give them their Meth and wait for them to get better? That's the self limiting option mentioned above.

Yes. The pharma-made meth won't kill them or anyone else, at least in the short term.

Conan, punishing one set of people for something another set of people is doing isn't terribly effective. The only thing that will happen if you completely ban pseudo in the US is that they'll start buying it from Mexican drug cartels again.

Also, I'm not sure that your assertion about causation is correct. From 2007:

The exact number of burn beds in the U.S. is a matter of dispute, and may well be overstated, because hospitals do not always distinguish between specialized burn beds and beds that are used for various traumatic injuries, including burns.

Wolfson said one recent report to the federal government showed that only 520 beds were actually available for use. Dr. William B. Hughes, director of the Temple University Hospital Burn Center in Philadelphia, said that more commonly, only about 300 beds are available at any one time.

Hughes said the United States had easily more than 3,000 dedicated burn beds in the early 1970s. But there has been a steady decline since then.

http://www.usatoday.com/news/health/2007-08-08-2713698343_x.htm

Sounds to me more like hospitals have come up with another excuse to use when they close burn units, given that the trend existed before "shake n bake".

So yeah, my need for sinus relief does indeed trump the need of someone to justify their unpopular decision by claiming it's all because of teh droogs. After all, how can you argue against the poor hospitals who have been trying so hard to keep these beds available that there were only 500 in 2007 but who just got bushwhacked by all the meth addicts burning themselves.

Edited to add: The best I've been able to find as far as a historical series goes is this: http://www.ncbi.nlm.nih.gov/pubmed/18182929

[Conan71]

According to the story in Huff-Po, Indiana only had 89 meth lab related injuries reported in a ten year period ending in 2009.  In the last 23 months, they've had 70 incidents.  This is largely due to the shake-n-bake method which has increased in popularity over the last 2-3 years.  I know it seems like meth lab fire reports in the news seem much more frequent now than they used to.  Certainly you aren't ignoring the crux of the problem for burn centers is net result is up to 1/3 of the patients in burn units are meth accidents and cannot pay for their treatment.  The net number of beds is irrelevant.  Burn treatment is expensive and if the beds are so limited in the range of 10 beds per state (that's highly suspect), then this makes the problem even worse. 

I didn't bother to count, but here's a 26 page list of burn units affiliated with ABA (American Burn Association). 

http://www.ameriburn.org/BCRDPublic.pdf

I notice that the Alexander Burn Center at Hillcrest is not on this list, so I'm assuming that not all burn centers in the US are affiliated with this association.

If tweakers want to get their meth from the Mexican cartels, fine.  By your logic if they can get meth by other means until they are ready to quit, at least it would help cut the number of meth lab explosions we are seeing as a result of this new manufacturing method.  Keep in mind, it's not just users who are being injured and killed in these explosions. Innocent neighbors and children of the cooks are also harmed.

The director of the burn center at Vanderbilt University in Tennessee, the state that led the nation in meth lab seizures in 2010, said meth injuries are doubly damaging because patients often suffer thermal burn from the explosion, as well as chemical burns. And the medical challenge is compounded by patients' addictions.

"You're not judgmental in this kind of work, but you see it day after day," said Vanderbilt's Dr. Jeffrey Guy. "We've had patients say, `I'm going out for a smoke,' and they come back all jacked up. It's clear they went out and did meth again."

Few people burned by meth will admit it.

"We get a lot of people who have strange stories," said Dr. David Greenhalgh, past president of the American Burn Association and director of the burn center at the University of California, Davis. "They'll say they were working on the carburetor at 2 or 3 in the morning and things blew up. So we don't know for sure, but 25 to 35 percent of our patients are meth-positive when we check them."

Guy cited a similar percentage at Vanderbilt, which operates the largest burn unit in Tennessee. He said the lies can come with a big price because the chemicals used in meth-making are often as dangerous as the burns themselves.

He recalled the case of a woman who arrived with facial burns that she said were caused by a toaster. As a result, she didn't tell doctors that meth-making chemicals got into her eyes, delaying treatment.

"Now she's probably going to be blind because she wasn't honest about it," Guy said.

In Indiana, about three-quarters of meth busts now involve shake-and-bake. And injuries are rising sharply, mostly because of burns, said Niki Crawford of the Indiana State Police Meth Suppression Team.

Indiana had 89 meth-related injuries during the 10-year period ending in 2009. The state has had 70 in the last 23 months, mostly from shake-and-bake labs, Crawford said.

What's more, meth-related burns often sear some of the body's most sensitive areas – the face and hands.

"I don't think a lot of these patients will be able to re-enter society, said Dr. Lucy Wibbenmeyer of the burn center at the University of Iowa. "They'll need rehab therapy, occupational therapy, which is very expensive."

Researchers at the University of Iowa found that people burned while making meth typically have longer hospital stays and more expensive bills than other burn patients – bills that are frequently absorbed by the hospital since a vast majority of the meth-makers lack insurance.

Medicaid provides reimbursement for many patients lacking private insurance, but experts say it amounts to pennies on the dollar.

Doctors at Bronson Methodist Hospital in Kalamazoo, Mich., performed a five-year study of meth patients in the early 2000s, then a follow-up study in 2009-2010. Their investigation concurred with the Iowa findings. The Kalamazoo study also found that meth burn victims were more likely to suffer damage to the lungs and windpipe, spent more time on ventilators and needed surgery more often.

That report also found that only about 10 percent of meth patients had private insurance coverage, compared with 59 percent of other patients. And in many cases, their injuries leave them unable to work.

http://www.huffingtonpost.com/2012/01/23/methamphetamine-burns_n_1222925.html

[nathanm]

If tweakers want to get their meth from the Mexican cartels, fine.  By your logic if they can get meth by other means until they are ready to quit, at least it would help cut the number of meth lab explosions we are seeing as a result of this new manufacturing method.  Keep in mind, it's not just users who are being injured and killed in these explosions. Innocent neighbors and children of the cooks are also harmed.

I agree that clandestine manufacturing of meth is a problem. I just don't think that forcing the supply chain through drug cartels is any better. Better for us, perhaps, but certainly worse for the Mexicans who have to live with them. Give the users maintenance doses in a controlled way and they won't need to cook or buy from a cartel. Everybody wins, except those whose thirst for punishment outweighs their desire to solve the problem.

[Conan71]

I agree that clandestine manufacturing of meth is a problem. I just don't think that forcing the supply chain through drug cartels is any better. Better for us, perhaps, but certainly worse for the Mexicans who have to live with them. Give the users maintenance doses in a controlled way and they won't need to cook or buy from a cartel. Everybody wins, except those whose thirst for punishment outweighs their desire to solve the problem.

That's also assuming you can get all users to go on the government program.  Hell most of them are so paranoid, I'd suspect enrollment in such a program would be really slim.  That is unless the black helicopters told them to. 

[custosnox]

That's also assuming you can get all users to go on the government program.  Hell most of them are so paranoid, I'd suspect enrollment in such a program would be really slim.  That is unless the black helicopters told them to. 

These are people willing to blow themselves up to get a fix, and you think if it's being handed to them they are going to worry that it's the government?

[Conan71]

Bottom line Custo, I just don't want you and Nate to get your Sudafed.

[custosnox]

Bottom line Custo, I just don't want you and Nate to get your Sudafed.

oh, we already knew this, your just a big ole meany. 

In any case, it's about more than just taking away my Sudafed (I rarely actually take it, this "winter" excluded), it's about this really being the wrong way to go about it.  While I don't know if giving them the drugs they are seeking is going to be the answer, we already know trying to keep it away by cutting of various supply routes isn't going to work.  I don't have the answer, but then, it's not my job to come up with the answers, it does seem though that those who's job it is, is coming up with the wrong answers.

[AquaMan]

Its been awhile since I checked. Just how effective are the methadone programs?