Should pseudoephedrine be by prescription only in Oklahoma?

[Conan71]

OKLAHOMA CITY - Three major state medical groups have come out against a proposed restriction on the sale of the allergy medicine that is a key ingredient in most Oklahoma methamphetamine labs.


The Oklahoma State Medical Association, the Oklahoma Osteopathic Association and the Oklahoma Academy of Family Physicians all have taken stances against proposals to make pseudoephedrine a prescription-only drug.

Advocates for the idea argue that it will reduce the number of meth labs in the state, but the physician groups say it will fill physicians' offices with people who don't need to see doctors and it will keep others from using a drug that the federal government has determined is effective and safe for over-the-counter sales.

"We agree that methamphetamines are a huge problem for the state, we just think this is the wrong way to go about fixing it," said Dr. Russell Kohl, legislative co-chairman for the Oklahoma Academy of Family Physicians.

"We don't think that the reason for the methamphetamine problem is the availability of pseudoephedrine," Kohl said. "There's just not good evidence that this is effective and it's going to be a huge inconvenience to the law-abiding citizens who are using it correctly."

Awesome! What is the good doctor's idea on the proper way to curb this scourge?  Again, the idea of clogging doctor's offices is complete hyperbole. People who have chronic allergies can get a prescription once a year on their annual check up.

[DolfanBob]

Yet leave it to Oklahoma lawmakers to make it a big deal, like eating fetuses and Sharia Law.   

Well they have to stay relative. Geez !

[jamesrage]

Should pseudoephedrine be by prescription only in Oklahoma?

No it shouldn't be prescription only.It cost money to go to a doctor. What they should do is make you sign for two worth of pills and that info is kept in the database which all the pharmacies keep track of and if you try to get some more before the two weeks is up then they should require a prescription from a doctor.Just to alleviate any privacy concerns the information in the database should only be kept for three months from the date of the last purchase of pseudo-ephedrine drugs.

[Conan71]

No it shouldn't be prescription only.It cost money to go to a doctor. What they should do is make you sign for two worth of pills and that info is kept in the database which all the pharmacies keep track of and if you try to get some more before the two weeks is up then they should require a prescription from a doctor.Just to alleviate any privacy concerns the information in the database should only be kept for three months from the date of the last purchase of pseudo-ephedrine drugs.

James, do you have the slightest clue how much of your tax money is going to clean up meth labs, to house meth cooks in prison, and to pay for uninsured visits to the burn ward?

Uh, other than the prescription part, that's how it's done now, only it's a 30 day supply I believe.  It's a failing proposition.  If you have a legit allergy issue, your doctor can issue 12 month prescriptions to be dispensed 30 days at a time.  Everyone should have a once a year check up anyhow.

This is hardly the hardship everyone is making this out to be.

Another alternative is they could eliminate it in tablet form since apparently the gel cap form is not a good precursor.

[Hoss]

James, do you have the slightest clue how much of your tax money is going to clean up meth labs, to house meth cooks in prison, and to pay for uninsured visits to the burn ward?

Uh, other than the prescription part, that's how it's done now, only it's a 30 day supply I believe.  It's a failing proposition.  If you have a legit allergy issue, your doctor can issue 12 month prescriptions to be dispensed 30 days at a time.  Everyone should have a once a year check up anyhow.

This is hardly the hardship everyone is making this out to be.

Another alternative is they could eliminate it in tablet form since apparently the gel cap form is not a good precursor.

There's no way this passes anyway; the lobby from physicians and pharmacists right now is pretty heavy against it.

If eliminating the tablet form makes people happy, and keeps us from forcing us to go to the physician just to get a damned decongestant, I'm all for it.

It sure surprises me how many people whine and complain about the gubmint all up in their business, but then when it comes to stuff like this, they'll allow it.  Baffling.

[Conan71]

There's no way this passes anyway; the lobby from physicians and pharmacists right now is pretty heavy against it.

If eliminating the tablet form makes people happy, and keeps us from forcing us to go to the physician just to get a damned decongestant, I'm all for it.

It sure surprises me how many people whine and complain about the gubmint all up in their business, but then when it comes to stuff like this, they'll allow it.  Baffling.

The other side of that coin is people who want the government to protect them and place restrictions on certain things until it's something which affects them.  It's kind of like I like to say: "Everyone's a fiscal conservative until the government threatens to cut their program."

If you need antibiotics, pain meds, sleeping meds, BP meds, heart meds, etc. you have to make a doctor's visit.  I don't hear people throwing an uproar over antibiotics not being available over the counter.  I know what AB meds work for me and I also know when I do and when I don't need them without a doctor's visit yet that is required every time you need them.  I think not only should they make pseudo by prescription only, I think they should require a piss test to get a script for it.  If you test positive for meth, you don't get a script.

Would it really be such a hardship for you to get an annual prescription once a year on your normal check-up?

No one is complete anti-government restriction other than anarchists.  There's a place for government and government restrictions that are for the betterment of society or where it provides a manner of protection.  This law wouldn't end addiction nor demand for meth.  There's a huge problem with meth labs.  Get rid of easy to obtain quantities of the precursor and people will quit cooking this crap state-side and blowing themselves and innocent bystanders up.

Or, quite simply, the feds should ban the manufacture of it in tablet form if the gel cap is really not a good precursor.

[Hoss]

The other side of that coin is people who want the government to protect them and place restrictions on certain things until it's something which affects them.  It's kind of like I like to say: "Everyone's a fiscal conservative until the government threatens to cut their program."

If you need antibiotics, pain meds, sleeping meds, BP meds, heart meds, etc. you have to make a doctor's visit.  I don't hear people throwing an uproar over antibiotics not being available over the counter.  I know what AB meds work for me and I also know when I do and when I don't need them without a doctor's visit yet that is required every time you need them.  I think not only should they make pseudo by prescription only, I think they should require a piss test to get a script for it.  If you test positive for meth, you don't get a script.

Would it really be such a hardship for you to get an annual prescription once a year on your normal check-up?

No one is complete anti-government restriction other than anarchists.  There's a place for government and government restrictions that are for the betterment of society or where it provides a manner of protection.  This law wouldn't end addiction nor demand for meth.  There's a huge problem with meth labs.  Get rid of easy to obtain quantities of the precursor and people will quit cooking this crap state-side and blowing themselves and innocent bystanders up.

Or, quite simply, the feds should ban the manufacture of it in tablet form if the gel cap is really not a good precursor.

I just think it's a fallacy to believe that banning a substance will preclude people from getting said substance with other measures.  We all saw how incredibly well prohibition did....

[Conan71]

I just think it's a fallacy to believe that banning a substance will preclude people from getting said substance with other measures.  We all saw how incredibly well prohibition did....

I really don't give two shits about them getting ahold of the end product of meth.  I'm sick and tired of my tax dollars paying to clean up meth labs, being used on turd hunts to track down meth labs, and tired of reading about five year old children burned in a lab fire or a 75 year old neighbor killed by a lab fire.  It's gotten crazy enough now that someone thought it was a great idea to cook it in a freaking Wal-Mart.

Why do you think pain meds are prescription-only?  They represent a danger to the public.  For those who can manage them, how is it fair they have to get a prescription?  FMC was cleaning out my bathroom and found a bottle with about 25 oxycodones with an expiration date of 2010.  She asked if I needed them, I said "of course not".  I had a shoulder surgery two years ago.  I took five the first day or two and changed over to Advil post-surgery and gutted out the rest of the pain.  I know how to manage pain meds.  Others don't.  That's why opiates are by prescription only.  Pain meds scare me.  Hell, pharmaceuticals in general scare me.

Point is, you use your Sudafed as intended.  Unfortunately the abuse of it represents a bigger danger to bystanders and society as a whole.

It's a public safety issue, Hoss and I think I've touched on something else that's really pissing me off:  it's the blatant unholy influence the drug manufacturers have over our government on the state and national levels.  

The drug companies don't give a smile about the obvious harms.  For those on here that rail about greedy corporatists, big pharma, and unconscionable profiteers:  all the pseudo manufacturers and marketers know is if you restrict sales of their product for nefarious purposes, their sales will plummet by a large margin.  Damn right they don't want to impede the flow.

I no longer partake, but I can say first hand there are really great therapeutic benefits to pot, yet it is still heavily banned.  It's a great anti-psychotic, appetite stimulator, muscle relaxer, pain killer, stress reliever, and has many other benefits.  It's as much a wonder drug as aspirin, but the best part is it's not even synthesized.  Ever hear of a pot lab fire?  Ever hear of someone hallucinating and smothering a child after staying up for five days straight on weed?  The after-effects are even less benign than alcohol.  You don't hear of people calling in sick because they have a pot hangover.  Most people just want to chill after they smoke it.  Granted, there is a danger of emotional addiction and over-use can lead to health issues but there is no physical addiction like crank or many stimulants and commonly-abused pain killers.  The cost to society as a whole is far less than government-sanctioned substances like alcohol, pain meds, and meth.  Yes, meth is government sanctioned as long as they allow a version of its precursor to exist.

[Hoss]

I really don't give two shits about them getting ahold of the end product of meth.  I'm sick and tired of my tax dollars paying to clean up meth labs, being used on turd hunts to track down meth labs, and tired of reading about five year old children burned in a lab fire or a 75 year old neighbor killed by a lab fire.  It's gotten crazy enough now that someone thought it was a great idea to cook it in a freaking Wal-Mart.

Why do you think pain meds are prescription-only?  They represent a danger to the public.  For those who can manage them, how is it fair they have to get a prescription?  FMC was cleaning out my bathroom and found a bottle with about 25 oxycodones with an expiration date of 2010.  She asked if I needed them, I said "of course not".  I had a shoulder surgery two years ago.  I took five the first day or two and changed over to Advil post-surgery and gutted out the rest of the pain.  I know how to manage pain meds.  Others don't.  That's why opiates are by prescription only.  Pain meds scare me.  Hell, pharmaceuticals in general scare me.

Point is, you use your Sudafed as intended.  Unfortunately the abuse of it represents a bigger danger to bystanders and society as a whole.

It's a public safety issue, Hoss and I think I've touched on something else that's really pissing me off:  it's the blatant unholy influence the drug manufacturers have over our government on the state and national levels.  

The drug companies don't give a smile about the obvious harms.  For those on here that rail about greedy corporatists, big pharma, and unconscionable profiteers:  all the pseudo manufacturers and marketers know is if you restrict sales of their product for nefarious purposes, their sales will plummet by a large margin.  Damn right they don't want to impede the flow.

I no longer partake, but I can say first hand there are really great therapeutic benefits to pot, yet it is still heavily banned.  It's a great anti-psychotic, appetite stimulator, muscle relaxer, pain killer, stress reliever, and has many other benefits.  It's as much a wonder drug as aspirin, but the best part is it's not even synthesized.  Ever hear of a pot lab fire?  Ever hear of someone hallucinating and smothering a child after staying up for five days straight on weed?  The after-effects are even less benign than alcohol.  You don't hear of people calling in sick because they have a pot hangover.  Most people just want to chill after they smoke it.  Granted, there is a danger of emotional addiction and over-use can lead to health issues but there is no physical addiction like crank or many stimulants and commonly-abused pain killers.  The cost to society as a whole is far less than government-sanctioned substances like alcohol, pain meds, and meth.  Yes, meth is government sanctioned as long as they allow a version of its precursor to exist.

C, I understand your anger, but it seems too vitriolic to me.

We'll agree to disagree and leave it there.  I think outright banning, or requiring it to be prescription-only is almost throwing the baby out with the bathwater.

What's next?  The next superdrug will contain acetyl-salicylic acid (also known as aspirin).  Do we start banning it.  How about the next superdrug contains ibuprofen, which once was prescription only but now isn't.  Do we ban that too?  Do we keep banning or requiring prescriptions until it breaks the average person.

You do know that many co-pay for insurance are high enough to wonder why the hell you would want a someone to go to their physician to get something the FDA has deemed safe for normal users.  Most physicians think this is insane.

Not everyone has the means, even with insurance, to afford to go to the doctor to get a prescription every 90 days for something they have been getting LEGALLY now for 25 years.  I have a hard enough time helping my mother who has osteoporosis medicine to try and get a 90-day supply through medicare.  What makes people think a doctor is going to write up a 1 year prescription without trying to mandate they can't do it except every 30-60-90 days.  Because if they have to be forced to do something, they might as well make money off the office visit...

[Conan71]

I don't hear diabetes or blood pressure sufferers bitching about more regular doctor visits to make sure they get the drugs which make their maladies more manageable or keep them alive.

Unless there's a 90 day limit mandate in the legislation that I've not read, you aren't making a valid argument by making the claim about a visit to the doc every 90 days.  As I've mentioned several times on the topic, most every PCP will give you an annual prescription for maintenance meds which are not as critical as heart or BP meds.  I can get 12 month prescriptions for albuterol (occasional asthma), and nasal steroids.  I really don't use either one very often any more since I became a whole lot more conscientious about food additives and exercise.  There's a lot to be said for preventative medicine starting with one's lifestyle.  I find it laughable that spray nasal steroids are still a prescription drug.  Far less potential side-effects and nefarious uses than Claritin D, but it is what it is and I don't sit around a grumble about needing to see my doc once a year to get it.

I used to be heavily-dependent on Sudafed to manage my hay fever and I was certain I could not live without it.  I've never bought it since it went behind the counter.  Instead I use a netti pot, nasal steroids when it gets too bad, and benadryl at night.  

If aspirin or ibuprofen became precursors for another drug scourge, then you ban them and make drug companies spend their obscene profits and move money from their massive lobbying and marketing budgets to find another chemical compound to do the same job with less potential dangers.  The government has done that for years to so many different industries, like the automotive industry for one.  This isn't breaking new ground, only getting pseudoephedrine users to see it in a light of safety they recognize for other areas they may approve of.

[Hoss]

I don't hear diabetes or blood pressure sufferers bitching about more regular doctor visits to make sure they get the drugs which make their maladies more manageable or keep them alive.

Unless there's a 90 day limit mandate in the legislation that I've not read, you aren't making a valid argument by making the claim about a visit to the doc every 90 days.  As I've mentioned several times on the topic, most every PCP will give you an annual prescription for maintenance meds which are not as critical as heart or BP meds.  I can get 12 month prescriptions for albuterol (occasional asthma), and nasal steroids.  I really don't use either one very often any more since I became a whole lot more conscientious about food additives and exercise.  There's a lot to be said for preventative medicine starting with one's lifestyle.  I find it laughable that spray nasal steroids are still a prescription drug.  Far less potential side-effects and nefarious uses than Claritin D, but it is what it is and I don't sit around a grumble about needing to see my doc once a year to get it.

I used to be heavily-dependent on Sudafed to manage my hay fever and I was certain I could not live without it.  I've never bought it since it went behind the counter.  Instead I use a netti pot, nasal steroids when it gets too bad, and benadryl at night.  

If aspirin or ibuprofen became precursors for another drug scourge, then you ban them and make drug companies spend their obscene profits and move money from their massive lobbying and marketing budgets to find another chemical compound to do the same job with less potential dangers.  The government has done that for years to so many different industries, like the automotive industry for one.  This isn't breaking new ground, only getting pseudoephedrine users to see it in a light of safety they recognize for other areas they may approve of.

As I said, you and I are on opposite sides on this one.  I disagree vehemently.

[nathanm]

If aspirin or ibuprofen became precursors for another drug scourge, then you ban them and make drug companies spend their obscene profits and move money from their massive lobbying and marketing budgets to find another chemical compound to do the same job with less potential dangers.

I have no problem with that. I have a problem with banning pseudoephedrine until such time as they do come up with something that works better than placebo in double-blind studies, which they have not.

The fact of meth addicts doesn't make forcing sick people to suffer OK.

[heironymouspasparagus]

Manufacture of meth as capital crime.

Becomes a self-limiting issue.

[Conan71]

Does anyone remember that Claritin D was prescription-only until 2003?

Nathan makes a valid point.  To expand on that: the FDA could motivate the hell out of drug manufacturers by giving them a deadline to develop the next generation of decongestants without pseudoephedrine.

As I said, you and I are on opposite sides on this one.  I disagree vehemently.

Which part do you vehemently disagree with?

-You don't think drug companies could better spend money on research to find a better decongestant rather than spending it lobbying to defend an obviously abused product?

-You think it's too much to ask to go to the doctor once a year for a metered, full year supply of Claritin?  That's how I used to do it.

-Do you realize that most people with prescription plans would pay less for generic versions of decongestants than they do without a prescription?

"A few years ago, Wellpoint Health Networks petitioned the FDA to switch Claritin and other allergy medicines (like Allergra and Zyrtec) to OTC status. What was their motivation? Well, insurance companies spend a lot of money paying for allergy medications for people who have prescription benefits, where they just pay a copay to get a medicine that has been prescribed to them. If allergy medicines were available over-the-counter, the insurance companies would save a lot of money since they wouldn't have to pay for these prescriptions. Schering-Plough, the company that makes Claritin, opposed the OTC switch of Claritin at that time. For them, they likely figured they might lose money if Claritin was over-the-counter and doctors didn't prescribe it anymore.

However , last year, Schering-Plough changed their mind and got the FDA to change Claritin to over-the-counter status. Why? Most likely because the patent for Claritin expired (December 2002) and generic versions would soon be available. These generic versions would likely be less expensive than brand name Claritin and provide a lot of competition for Schering.
It was also likely that the makers of these generic versions would push to get Claritin changed to an OTC medicine. So, by getting their own version of Claritin available without a prescription now, they would hopefully get a jump on their competition
Also, Schering-Plough had introduced Clarinex, a newer version of Claritin. By moving Claritin to OTC status, there may be less confusing among doctors prescribing Clarinex.

Neither the drug companies or insurance companies likely had the best interests of people with allergies in mind (unless they are also shareholders of these companies) when they pursued the switch to over-the-counter Claritin.

Some allergy suffers will benefit though. Most allergy medications are fairly expensive, and if you didn't have any health insurance or prescription benefits, you might pay $60-80 for a month's supply of Claritin. Plus you would have to pay for a doctor's office visit to get your initial prescription. With OTC Claritin, you could just go to the pharmacy and pay about $30 for a month's supply of regular Claritin. Other versions, will be more expensive, for example $39 for a month's supply of Claritin Reditabs or Claritin D.

Other allergy suffers will also suffer as they are faced with higher costs. Many people with prescription benefits only pay about $10-20 for their prescriptions, as their insurance company pays for the rest. Now, instead of a copay, they will have to pay full price.

The people who will lose out the most are those with a low copay. For example, many people on Medicaid only pay $1-$5 for a prescription. Now they will have to pay a lot more, as they pay full price for OTC Claritin.

So if the cost of a month's supply of OTC Claritin is more than your current copay for prescription Claritin, then treating your allergies will cost you more each month. Prices will likely come down though once generic versions of OTC Claritin, like Alavert, become available early next year.
Those people on other forms of allergy medicines, like Allergra and Zyrtec, will also likely not benefit from Claritin being over-the-counter. Insurance companies will likely raise their copays or refuse to pay for these allergy medicines, as they try to push patients to take OTC allergy medications. And Claritin users who ask their doctor's to switch them to another antihistamine so that their insurance will continue to pay for the prescription might not save money either, as the copay for these medicines go up.

The other big question is will patients know when to take OTC Claritin without first consulting a doctor. For people with year round allergies and true seasonal allergies, the answer will likely be yes. However, it can often be difficult to know when someone has true allergies. A runny nose can also be caused by other things, including the common cold. Instead of reaching for a cold medicine in the pharmacy, many people may now buy Claritin instead. And if they have a cold, they will be wasting their money. To prevent this, even though you can buy Claritin without a prescription, you should first consult with your doctor, especially if you haven't been diagnosed with allergies before.

http://pediatrics.about.com/cs/weeklyquestion/a/120902_ask.htm

[Hoss]

Does anyone remember that Claritin D was prescription-only until 2003?

Nathan makes a valid point.  To expand on that: the FDA could motivate the hell out of drug manufacturers by giving them a deadline to develop the next generation of decongestants without pseudoephedrine.


Which part do you vehemently disagree with?

-You don't think drug companies could better spend money on research to find a better decongestant rather than spending it lobbying to defend an obviously abused product?

-You think it's too much to ask to go to the doctor once a year for a metered, full year supply of Claritin?  That's how I used to do it.

-Do you realize that most people with prescription plans would pay less for generic versions of decongestants than they do without a prescription?

http://pediatrics.about.com/cs/weeklyquestion/a/120902_ask.htm

Looks like it failed again:

http://www.tulsaworld.com/news/article.aspx?subjectid=336&articleid=20120221_336_0_OKLAHO988864

For those behind the paywall...

By WAYNE GREENE World Senior Writer
Published: 2/21/2012  4:09 PM
Last Modified: 2/21/2012  4:21 PM

OKLAHOMA CITY - The House Public Health Committee rejected a plan to restrict access to pseudoephedrine, the popular allergy medicine that is a key ingredient in most Oklahoma meth labs.


The measure, supported by police and prosecutors, would have required a prescription to purchase the drug.

After an hour of heated questioning and debate, the measure failed 6-7 in front of an overflow audience of police, doctors and lobbyists.

"This is blood money for the pharmaceutical industry," Rep. Doug Cox, R-Grove told lawmakers before the vote was taken, but Rep. David Derby, R-Owasso, argued the measure punishes people who use the drug legally, but won't stop meth addictions.

"I do not agree that Oklahoma Legislature needs to pass a law to castigate individuals who are using this for legitimate purposes," Derby said.

Advocates of the measure say it would reduce the number of drug labs in the state, but opponents say it would inconvenience legitimate buyers, but wouldn't deal with the problem of methamphetamine addiction.

The same committee approved an alternative measure pushed by over-the-counter drug manufacturers. The measure would link the state to a multistate electronic registry that would track and block the sales of the drug. It also would reduce the legal limit Oklahomans could buy.