Requiring prescription for pseudoephedrine is 'silver bullet' against meth, drug officials say; some lawmakers disagree

By Tara Kaprowy
Kentucky Health News

If Kentucky wants to arm itself with a "silver bullet" against methamphetamine, it needs to make pseudoephedrine available only prescription. That was the advice of top drug officials in Mississippi and Oklahoma, who testified before lawmakers Thursday. Opponents of the idea did not testify but legislators on their side had their say.

"This is a high-stakes cat and mouse game which has damaging results if we don't win," said Darryl Weaver, director of the Oklahoma Bureau of Narcotics. "The bottom line is: Do you want to track meth labs or do you want to eliminate meth labs?"

Marshall Fisher, director of the Mississippi Bureau of Narcotics agreed: "There is a silver bullet and the silver bullet wasn't tracking it; it wasn't limiting the amount. Weaver and Fisher testified at the request of the Senate and House Judiciary Committees, whose members heard exclusively from officials who support prescription-only policy.

Several related bills are on the table this year, including measures by state Rep. Linda Belcher, D-Shepherdsville, and state Sen. Tom Jensen, R-London, that would reclassify the drug to make it prescription-only. State Rep. Brent Yonts, D-Greenville, would apply the prescription rule only to people who have been convicted of a meth-related charge. The bill sponsored by Sen. Jerry Rhoads, D-Madisonville, would prohibit such offenders from buying the drug for five years.

Mississippi passed a prescription-only law 18 months ago and has seen a 67 percent drop in the number of its meth labs, Fisher said. Weaver said he is pushing for a prescription-only law in Oklahoma since its meth problem continues to grow, despite efforts to electronically track and limit sales of the drug.

All efforts have just been temporary fixes in Oklahoma, Weaver said, since they resulted in "smurfing," in which meth cooks pay others to buy pseudoephedrine for them. The same thing happened when that state instituted a drug registry, in which people who had been convicted of a meth-related crime were prohibited from buying pseudoephedrine without a prescription. The problem, Weaver said, is the tracking and registry "formed more of a conspirator group," where cooks were approaching the homeless and the previously uninvolved African American community to buy the drug for them.

Lt. Col. Joe Williams, executive director of the Appalachia High Intensity Drug Trafficking Area, said smurfing is a big problem in Kentucky too, and MethCheck, the tracking system in place now, does little good in helping law enforcement find meth labs. Meth labs "find us for the most part, we don't find them," he said. "Once we find a meth lab, we'll use the electronic tracking system and use that to trace back."

That runs counter to what Maj. Tony King of the Jefferson County Sheriff's Office said Monday on KET's Kentucky Tonight. In order for pseudoephedrine to be made available only by prescription, it must be reclassified as a legend drug. But those drugs are not tracked by MethCheck, which instantly tracks purchases at the point of sale, but by KASPER, the state's slower system for monitoring prescription drug abuse. "We will lose the ability to track these people and we will lose the ability to track these labs," he said.

Several lawmakers asked whether making pseudoephedrine available only by prescription would just result in doctor shopping and cold and allergy clinics popping up like so-called prescription pill mills. Williams said smurfers just won't take that risk. "It's very hard to fake snot in your nose," he said. "It's pretty easy to fake back pain."

Belcher's proposal would exempt pills in gel-cap format from the prescription rule, which prompted Rep. Sarah Beth Gregory, R-Monticello, to ask if that wouldn't eventually become a problem. Yonts pointed out that the U.S. Drug Enforcement Administration has said pseudoephedrine is "readily extractable" from gel caps. Weaver said he's "yet to see one lab that has been made with gel caps and liquids," he said, adding, "We have to find a balance between intrusion of government and what we need to stop the problem."

But it's that intrusion that has Yonts calling his measure the "middle ground," saying it protects "the soccer moms and Walmart moms" from having to constantly take their kids to the doctor but punishes the offenders. And while officials say only 15 cold medicines would be affected by requiring a prescription, leaving 137 other options, Yonts said medicines containing pseudoephedrine account for 63 percent of sales.

Williams said the average meth lab costs $2,100 in law enforcement, including manpower, overtime, equipment and waste disposal. With 1,146 labs found in Kentucky in 2011, that translates to $2.4 million. Sen. Robert Stivers, R-Manchester, said the problem is "a much larger cost to the taxpayers" since "the majority of these people are probably indigent care and the taxpayer is paying the bill for this."

Whatever the cost, Rep. Johnny Bell, D-Glasgow, called the issue "the most important" of the session. "I hope that we'll step forward and think about the human life and the impact it's having."

Representatives of the Consumer Healthcare Products Association said after the meeting that Pat Davis, identified as a mother of six from northern Kentucky, signed up to speak at the meeting but did not get to. She said she would have spoken about a prescription bill's "impact on consumers and parents, yet the committee was forced to watch videos of news reports and slides that have been seen several times already. It is apparent that the voices of consumers and parents aren’t important to the people running this process."