Pseudoephedrine prescription laws draw mixed reactions from health care industry

Cathryn Maya drove from Jackson to Perryville last month to pick up some medicine for what she described as a "terrible, terrible" sinus infection.

But it was a trip that infuriated her.

That's because until a couple of months ago, she could pick up the medicines over the counter locally. But the pills now require a doctor's prescription in Cape Girardeau, Jackson, Scott City -- and a growing number of Missouri communities -- because they contain pseudoephedrine, a key ingredient in the manufacture of methamphetamine.

"It irritates me to no end," Maya said. "I'm so angered by it. Because a few people misuse something, everyone has to be penalized for it."

Area doctors and pharmacists say they have come into contact with others who feel like Maya does: Like they've had access cut off from an affordable medicine that works while placing a significant financial burden on them and their families.

Law enforcement agencies argue that requiring prescriptions makes it harder for meth-makers to get their hands on the medicine, which include Claritin-D, Mucinex-D, Advil Cold & Sinus and Sudafed. But some national lobbyist groups, such as the National Association of Chain Drug Stores and the Consumer Healthcare Products Association, are strongly against it.

They argue that the new electronic tracking system in Missouri hasn't been given a chance to work. They point out that the Food and Drug Administration has approved these products as safe for over-the-counter distribution. Requiring a prescription for products that treat colds, flu and allergies unnecessarily increases overall health care cost for customers, governments and private employers.

Elizabeth Funderburk is the spokeswoman of the Consumer Healthcare Products Association, which represents pharmaceutical companies like McNeil, Merck, Novartis and Bayer. She said a more effective way of stopping meth makers from acquiring the medicine is to give the electronic technologies time to work. She believes such tracking systems, which monitor sales in real time, would work better than requiring prescriptions without placing hardships on legitimate customers.

"Just because there are more sales in a neighboring community, that doesn't mean that those sales are driven by people wanting to make illegal drugs," she said. "The people who need the medicines are at least a part of the reason that those sales are spiking."

In January, according to a statewide database tracking sales of the methamphetamine precursor, Perryville's Walmart sold 1,366 boxes of the medication, compared to 471 in November and 819 in December. Law enforcement officers attribute most of the huge increase to people seeking the drug for illicit purposes, not to people from surrounding communities trying to bypass prescription regulations to treat colds and allergies.

Locally, physicians, pharmacists and others have a mixed reaction.

Some doctors, like Cape Girardeau allergist Dr. Janna Tuck, aren't fans of requiring prescriptions, citing some of the same reasons. Tuck also would like to see how the electronic tracking system would work.

"I think that's a better choice," she said. "Requiring prescriptions are going to overutilize our health-care system and it does penalize patients who don't have good insurance or no insurance and those are the ones we worry about."

Dr. Byron Glenn, a physician at Cape Urgent Care, says he thinks those medicines should be controlled regardless of the methamphetamine factor. He said the cold medicines are dangerous and can cause increased blood pressure and arrhythmia.

"They shouldn't be gotten over the counter," he said. "And they can cause dependencies on their own. These are not side effects. These are direct effects."

Some area pharmacists, such as Jim Crain of the Medicine Shoppe, don't have a problem with it, though he said he has seen an increase in prescription sales. He said he trusts that law enforcement knows how to best fight the methamphetamine scourge.

"I'm sure it's inconvenient for some folks, but if you want to control it, somehow you have to restrict sales," he said. "That's just the way it is."

Brandi Hamm, who owns Broadway Prescription Shop, said they haven't seen a major uptick in prescription sales. She said that she's noticed customers switching to alternative forms of treatment, such as nasal decongestants.

"With the area of the country we live in and the huge meth problem we have in Southeast Missouri, I understand that it's seen as a way of trying to get it under control," she said.

Still, some people who legitimately use the medicines may opt to drive to surrounding communities, where the medicines don't require prescriptions. But that number of communities is shrinking. In Perryville, the city council has approved a prescription-only ordinance that will take effect April 1.

Maya said she would drive to Ste. Genevieve, Mo., for the medicine if that's what it takes, which would still be cheaper than gas and a doctor bill. She's considering many options.

smoyers@semissourian.com

388-3642