Cough Syrup As a Controlled Substance

Lynne Kiesling

Over at the Adam Smith Institute, Megan Rudebeck speaks truth about the cough syrup restrictions that are now all the rage in the US. She comments on a proposed piece of legislation that would create a national cough syrup registry:

The only thing this legislation will do is create a nuisance for consumers and business owners. So pharmacies all over the United States use a sign in sheet. How will independent businesses all over the country collaborate in order to figure out if an individual has bought more than three boxes of Sudafed in a month, providing that individual is even using their real identity? The lawmakers who are proposing this legislation are from the same body that decided that emergency contraception could not be offered behind-the-counter because pharmacies did not have the facilities to keep it under lock and key. This proposal, however, requires even more involvement from pharmacy staff just to dispense ordinary cold medicine. Funny how that changed so quickly.

In this as in so many other issues, when will US policymakers learn that such restrictions do not reduce use?

8 thoughts on “Cough Syrup As a Controlled Substance”

  1. They will use the same elaborate system employers use to instantly determine whether applicants for positions are citizens, legal aliens or illegal aliens. Or, they could use the system local and state law enforcement authorities use to determine whether individuals they are interviewing are here legally. I’m sure DEA would respond in time to catch the perps in the process of cough syrup abuse, just like DHS shows up to take custody of the illegal aliens for deportation. (I also still believe in Santa Claus, the Easter Bunny, the Tooth Fairy and the Great Pumpkin.)

    However, if the pharmacist doesn’t keep the records, can loss of license and the slammer be far off?

  2. Such restrictions do reduce use. They reduce use by the law-abiding and honest, who would rather deal with a sniffle than with the hassle of the pharmacy.

    They will not, of course, reduce the use of methamphetamine at all, as most of it’s still imported from Mexico.

  3. Hi Lynne-

    There are several issues here that might merit comment. I am a lawyer, not a pharmacist, so I will gladly be corrected as necessary. That being said, the article and commentary note the possible emergence of mandatory record-keeping for over-the-counter items containing pseudoephedrine, which can be used in the manufacture of methamphetamine (hereinafter, “Meth”). “Cough syrup” does not usually contain pseudoephedrine, but it can. More likely it will be marketed as a cold remedy with containing cough suppressant. Interestingly, cough syrup which contains codeine (Robitussin AC, for instance) is already dispensed in some jurisdictions as an over-the-counter medication, but the patient may be required to sign for the item. This varies from state to state. I note that few people have decried this restriction of free trade, which has existed for years.

    The preferred product for making meth is the pill form of pseudoephedrine, such as contained in Sudafed. The pills provide an easier manner of obtaining the required chemical. Any ledger of sales kept by a pharmacy (and they are accustomed to keeping such ledgers for controlled substances) would be provided to law enforcement upon request, according to law. Law enforcement would only request such a ledger if they have an active case, usually caused by some outside information concerning the manufacture of meth. In short, the demand for the information contained within the ledger does not exist until an underlying trigger has been tripped. No collaboration of individual businesses is required. The police will sort the information to determine if their suspect has purchased, say, 40 cases of Sudafed in the past month.

    You also touch upon the matter of identity theft with regard to the meth “industry”. This has apparently become a problem. See, for instance, the recent article at http://www.cnn.com/2005/LAW/12/28/meth.idtheft.ap/index.html

    I agree that the keeping of this ledger will require slightly more work from the pharmacist and staff. I agree that there are (and always will be) ways to circumvent it. Nevertheless, it would appear that something needs to be done to curtail the rampant manufacture of meth in the midwest, if only to remove the drain on productive society caused by “meth babies”, increased crime, etc.

    So my question is, If we can quantify the costs of restricting pseudoephedrine dispensation, how does that compare to the cost of allowing the unrestricted dispensation of pseudoephedrine, of which presumably some quantity will be used to manufacture meth?

    Kindest regards-

  4. Hi Lynne-

    There are several issues here that might merit comment. I am a lawyer, not a pharmacist, so I will gladly be corrected as necessary. That being said, the article and commentary note the possible emergence of mandatory record-keeping for over-the-counter items containing pseudoephedrine, which can be used in the manufacture of methamphetamine (hereinafter, “Meth”). “Cough syrup” does not usually contain pseudoephedrine, but it can. More likely it will be marketed as a cold remedy with containing cough suppressant. Interestingly, cough syrup which contains codeine (Robitussin AC, for instance) is already dispensed in some jurisdictions as an over-the-counter medication, but the patient may be required to sign for the item. This varies from state to state. I note that few people have decried this restriction of free trade, which has existed for years.

    The preferred product for making meth is the pill form of pseudoephedrine, such as contained in Sudafed. The pills provide an easier manner of obtaining the required chemical. Any ledger of sales kept by a pharmacy (and they are accustomed to keeping such ledgers for controlled substances) would be provided to law enforcement upon request, according to law. Law enforcement would only request such a ledger if they have an active case, usually caused by some outside information concerning the manufacture of meth. In short, the demand for the information contained within the ledger does not exist until an underlying trigger has been tripped. No collaboration of individual businesses is required. The police will sort the information to determine if their suspect has purchased, say, 40 cases of Sudafed in the past month.

    You also touch upon the matter of identity theft with regard to the meth “industry”. This has apparently become a problem. See, for instance, the recent article at http://www.cnn.com/2005/LAW/12/28/meth.idtheft.ap/index.html

    I agree that the keeping of this ledger will require slightly more work from the pharmacist and staff. I agree that there are (and always will be) ways to circumvent it. Nevertheless, it would appear that something needs to be done to curtail the rampant manufacture of meth in the midwest, if only to remove the drain on productive society caused by “meth babies”, increased crime, etc.

    So my question is, If we can quantify the costs of restricting pseudoephedrine dispensation, how does that compare to the cost of allowing the unrestricted dispensation of pseudoephedrine, of which presumably some quantity will be used to manufacture meth?

    Kindest regards-

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