Meth and the common cold

Cold and flu season is just around the corner – do you know where to find your favorite antihistamine?


On July 30, the Oregon Senate approved a bill requiring prescriptions for all medicines containing pseudoephedrine. The new rule will affect many of the most common cold and flu medications, all previously available over-the-counter.


The move is an attempt to slow down methamphetamine (meth) labs by making it more difficult to access pseudoephedrine, a key ingredient in meth production. Oregon is the first state in the nation to make pseudoephedrine a prescription substance.


Pseudoephedrine has long been a key ingredient in many well-known over-the-counter cold medications, including Sudafed, Claritin-D, Theraflu and Nyquil. It works by causing nasal vasoconstriction – a shrinking of the blood vessels in the nose.


This decongestive effect causes secretions to dry up and opens nasal passages. While pseudoephedrine doesn’t affect the length of the cold, it makes it easier for a cold or flu victim to breathe, and makes them more comfortable.


Without pseudoephedrine, what’s a stuffy, congested, sniffling PSU student to do?


“Students with colds and flu might be a little more miserable than they were when [pseudoephedrine] was available,” said Nancy Felter, a nurse at PSU’s Center for Student Health and Counseling. “But there will be alternatives.”


As many as 40 over-the-counter medications have already been reformulated, most using phenylephrine to replace pseudoephedrine. Phenylephrine is a milder nasal decongestant that can’t be converted to methamphetamine.


On Aug. 17, Oregon Gov. Kulongoski signed a set of four anti-meth bills. Together, the bills make pseudoephedrine a Schedule III controlled prescription drug, enhance penalties for meth use and provide money for legal expenses and drug treatment for meth-related crimes.


“We all have a role to play to fight the meth epidemic in our state,” Kulongoski said after signing the bills. “For some that means developing new ways to prevent meth use and for others that means finding an alternative cold remedy. Together we can win this fight. The bills I signed today are one more in that direction.”


Opponents of the bill fear that it may impact lower income and medically indigent, 60,000 of whom lack health insurance, do not have regular physicians and will not be able to afford a prescription.


“The cost is bound to increase because of the different packaging,” said Matthew Ray, a pharmacist at the Museum Place Safeway store. “I’ve been a pharmacist for eight years, and I can’t think of any time in that period where a med went from over-the-counter to being a prescription medication and the price didn’t go up.”


“Anytime you bring a medication into the pharmacy, anytime you have to have a pharmacist prepare and dispense it, there’s labor involved, there’s packaging, there’s the pharmacist having to check about drug interactions and counsel the patient,” Ray continued. “The price invariably goes up.”


U.S. Attorney General Alberto Gonzales recently named meth “the most dangerous drug in America,” and Oregon proponents see the legislation as an essential step in what they call the war against methamphetamine production. They claim that it will protect children whose parents are meth producers. These children are often neglected, and by living in meth houses, are exposed to dangerously toxic chemicals.

With PSU students unable to buy pseudoephedrine-based decongestants over-the-counter, will Student Health and Counseling at Portland State experience a barrage of sniffling, prescription-seeking students once the winter cold and flu season rolls around?


“Things will settle down eventually,” Felter said. “We’ll keep encouraging supportive cold treatments – like steam, rest and fluids.”


And at least for the time being, anyone set on using their favorite pseudoephedrine-based medicine can go to Vancouver, Wash., where pharmacies will continue to sell the decongestant without a prescription.


Oregon is one of more than a dozen states that restrict the sale of pseudoephedrine-based tablets to pharmacies and require that the medications be stored behind the pharmacist’s counter.


Legislation is now underway to extend similar restrictions to pseudoephedrine-based capsules, liquids and gel-caps.


Currently, customers purchasing pseudoephedrine-containing medicines in Oregon must show photo identification and sign a logbook. There is no crosschecking between stores, and many argue that these so-called restrictions have done nothing to stem access to pseudoephedrine for non-medical purposes. However, since this procedure was enacted, identification of new meth labs has dropped by 79 percent.