Jun 1, 2018
Pseudoephedrine in the States
Pseudoephedrine is a common decongestant and cough suppressant available over-the-counter in many cold medicines. While an effective nasal decongestant, there have been cases where these otherwise legal and safe drugs have been diverted to illegally manufacture the dangerous drug methamphetamine. This led Congress in 2005 to overwhelmingly pass the bipartisan Combat Methamphetamine Epidemic Act (CMEA) establishing federal guidelines for controlling medicines containing pseudoephedrine. The CMEA enforces purchaser ID checks, strict purchase limits on products containing pseudoephedrine and a quota system on retail level transactions to deter suspicious activity or purchasing. Additionally, manufacturers of PSE containing medications voluntarily created the National Precursor Log Exchange (NPLEx) to further enhance monitoring capabilities. The CMEA and utilization of NPLEX by retailers and pharmacies represents the collaborative efforts of the pharmacy community, pharmaceutical producers and federal legislators coming together to balance patient access needs for these legitimate therapies with drug enforcement goals. Over 15 years later, the federal CMEA stands as an effective model policy blending compassionate care and responsible oversight.
The national pseudoephedrine regulations provide reasonable controls curtailing meth production and diversion while still enabling legal consumer access rather than resorting to expansive purchase restrictions as some states have attempted.
The bipartisan federal Combat Meth Epidemic Act strikes the proper policy balance between restricting pseudoephedrine access for illicit use without unduly burdening consumers seeking safe, effective cold relief. Therefore, state legislators should refrain from overriding federal guidelines requiring prescriptions for these legitimate over-the-counter medications, as such measures negatively impact public health and provide minimal incremental benefit for enforcement efforts already bolstered through NPLEx real-time monitoring. Upholding consistent rules allows appropriate availability guided by evidence-based concerns.