Should Pseudoephedrine (PSE) Be Moved from Behind the Counter to Prescription-Only? An Analysis of PSE as an OTC Medication and a Precursor for Methamphetamine Production

Kentucky State Senator Tom Jensen recently sponsored Senate Bill 45, which would change pseudoephedrine (PSE) from an over-the-counter to a schedule V prescription-only drug. The bill failed, but the debate continues as to whether Kentucky should make PSE, a precursor required to manufacture illicit methamphetamine, a controlled drug that is available by prescription only. Methamphetamine abuse has been increasing in Kentucky as well as in the rest of the country, despite efforts to control the sale of PSE through federal and state legislation. The Combat Methamphetamine Epidemic Act (CMEA) of 2006 and Kentucky’s initiative to electronically monitor the sales of PSE have both resulted in a decrease in the number of meth labs in Kentucky. However, those decreases were followed shortly by sharp rebounds, with the number of labs in 2010 surpassing 1,000. If previous measures have been unsuccessful, can we expect prescription-only legislation to have the desired effect of reducing methamphetamine abuse in Kentucky? This approach has seemed to have worked for Oregon, and has recently been adopted by Mississippi. The primary purpose of this paper is to analyze efforts made by Kentucky and other states to reduce methamphetamine abuse. In order to determine if those efforts were successful, research has been conducted concerning the number of methamphetamine labs and hospital admissions related to methamphetamine abuse in Kentucky as well as other states that have instituted laws more stringent than federal regulations. This analysis has been conducted over a range of years in order to compare the numbers of meth labs and hospital admissions both before and after Dillon 3 certain regulations were enacted in order to better determine the level of success of those measures. In addition, this paper will address some other areas of concern related to the possibility of a prescription only PSE law in Kentucky such as; what are some of the methods methamphetamine abusers and ‘cookers’ have employed to bypass previous legislation, and how might they attempt to bypass future legislation? If it can be determined that new legislation would fail to lead to a decrease in methamphetamine abuse, then perhaps alternative means of controlled methamphetamine use should be considered. Finally, what is the practicality of making PSE prescription only? PSE is not the only over-the-counter (OTC) medication available to treat symptoms related to nasal congestion, but is it the best alternative? Are there other compelling reasons that might make a prescription-only law a benefit to the citizens of Kentucky? How might a prescription-only law be a hindrance to Kentucky citizens who use PSE for its intended purpose? These questions must be answered in addition to the primary research question in order to determine the advisability of a PSE prescription-only law in Kentucky