Kansas bill would require prescription for cold meds like Sudafed and Claritin-D

Some Kansas lawmakers want to make some cold and allergy medications available only by prescription as a way of reducing methamphetamine production in the state.

A new bill would force patients seeking drugs that contain pseudoephedrine, a nasal decongestant and key ingredient in meth, to get approval from their doctors first.

Such cold and allergy medicines have been sold without a prescription since 1976, though a 2005 state law mandated that they be sold only by pharmacists.

Only two states — Oregon and Mississippi — now require prescriptions for the medicines. Meth production has dropped dramatically there, and a dozen other state are considering similar proposals. The effort to introduce the legislation in Kansas was led by Larry Anderson, a Wellington doctor who has seen the effects of methamphetamine while dealing with kids whose parents are in jail on meth-related charges.

"What it means is kids in and out of foster care because one or both parents are involved in making, selling or using methamphetamine," he said. "It means kids moving from school to school, losing their stream of education and falling behind their friends, making it difficult for them to graduate and succeed in life."

Anderson read a New York Times article by the Oregon district attorney who wrote that state's law, and took the idea to his representatives.

"Anything you can do to make it harder to get pseudoephedrine is what we've got to do," he said.

Behind the counter

Earlier legislation to reduce meth production in Kansas has met with intermittent success.

Meth labs declined after the lawmakers passed the Matt Samuels Law in 2005, which called for over-the-counter medications containing pseudoephedrine to be sold only by licensed pharmacists.

The law was named after the Greenwood County sheriff who was shot to death at a house being used as a meth lab. His killer, Scott Cheever, claimed to be high on meth at the time.

Meth lab incidents statewide dropped from 390 in 2005 to 168 in 2006 and 97 in 2007, according to the KBI

But they rose to 153 in 2008. Last year there were 143. "Incidents" include labs, dump sites and chemical and glassware seizures.

Laws currently restrict daily and monthly pseudoephedrine purchases, and require that purchasers must be at least 18. Photo IDs and signatures are required.

But law enforcement officials have found that meth cooks and associates travel from pharmacy to pharmacy to buy legal quantities of the drugs and divert them to meth.

The practice, called "smurfing," has led to an increase in meth labs and drawn people, such as college students, into the illegal drug trade who otherwise would not have been involved, said Rep. Pat Colloton, R-Leawood, chair of the House Committee on Corrections and Juvenile Justice. That committee has scheduled a hearing on the new bill for Feb. 16.

Two years ago, the state Legislature authorized an electronic logging system to track the sales of meth precursors. But the state couldn't reach an agreement with the company that was going to provide the equipment and software, so nothing happened. Only recently have the two sides reached an agreement, Colloton said.

Electronic monitoring systems have many critics.

"It doesn't work," said David Barton, director of the federal Midwest High Intensity Drug Trafficking Area program, which includes Kansas. "They have no impact on retail meth production. That's been proven over time."

Electronic monitoring has only encouraged "smurfing" by creating a black market that makes the activity more profitable, he said.

Other states' practices

Legislation is pending in a dozen other states, including Missouri, Indiana and Kentucky, to return the meth precursors to prescription-only status.

Mississippi passed its law six months ago and already has seen a 65 percent drop in meth labs.

Oregon's law has been in effect since 2006, and meth labs have all but disappeared. The state has seen a 96 percent reduction in meth lab incidents, according to the Oregon Narcotics Enforcement Association.

"We eliminated smurfing. It's gone," said Rob Bovett, the district attorney in Lincoln County, Ore., who was the primary author of Oregon's law and who wrote the New York Times article that influenced Anderson.

Bovett knows about the new Kansas legislation and said it would be effective at eliminating smurfing and reducing meth production here.

But he predicts a fight to get it passed. It took three legislative sessions over a six-year period to pass Oregon's law.

"If you get traction to pass this, the pharmaceutical industry will spend a lot of money and lot of effort to kill the bill," Bovett said. "They've done it repeatedly in state after state that have tried this."

Positions shaping up

The new Kansas bill, HB 2098, was introduced by representatives Peter DeGraaf, R-Mulvane, and Vince Wetta, D-Wellington. State Sen. Steve Abrams, R-Arkansas City, said he will introduce a similar bill Monday in the Senate's public health and welfare committee.

Because the Kansas legislation has just been introduced, most state medical, pharmaceutical and law enforcement agencies have yet to take a position on it.

The Kansas Board of Pharmacy plans to support it, Colloton said. But Mike Larkin, executive director of the Kansas Pharmacists Association, which represents all pharmacists in the state, said his organization still is looking at the legislation.

"Making anything like pseudoephedrine more difficult to get makes a hardship on a patient and physician who has to write a prescription for it," he said. "There's pros and cons."

"We're not opposed to it, and it may be good legislation," said Jerry Slaughter, executive director of the Kansas Medical Society. "We just want to have more discussion with our membership before we weigh in on it."

Organizations representing sheriffs and police officers also are considering their positions on the bill.

One group opposed

The Consumer Healthcare Products Association is a major opponent of such laws. It argues that they burden consumers with the costs of insurance co-payments to doctors and pharmacies.

Those without insurance would have to pay full costs for doctor or clinic visits to obtain allergy or cold remedies, it says.

Doctors would have to waste their time seeing patients with complaints about seasonal allergies and the common cold, it says.

And cash-strapped states would have to absorb additional Medicaid costs and lose sales tax revenue generated by the products due to prescription tax exemptions.

None of those fears came to pass in Oregon after his law passed, Bovett said. Medicaid costs didn't go up significantly, nor were doctors swamped by patients wanting prescriptions for common cold medicines.

Stores are stocked with cold and allergy medicines that don't contain meth precursors, he said.

"Most consumers long ago just purchased any drug over the counter after laws were passed to move it behind the counter," he said.

The pharmaceutical industry estimates that it makes about $600 million annually from the sales of pseudoephedrine products. But it denies that large amounts are diverted for meth making.

In April remarks to a U.S. Senate caucus on drug enforcement, Linda Suydam, president of the Consumer Healthcare Products Association, said a comparison of meth labs and pharmaceutical data shows no relationship between sales in states with many meth labs compared with states with few labs.

"In other words, and despite undocumented assertions, the diversion of (pseudoephedrine) into meth labs is such a small portion of overall sales that it is not measurable in sales patterns between states with and without meth labs," Suydam said.

Anderson said he is concerned about those who use such drugs legitimately for colds and allergies.

But, he said, "Nobody ever died of a stuffed nose. Methamphetamine kills."