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The Uselessness of Phenylephrine

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Re: The Uselessness of Phenylephrine

#81

Post by hammock »

ericbarrett wrote: post #55
techsupporter wrote: post #44

Earlier quoted context omitted.

> With explanation in abstract that its easier to buy meth than pseudoephedrine. People may laugh at this, as they should since it is an absurd situation, but this isn't entirely wrong. Neither my wife or I drive and during the pandemic she gave up her license after getting an appointment at the DOL was difficult. Both of us carry US passport cards as our ID. This has resulted in several situations where we've been t…

Why not get a non-motorist ID card? Every US state has these; here's Washington's: https://www.dol.wa.gov/driverslicense/gettingidcard.html

Many Americans have difficulty obtaining ID, because they cannot afford or cannot obtain the underlying documents that are a prerequisite to obtaining government-issued photo ID card.

Underlying documents required to obtain ID cost money, a significant expense for lower-income Americans. The combined cost of document fees, travel expenses and waiting time are estimated to range from $75 to $175.

The travel required is often a major burden on people with disabilities, the elderly, or those in rural areas without access to a car or public transportation. In Texas, some people in rural areas must travel approximately 170 miles to reach the nearest ID office.

Re: The Uselessness of Phenylephrine

#82

Post by somebodynew »

rootusrootus wrote: post #60
Zak wrote: post #17

I wonder how difficult it would be to get the restrictions on pseudoephedrine rolled back now that it appears unlikely they're accomplishing their original goal of limiting the methamphetamine supply. Concern (legitimate and otherwise) over ability to breathe is a popular topic in politics lately.

It's happening slowly. Oregon had pushed it all the way to requiring a prescription to get pseudoephedrine. It does still require a visit to the store pharmacy and showing your ID to prove you are an adult, but at least you can buy it without a prescription now. I think only a couple states ever went that far. But at least it is a step back in the right direction.

The ID check isn't for age verification. Federal law requires IDs to be recorded* to enforce restrictions on the maximum quantity that an individual is permitted to purchase per month.

* Edit: Where the word "recorded" appears, this comment previously said "scanned and submitted to a central database". While most states use a central database, the comment reply below pointed out that this goes beyond the minimum that federal law requires.

Re: The Uselessness of Phenylephrine

#83

Post by natechols »

PragmaticPulp wrote: post #74
JumpCrisscross wrote: post #63

Earlier quoted context omitted.

Do we have a study showing these (second dose within 30 minutes or paracetamol + phenylephrine) performing better than placebo?

We actually have a lot of studies where even standard 10mg phenylephrine taken alone outperforms placebo: https://pubmed.ncbi.nlm.nih.gov/17692721/ Note that Figure 3 also mentions the Tylenol combination effect and even shows how 10mg Phenylephrine + Tylenol performs somewhere between 10mg and 45mg of phenylephrine. The article author just cherry-picked the one study where phenylephrine performed the worst. Cherry-p…

"Data from 7 crossover studies involving a total of 113 subjects were reanalyzed and then pooled for meta-analysis"

This is a huge red flag - I've read too many of Derek Lowe's blog posts to take that kind of study very seriously as medical advice. Much more promising leads than this have utterly bombed in clinical trials, it happens all the time.

Re: The Uselessness of Phenylephrine

#84

Post by mise_en_place »

munificent wrote: post #43

My drug of choice for colds is NyQuil. It's always been great for opening up my nasal passages enough to let me breathe easily and then knocking me the fuck out so I could sleep off most of the cold. I remember several years ago when all of a sudden NyQuil stopped doing anything useful. I had no idea why but I directly observed that it was like it had been replaced with a non-functioning placebo. Only a couple years…

From what I've read, d-amphetamine[0] was the decongestant of choice for much of the 20th century. It's just that the counterculture weirdos were abusing it and that led to its restriction. Compared to pseudoephedrine its way more useful with minimal side effects like drinking a cup of coffee.

[0]https://www.theatlantic.com/health/archive/2012/04/the-lost-...

Re: The Uselessness of Phenylephrine

#85

Post by PragmaticPulp »

natechols wrote: post #83
PragmaticPulp wrote: post #74

Earlier quoted context omitted.

We actually have a lot of studies where even standard 10mg phenylephrine taken alone outperforms placebo: https://pubmed.ncbi.nlm.nih.gov/17692721/ Note that Figure 3 also mentions the Tylenol combination effect and even shows how 10mg Phenylephrine + Tylenol performs somewhere between 10mg and 45mg of phenylephrine. The article author just cherry-picked the one study where phenylephrine performed the worst. Cherry-p…

"Data from 7 crossover studies involving a total of 113 subjects were reanalyzed and then pooled for meta-analysis" This is a huge red flag - I've read too many of Derek Lowe's blog posts to take that kind of study very seriously as medical advice. Much more promising leads than this have utterly bombed in clinical trials, it happens all the time.

Read the whole abstract. They showed which studies reached statistical significance on their own.

You could just read those studies and ignore the meta-analyses if you want.

I honestly don't understand this current trend of assuming meta-analyses are inherently incorrect and cherry-picking the worst study as the source of the truth.

Re: The Uselessness of Phenylephrine

#86

Post by zacherates »

michaelmcdonald wrote: post #67
ericbarrett wrote: post #55

Earlier quoted context omitted.

Why not get a non-motorist ID card? Every US state has these; here's Washington's: https://www.dol.wa.gov/driverslicense/gettingidcard.html

I believe this is the key element: > she gave up her license after getting an appointment at the DOL was difficult. I'm not sure what DOL is a reference to; however I now many individuals struggled to get appointments at the Secretary of State (SoS) and that is also where one (at least where I live) would need to get a non-motorist ID. Same amount of frustration / time spent to get a non-motorist ID as it would be to…

DOL = Washington Department of Licensing: https://www.dol.wa.gov/

Re: The Uselessness of Phenylephrine

#87

Post by Johnny555 »

arkades wrote: post #54
p_l wrote: post #13

The lack of availability of proper pseudoephedrine in USA led to situation where there are papers describing how to turn methamphetamine into pseudoephedrine, not the other way around. With explanation in abstract that its easier to buy meth than pseudoephedrine.

Pseudoephedrine is still available -behind the counter-. You literally just have to ask the pharmacist for it. Let’s not turn grad students having a laugh into an actual statement on public policy.

Around here, you pick up a card from the shelf with a picture of the product you want, then wait in line for the pharmacist. Then they say "Sorry, we're out of that one, what else do you want", "I don't know, what do you have", "sigh... here's what we have left...".

Then you show your drivers license and the pharmacist records it and you pay and finally walk out with your sudafed. If you want to buy several boxes because it's allergy season, well too bad, you can't buy 2 boxes today, you have to come back tomorrow for the second one.

It's actually easier to buy as a prescription, then the Dr can write you a prescription for any amount you need/want.

Re: The Uselessness of Phenylephrine

#88

Post by AtlasBarfed »

My college buddy stayed with me about 22 years ago while he went to med school, and then when he graduated he moved out. I found after he left a box of phenylephine with "PLACEBO" scribbled over it.

That is to say, this has been known for at least 20 years. And yet this big, ok, medium-big, lie persists.

Re: The Uselessness of Phenylephrine

#89

Post by baggy_trough »

Zak wrote: post #42
baggy_trough wrote: post #28

Earlier quoted context omitted.

Very difficult. Regulations live on regardless of their negative effects because there's very little incentive to get rid of them.

For a long time, I've had the idea in the back of my mind that all laws should have expiration dates, and the maximum duration shouldn't be very long (12 or 18 years would be two or three senate terms in the US). Ideally, it would be combined with something to keep the scope of each bill narrow.

It wouldn't work because what would happen would be a mass reapproval of all regulations.

What I'd like to see is a constitutional amendment that the total body of federal laws and regulations can't be any longer or more complicated than a person of average intelligence can be taught in a week.

Re: The Uselessness of Phenylephrine

#90

Post by f7ebc20c97 »

dylan604 wrote: post #77
ericbarrett wrote: post #55

Earlier quoted context omitted.

Why not get a non-motorist ID card? Every US state has these; here's Washington's: https://www.dol.wa.gov/driverslicense/gettingidcard.html

Would that not still require an in-person visit that they've already stated was not possible? I'd assume the state would require a new photo for a new ID at the least to make an in-person visit required. Probably need new fingerpritns as well (if that's something WA does).

Society wouldn't function if people weren't willing to bend the rules.
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