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The Uselessness of Phenylephrine (2022)

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Re: The Uselessness of Phenylephrine (2022)

#101
post #97

Earlier quoted context omitted.

For me, it’s a matter of it’s none of their business . No one’s accused me of making meth, but here’s all my PII in a database “just in case”. It’s literally harder for me to buy cold medicine than a gun. I hate everything about that situation.

I mean, the reason they keep the database is especially clear here, right? They're just trying to enforce a rate limit. It's the most obvious public policy response you can have to "a drug that in small quantities is a useful decongestant, but in moderate quantities or above is an ultra powerful stimulant whose abuse is ravaging parts of the country".

I get it. I just find it frustrating, and I'd like to know that my PII was removed after the rate limit period.

Re: The Uselessness of Phenylephrine (2022)

#102
post #62

Earlier quoted context omitted.

At least if I followed that path, I would not be required to have my purchase recorded in an insecure government database.

Why are you worried about the government recording your usage of Sudafed? What is anybody going to do with that information? Serious question! I understand the principle involved; I just want to know if there's some practical concern.

It's legal defense in depth, similar to not talking to police without an attorney present. All it takes is an overzealous prosecutor or social worker to ruin someone's life by misrepresenting some random circumstantial facts. This happens all the time in drug cases, for example, where the possession of innocuous items like small baggies allows prosecutors to take charges from regular possession to intent to distribute or trafficking.

Even if someone isn't doing anything illegal, since >90% of cases end in plea deals it's good legal hygiene.

Re: The Uselessness of Phenylephrine (2022)

#103
post #62

Earlier quoted context omitted.

At least if I followed that path, I would not be required to have my purchase recorded in an insecure government database.

Why are you worried about the government recording your usage of Sudafed? What is anybody going to do with that information? Serious question! I understand the principle involved; I just want to know if there's some practical concern.

[deleted]

Re: The Uselessness of Phenylephrine (2022)

#104
post #63

Earlier quoted context omitted.

In what way did it backfire? It's a useful decongestant. But it also basically is methamphetamine, with just a couple easily-reversible Rubik's turns to make it a decongestant instead of an ultra-powerful stimulant.

Didn’t prevent people from getting meth, but did allow drug companies to make millions selling a useless compound. I doubt that was the intent of the legislation.

The same company sells both compounds. I don't think this was a huge moneymaker. I think the PE thing was just there to retain the sales that moving Sudafed behind the counter sacrificed. That doesn't make it OK, but it does sort of argue against the idea that the regulation was just a moneymaking scheme.

Re: The Uselessness of Phenylephrine (2022)

#105

Public service announcement: sinus rinse (e.g. NeilMed) works. Available in every drug store with no prescription or pharmacist involvement necessary. It's gross, though. Do it in private.

It doesn't reduce the sinus inflammation. At least for me all I end up with is a still congested, but now watery nose.

Noted. At least you've tried it.

The water dripping out of your nose: that's a feature, not a bug /s

Re: The Uselessness of Phenylephrine (2022)

#106
post #97

Earlier quoted context omitted.

I mean, the reason they keep the database is especially clear here, right? They're just trying to enforce a rate limit. It's the most obvious public policy response you can have to "a drug that in small quantities is a useful decongestant, but in moderate quantities or above is an ultra powerful stimulant whose abuse is ravaging parts of the country".

I get it. I just find it frustrating, and I'd like to know that my PII was removed after the rate limit period.

I agree with this!

Re: The Uselessness of Phenylephrine (2022)

#107
post #16

Probably will get downvoted for this, but a bunch of my family members are pharmacists. Their quiet opinion is that most pharmaceuticals don’t work. Even the ones that are thought effective. The data is anecdotal, but is over 15 years of watching people come in for prescriptions. The other aspect, is they say it’s mind boggling to see what kind of drugs people are on.

It’s really difficult to untangle the placebo and nocebo effects. I was recently surprised to learn there are studies showing placebos can be effective even when people are told they are taking a placebo. Ie literally telling people, “take this pill every day, but please understand it’s a placebo and has no active ingredients whatsoever”. And yet, their symptoms improve. The theory is that the subconscious mind acts…

"Suggestible You" by Erik Vance explores this phenomenon, and really turned me around on placebos. I'm, generally speaking, not particularly susceptible to placebo effects, and always kind of (arrogantly) chalked placebo effects up to people just being gullible and wanting to see something that wasn't there. It turns out there are actually genes that might be responsible for the physical impact of the placebo effect in the brain.

There's an enzyme - catechol-O-methyltransferase - which is coded for by the COMT gene. This enzyme catalyzes the metabolism of dopamine in the brain. COMT has three common variations - AA/AG/GG - which substantially alters how effective the enzyme is at metabolizing dopamine. AA results in significantly reduced enzyme activity, which can result in dopamine built-up in the brain, which results in increased sensitivity to stress, anxiety, and pain, but comes with the bonus of enhanced cognition, motor skills, and memory.

AA genotypes also tend to be "placebo responders", while GG genotypes tend to be non-responders. This tends to imply that placebo responsiveness isn't purely psychological, but physical - and indeed, it turns out that in AA "responders" you can turn off the placebo effect by administrating naloxone (which works by binding to opioid receptors)!

This has really interesting implications for pharmacological research, too - if there are people who are genotypically predisposed towards or against placebo effects, then a drug trial that stacks responders in the trial group and non-responders in the placebo group which would produce a drug efficacy signal that could be just the placebo effect.

Re: The Uselessness of Phenylephrine (2022)

#108

This strikes me as an example of a larger phenomenon. Take for example the counter-insurgency wars that have become normalized since 9/11. In these conflicts, there is enormous pressure to minimize casualties because these directly undermine the political will to conduct military operations. As such, the strategic objectives eventually degenerate to mere "presence", and commanders are effectively unable to pursue the…

The Dutch take this to the extreme, where the actually effective anti-cough medication dextromethorphan is completely unavailable, but complete bullshit herbal mixes which claim to help are a dime a dozen on every store shelf. I can't even imagine the amount of needless suffering people with chronic cough go through in the Netherlands.

The effectiveness of dextrometorphan is... underwhelming in most people. But you are correct that no effective cough suppressant is available OTC in Europe.

Re: The Uselessness of Phenylephrine (2022)

#109
I wish they would give similar treatment to homeopathic "remedies." It's appalling to find them sold at drug stores when they've never even been proven effective in any way. You can literally give the opposite "medicine" to someone and they wouldn't be able to tell the difference.

Re: The Uselessness of Phenylephrine (2022)

#110

Earlier quoted context omitted.

Didn’t prevent people from getting meth, but did allow drug companies to make millions selling a useless compound. I doubt that was the intent of the legislation.

The same company sells both compounds. I don't think this was a huge moneymaker. I think the PE thing was just there to retain the sales that moving Sudafed behind the counter sacrificed. That doesn't make it OK, but it does sort of argue against the idea that the regulation was just a moneymaking scheme.

Agree with that. Just more failed war on drugs stuff.
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