Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

The Uselessness of Phenylephrine (2022)

science.org

Post reply on HN
Print view View original

181–190 of 350 posts

Re: The Uselessness of Phenylephrine (2022)

#181

Post by NickNameNick »

tshaddox wrote: post #179
tyingq wrote: post #160

Earlier quoted context omitted.

That's mostly right, but it's not reported to anyone. It came from the "The Combat Methamphetamine Epidemic Act of 2005" . If you want to sell pseudoephedrine, your org has to "self certify", keep a logbook purchasers have to sign, require ID, enforce the purchase limits, train employees, etc. But, the logbook doesn't go anywhere unless some investigation or audit prompts that. So, if you're a really determined cooke…

> So, if you're a really determined cooker, you can still go to a bunch of different stores...though you're leaving a paper trail. Isn't meth a lot easier to come by these days? I have to imagine it's more convenient to cook street meth back into Sudafed to fix your stuffy nose than it is to cook Sudafed into meth to get your fix.

see "A Simple and Convenient Synthesis of Pseudoephedrine From N-Methylamphetamine"

https://improbable.com/airchives/paperair/volume19/v19i3/Pse...

Re: The Uselessness of Phenylephrine (2022)

#182

Post by paint »

buildsjets wrote: post #9

The fact that phenylepherine is ineffective is quite old and has been common knowledge for many years. What is news is that the FDA is finally acknowledging it. I've maintained my own reserve of pseudoephedrine for years. https://gizmodo.com/report-many-over-the-counter-decongestan... https://www.forbes.com/sites/daviddisalvo/2015/10/26/the-pop... https://www.newscientist.com/article/2089555-breaking-bad-sn...

I mean, I get the reason behind it and I honestly don't know if it's a good or a bad thing, but the idea of pseudoephedrene sales being monitored like that is so foreign to me. I bought cold medication in pharmacies in 3 different countries always asking specifically for pseudoephedrine and it never occured to me that was a meth cook thing.

Re: The Uselessness of Phenylephrine (2022)

#183

Post by fragmede »

tptacek wrote: post #63
nimish wrote: post #40

Earlier quoted context omitted.

Easily the best example of why the stupid federal law limiting access to a useful decongestant backfired.

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.

Water, consisting of hydrogen "basically is" and explosive, as is table salt, consisting of Sodium, which explodes when coming into contact with water. How can we let these two dangerous substances go unregulated! Think of the children! who will get to have interesting high school chemistry labs, that is.

That Sudafed "basically is" meth misunderstands chemistry, and the resourcefulness of the real life Walter Whites of the world. Hells Angels and the Cartels operate under the nose of the DEA so there's no way meth or drugs are going away. It's time for the government to admit they lost the current battle of the war on drugs to drugs. Current tactics aren't working and it's time to take the war to the demand side of the equation. Cut down the demand for drugs by getting addicts off opiates and stimulants with an army of therapists and councilors and rehab programs. With a large helping of harm reduction and government assistance. Wishful thinking, I know, but making all forms of basic chemistry illegal is like trying to make water not wet.

Re: The Uselessness of Phenylephrine (2022)

#184

Post by skipkey »

tptacek wrote: post #65
omginternets wrote: post #6

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…

(1) I think there's pretty wide agreement that selling Sudafed PE is worse than selling nothing at all, and I'd sort of expect it to be off the shelves sometime soon (it should have been much earlier than this). (2) "Selling nothing at all" is actually not the policy. Real Sudafed is simply a behind-the-pharmacy-counter drug. You don't need a script to get it (plenty of non-abusable drugs do require scripts, a much h…

Not sure if it’s still the case, but a few years ago I was traveling and staying overnight near St Louis, and was shocked to find that it actually required a prescription there, but only in the county that St Louis was in.

Re: The Uselessness of Phenylephrine (2022)

#186

Post by pengaru »

tshaddox wrote: post #179
tyingq wrote: post #160

Earlier quoted context omitted.

That's mostly right, but it's not reported to anyone. It came from the "The Combat Methamphetamine Epidemic Act of 2005" . If you want to sell pseudoephedrine, your org has to "self certify", keep a logbook purchasers have to sign, require ID, enforce the purchase limits, train employees, etc. But, the logbook doesn't go anywhere unless some investigation or audit prompts that. So, if you're a really determined cooke…

> So, if you're a really determined cooker, you can still go to a bunch of different stores...though you're leaving a paper trail. Isn't meth a lot easier to come by these days? I have to imagine it's more convenient to cook street meth back into Sudafed to fix your stuffy nose than it is to cook Sudafed into meth to get your fix.

A "cook house" burned down from me a couple months ago, so there's clearly still domestic cooking going on here (Cali hi-desert around JTNP).

Re: The Uselessness of Phenylephrine (2022)

#187

Post by dragonwriter »

tyingq wrote: post #160
JJMcJ wrote: post #136

Earlier quoted context omitted.

You can still get pseudoephedrine, for example Claritin D, the D for decongestant. It's not by prescription but you have to sign for it at the pharmacy desk, present ID, and I believe it's reported to FDA/DEA and there are limits to how much you can buy per month.

That's mostly right, but it's not reported to anyone. It came from the "The Combat Methamphetamine Epidemic Act of 2005" . If you want to sell pseudoephedrine, your org has to "self certify", keep a logbook purchasers have to sign, require ID, enforce the purchase limits, train employees, etc. But, the logbook doesn't go anywhere unless some investigation or audit prompts that. So, if you're a really determined cooke…

> That's mostly right, but it's not reported to anyone.

IIRC, its reported to a centralized state database in (near) realtime in some states, but in any case it is definitely the case that chain pharmacies generally have their own electronic tracking and flagging to avoid getting nailed the way CVS did [0], which may be shared systems like MethCheck [1], which can also be used by independent pharmacies.

So, you’ve got to choose your targets carefully for your “shop at lots of different pharmacies” plan.

[0] https://www.justice.gov/archive/usao/cac/Pressroom/pr2010/14...

[1] https://totalverify.equifax.com/solutions/methcheck

Re: The Uselessness of Phenylephrine (2022)

#188

Post by tshaddox »

jawns wrote: post #33

I laughed out loud when I read about the lobbyists who are trying to keep phenylephrine from being taken off store shelves. In one article about the FDA panel vote, a lobbyist said that most consumers hate the alternatives -- nasal sprays because of the discomfort and pseudoephedrine because it's stored behind the pharmacy counter -- and so depriving them of a hassle-free option is anti-consumer. The fact that the ha…

If only there was a simple physical maneuver that could transform the location of something from behind a pharmacy counter to the customer-facing shelves!

Re: The Uselessness of Phenylephrine (2022)

#189

Post by m463 »

303uru wrote: post #143
m463 wrote: post #34

Earlier quoted context omitted.

I think american medicine just chooses prescribing medication first. Patients are definitely more likely to take a medication than change their behavior. Patients also ask for medication. And then there's the whole pharmaceutical system. My personal experience is that many older people I've known have a startling number of bottles of medication they take every day. I also know some older people that have exercise and…

>I also know some older people that have exercise and eating right as part of their regimen and rarely take any medication. Not to be pedantic, well actually let's be. But this is pretty poor medical thinking. Are patient's not on meds at advanced age because they exercise? Or are they able to exercise because they're otherwise healthy and feel good? This kind of simplifying causes a lot of harm in medicine and a lot…

My observation seems to be two broad groups. Maybe the fit ones eventually become the bottle ones? Maybe the no-bottle ones are resisting medicine?

One thing is for certain - it makes me uncomfortable how many different medications some people take every day.

Re: The Uselessness of Phenylephrine (2022)

#190

Post by xylophonermore »

nicole_express wrote: post #168

Phenylephrine did its job of convincing people to accept restricting access to pseudoephedrine, since there was a substitute that could still be freely available. Now it'll be taken off the market, but pseudoephedrine that actually works will still be restricted. At least the homeopathics consumers will buy instead have fewer side effects

I, like many others I suspect, bought phenylephrine when Sudafed first disappeared from store shelves. It was 100% ineffective for me from the first dose.

In the meantime, Sudafed has become one of the most difficult to acquire substances for my daily life (I need it every day as directed by my doc). So many times when I go to a pharmacy to get it, they're out of 96-count or 48-count or any count, meaning my one allowed purchase/month nets me less than a month's worth. Or the state's tracking system is down (this happens frequently) and they won't sell me anything. IOW, buying Sudafed is difficult and often infuriating.

Meanwhile, meth problems haven't gone away—-in fact meth use is WAY up since these restrictions were put in place in the aughts. Sure, hiding and tracking it got some of the meth production moved south, but it didn't negatively affect meth availability. Supply is plentiful, prices are down, purity is up. Even Oregon, who restricted Sudafed to prescription only, has seen a 3x increase in meth deaths. [1]

Sadly, the restrictions on Sudafed are unlikely to ever change as lawmakers rarely care that their laws hurt a ton of law-abiding people as long as they can claim something about being tough on crime.

[1] https://www.nytimes.com/2018/02/13/us/meth-crystal-drug.html

Post reply on HN