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The Uselessness of Phenylephrine (2022)

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Re: The Uselessness of Phenylephrine (2022)

#231
post #75

Earlier quoted context omitted.

Meth is not harder to produce. It's now mass-produced from P2P, with chiral purification using various methods (like pulling one enantiomer with tartaric acid).

I'm curious about the chemistry here (though I have very little chemistry background), so, bearing in mind that I have zero interest in producing methamphetamine, perhaps you can elaborate a little: – I can't see how Phenylacetone can have chirality – I don't understand how any enantiomer of P2P (if one exists, see above) can be selected for specifically via a chemical reaction, especially here with tartaric acid, wh…

P2P doesn't have chirality, but methamphetamine does. Any carbon atom with 4 different groups attached to it will always be chiral, in meth it's the carbon next to the nitrogen. It has: methyl group, phenol group, hydrogen, and the amino group.

> – I don't understand how any enantiomer of P2P (if one exists, see above) can be selected for specifically via a chemical reaction

You just react P2P and get a racemic mix of L- and D- enantiomers of meth. Then you react it with tartaric acid, which will preferentially react with the "right" meth.

> tartaric acid, which is a chiral molecule itself

Ah, I see the confusion. Tartaric acid derived from biological sources consists of just one enantiomer, that's why you can use it to do chiral resolution.

Re: The Uselessness of Phenylephrine (2022)

#232

Earlier quoted context omitted.

In order for a rate limit to be effective, at some point it has to apply, and at that point, I'm told "no." More concretely, in order to implement a rate limit, you have to sign an electronic log book, and the government can view that log book whenever it likes, without any sort of review or auditing, of course. This isn't the primary concern anyways, the point was, in order to implement this seemingly simple action,…

The only liberty being sacrificed here is showing an ID at a pharmacy counter to get Sudafed. I'll stipulate that's a liberty being sacrificed, but it isn't "many". This particular "logbook" has existed for almost 2 decades now, and its scope hasn't creeped from there, so your second argument is pretty easy to shoot down. I think the evidence pretty strongly suggests that this policy, which was put in place to create…

> The only liberty being sacrificed here is showing an ID at a pharmacy counter to get Sudafed.

It would be interesting to know if the people concerned about the need to show an ID to vote share that concern about the need to show an ID for access to medicine.

> This particular "logbook" has existed for almost 2 decades now, and its scope hasn't creeped from there, so your second argument is pretty easy to shoot down.

The policy has proved ineffective at curtailing the availability of methamphetamine while inconveniencing honest people. That's not something the public is clamoring for more of.

But it never really was. It came about to begin with as part of the Patriot Act. The lack of expansion is unsurprising given the lack of any 9/11-style crisis to use as an excuse in the intervening two decades. The test is when the next one comes.

One of the failings of the existing style of government is that the "passage by both houses of Congress and signed by the President" system used to pass legislation is the same system required to repeal it, which rightfully makes it harder to pass bad laws, but wrongfully makes it harder to repeal them. And then they get passed during a crisis and inconveniently stick.

Re: The Uselessness of Phenylephrine (2022)

#233

Earlier quoted context omitted.

The "fundamental problem" is the breakdown of community (drug abuse being primarily being a function of the existence or lack of interpersonal involvement and responsibilities that would preclude spending time and money on them). People who are comfortable huddling in their cars, homes, and exclusive social clubs, and who would rather spend money on cops rather than social programs, aren't going to like the fix for t…

Do you have a source for this? > drug abuse being primarily being a function of the existence or lack of interpersonal involvement and responsibilities that would preclude spending time and money on them AFAIK there have always been addicts in every culture. Alcohol, various drugs, and strongly self destructive behaviors are not recent additions to the human experience. But I don't know any if the numbers or the rese…

"AFAIK there have always been addicts in every culture."

Surely you would agree that there the proportion of addicts varies by culture and society, that the US for example has a much higher proportion than many poorer nations? I don't know about the first comment's claim that lack of interpersonal relationship is the root cause, but a strong social component looks obvious to me.

Re: The Uselessness of Phenylephrine (2022)

#234
post #107
post #16

Earlier quoted context omitted.

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…

Is the COMT gene stuff discussed in "Suggestible You"? I recently learned I have the AA variation and from what I understand so far, it seems like it might be an explanation (or at least part of one) for why I am so sensitive to a number of vitamins and medications. I hadn't heard about the placebo related thing. But anyway, I am interested in continuing to learn more about it (it has been somewhat difficult for me to find digestible information about it online) so might look into that book if it discusses it much at all.

Re: The Uselessness of Phenylephrine (2022)

#235
post #86

Earlier quoted context omitted.

It’s worth a try. I’d recommend buying a separate spray for your nose though.

Reminds me of the old joke: what's the difference between an oral thermometer and a rectal thermometer? Answer: the taste

This reminds me of the funniest scene in the movie Idiocracy, where he loses track of which cable goes in the mouth vs ear vs butt. A laugh a day keeps the doctor away, enjoy :-)

https://youtu.be/zop3VG_K9HU?si=k8LDptGhvQDxtsTB

Re: The Uselessness of Phenylephrine (2022)

#236

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.

Since I have seen a number of recommendations for sinus rinse in this thread but haven't (yet) noticed this specifically mentioned: It is important to use sterile water if you are using water for the rinse. Water directly from the tap apparently may not be safe for that purpose (there was a case earlier this year where a person died from a brain eating bacteria - they were apparently infected from using unboiled tap water for a sinus rinse.)

https://www.healthywa.wa.gov.au/Articles/N_R/Nasal-irrigatio... https://www.everydayhealth.com/lung-respiratory/too-many-peo...

Re: The Uselessness of Phenylephrine (2022)

#237
post #160
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…

It very much is reported in a national database.

https://help.eaglesoa.com/29/en-n-eagle/Pharmacy/Pseudoephed...

Anecdotally, I usually by psuedophredrine at CVS. I bought some in Orlando and tried to buy more at a completely unrelated store in Puerto Rico and was denied.

Re: The Uselessness of Phenylephrine (2022)

#238
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…

I was under the impression that there are state-level databases in some states that actually track sales. I am likely incorrect, since a quick google doesn't find anything.

https://help.eaglesoa.com/29/en-n-eagle/Pharmacy/Pseudoephed...

Re: The Uselessness of Phenylephrine (2022)

#239

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 just came here to say that I actually find phenylephrine nasal spray quite effective - but I use it for a different use case: stopping nosebleeds quickly. It's quite effective at that and came recommended by an ENT, so I do believe it's an effective vasoconstrictor when applied locally and I'm glad it's available.

This. Phenylephrine works great as a decongestant nasal spray, and it's not as addictive as oxymetazoline. (It doesn't last as long either, but that doesn't bother me.)

Re: The Uselessness of Phenylephrine (2022)

#240

Earlier quoted context omitted.

You can't fight a war against inanimate objects. You can fight a war against drug addicts. You cannot possibly win a war against drug addicts without addressing the fundamental problem.

Most of us cannot make these drugs ourselves. To restrict them effectively would certainly curtail their abuse?

It turns out it's not possible to do that. We've been trying since the 1960's.
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