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The Uselessness of Phenylephrine (2022)

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Re: The Uselessness of Phenylephrine (2022)

#341

Post by tptacek »

AnthonyMouse wrote: post #308
tptacek wrote: post #266

Earlier quoted context omitted.

The problem with Sudafed isn't that it's ineffective or unsafe for its users; it's that it has the same or higher abuse potential as codeine cough drops did. We took codeine completely off the market, but you can just go buy Sudafed whenever you want.

Significant numbers of people are not going to the pharmacy and buying Sudafed because they have a cold and consequently getting addicted to Sudafed, which is what had been happening with codeine. It's clearly because you can make methamphetamine out of it. But you can also make methamphetamine out of other things which limiting access to cold medicine demonstrably hasn't prevented.

When Sudafed was put behind the counter, it was likely that a plurality of all Sudafed purchases in California were abusive.

Re: The Uselessness of Phenylephrine (2022)

#342

Post by cheald »

nonethewiser wrote: post #269
cheald wrote: post #119

Earlier quoted context omitted.

The point is more to not be in a position to have to go out and buy some when I'm feeling cruddy. Since it's controlled, I can't just have some shipped to my door when I'm laying in bed sick. I just got in the habit of picking it up periodically to ensure that it's on hand when I need it.

So why buy 1 every 6 months? Just go buy 6. This sounded like you were trying to avoid the limits: > Indeed. I've known that phenylepherine is worthless for a long while, and just make it a point to buy a pack of the real stuff every 6 months or so, so that I always have it on hand when I need it. In my state, it's controlled - you have to get it from a pharmacist (though you can do so without a prescription) - they…

I think you're reading something into it that isn't there. It's just not on the shelf, I'm not likely to notice it and incidentally purchase it when I'm buying ibuprofen or whatever, and I have to go out of my way to get it. I can't just have Amazon overnight some to me. As a result I've just gotten in the habit of buying it periodically without waiting for "I'm sick" to be the reason for the purchase. The 6 month period isn't "trying to not get noticed", it's "that period comfortably covers my household's needs with some breathing room".

Sure, I could buy 6 boxes at a time. I just don't. There's not really any good reason to min-max my pseuodephedrine acquisition.

Re: The Uselessness of Phenylephrine (2022)

#343

Post by AnthonyMouse »

tptacek wrote: post #341
AnthonyMouse wrote: post #308

Earlier quoted context omitted.

Significant numbers of people are not going to the pharmacy and buying Sudafed because they have a cold and consequently getting addicted to Sudafed, which is what had been happening with codeine. It's clearly because you can make methamphetamine out of it. But you can also make methamphetamine out of other things which limiting access to cold medicine demonstrably hasn't prevented.

When Sudafed was put behind the counter, it was likely that a plurality of all Sudafed purchases in California were abusive.

More than likely, I would think, since plurality just means more than one.

But the justification is not the same. People were going to the drug store for cough drops and unintentionally ending up addicted to opioids. Nobody was going to the drug store for a decongestant and accidentally making meth out of it, and the number of people getting addicted to pseudoephedrine itself was neither large enough to justify the change, nor its explicitly stated rationale. Nor an effective means to bring it about if the claim that showing an ID isn't a burden is to be believed because it would have no effect on the small minority of people who might go to the pharmacy for a stuffy nose and thereby become dependent on pseudoephedrine, since they would still get it.

Meanwhile the stated rational of limiting availability of methamphetamine hasn't gone well either.

This before we even mention that the OTC replacement, phenylephrine, is not only ineffective, it's a more dangerous drug than pseudoephedrine from a cardiovascular perspective and the switch has plausibly killed some people.

Re: The Uselessness of Phenylephrine (2022)

#344

Post by jgalt212 »

tptacek wrote: post #95
omginternets wrote: post #93

Earlier quoted context omitted.

> Real Sudafed is to a first approximation available to everybody. I didn't actually know this, and it's good to know. That said, I'm not certain that most people are aware that it is available without a script. Maybe I'm wrong.

If you walk up to the pharmacy counter at any Walgreens or CVS, literally the first thing you're going to see is a shelf of decongestants.

you need to provide a government ID. so probably not an option available to illegal aliens (in many states).

Re: The Uselessness of Phenylephrine (2022)

#345

Post by [deleted] »

lazide wrote: post #255
jasonfarnon wrote: post #233

Earlier quoted context omitted.

"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.

Cite? Every nation has an underbelly. Poorer nations, those folks tend to die pretty fast though.

[deleted]

Re: The Uselessness of Phenylephrine (2022)

#346

Post by jasonfarnon »

lazide wrote: post #255
jasonfarnon wrote: post #233

Earlier quoted context omitted.

"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.

Cite? Every nation has an underbelly. Poorer nations, those folks tend to die pretty fast though.

cite for what? my comment is basically asking for a citation for the OP's (and your) claim that substance abuse isn't culturally dependent?

Re: The Uselessness of Phenylephrine (2022)

#347

Post by underlipton »

dumpsterdiver wrote: post #297
underlipton wrote: post #257

Earlier quoted context omitted.

I don't, but I'll ask you to consider the following: 1) The implication of my statement wasn't that social programs would solve the problem single-handedly, but that they're more effective than enhanced law enforcement spending. 2) This would seem to be, at the very least, supported by the people who advocated for treating the (mostly white and middle-class) victims of the opioid epidemic in the US as suffering from…

> I don't, but I'll ask you to consider the following: 1) The implication of my statement wasn't that social programs would solve the problem single-handedly, but that they're more effective than enhanced law enforcement spending. What do police have to do with the effectiveness of social programs? A fundamentally ineffective social program will be just about as ineffective no matter how much funding it gets - becaus…

>A fundamentally ineffective social program will be just about as ineffective no matter how much funding it gets - because the problem they are approaching isn't one that they can solve.

Correct - ironically, as you're describing most law enforcement agencies. The money spent on police - particularly their generous overtime and pension pay, equipment outlays, and hilariously ineffectual training - could be used to fund social interventions that actually work.

Re: The Uselessness of Phenylephrine (2022)

#348

Post by underlipton »

jasonfarnon wrote: post #346
lazide wrote: post #255

Earlier quoted context omitted.

Cite? Every nation has an underbelly. Poorer nations, those folks tend to die pretty fast though.

cite for what? my comment is basically asking for a citation for the OP's (and your) claim that substance abuse isn't culturally dependent?

I didn't claim that it wasn't culturally-dependent. Both people turning to drugs to self-medicate, and people not supporting and funding effective interventions - people on both sides rejecting or not seeing the opportunity to engage in community-building - is absolutely a culture issue.

Re: The Uselessness of Phenylephrine (2022)

#349

Post by phone8675309 »

akerl_ wrote: post #339
phone8675309 wrote: post #336

Earlier quoted context omitted.

A more robust fix compared to keeping a list of cold medicine buyers would be to decriminalize or legalize hard drugs, ensuring that a clean, inexpensive supply is available for those addicted under medical supervision, providing a safe place for those who choose to use, providing judgement free addiction treatment, increasing invest in addiction prevention, and addressing the systemic issues that drive people toward…

Oh, so I guess we just draw the rest of the owl. Good to know that if we fundamentally alter society and sidestep the challenges in doing so, we can avoid the burden of occasionally having to show our ID for one more drug than before. We can and should do the things you're suggesting, but I can't get behind the logic that we should wait til we can accomplish those things, when we can take any other more straightforwa…

> I can't get behind the logic that we should wait til we can accomplish those things

Where in my post did I say we should stop taking IDs and then wait until all of those are 100% fully accomplished before trying something else? Re-read the post - it's not there.

I'm arguing a more robust fix would be to do all of those things. That's not incompatible with keeping the current system of checking IDs until we hit some critical mass where the fixes for the more systemic issues reduce the need for checking IDs.

Re: The Uselessness of Phenylephrine (2022)

#350

Post by rkuykendall-com »

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…

I recently went to the grocery store for ear drops. The real ones were sold out but two fake ones were still on sale. Just magic water, might have even made my ear ache worse. Nobody cared that meds are on sale in the pharmacy were fake. The pharmacist didn't care, the manager didn't care. I ended up making a simple alcohol vinegar mix at home on the recommendation of the pharmacist.
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