Also, some new developments:
http://www.emissourian.com/site/news.cfm?newsid=20381872&BRD=1409&PAG=461&dept_id=33071&rfi=6

Vote Vroman for Franklin County Sheriff
I promise to deliver
-Random house to house searches
-Generous informant payoffs
-Exorbitant surcharge on anything remotely connected to meth manufacturing

When Im done you’ll wish you just had a drug problem

The drug’s cost: $25. The doctor costs (I shopped around): $75-$300. And for what exactly?

Doctor: “So, you want this refilled?”
Me: “Yes.”
Doctor: “Okay.”

As Stokes pointed out, putting pseudoephedrine behind a prescription likely wouldn’t stop meth production. And on top of that, it would make the medicine prohibitively expensive for many.

http://www.stltoday.com/stltoday/news/stories.nsf/missouristatenews/story/9ABDEAE5446646D88625765000674304?OpenDocument

I am sure they can solve this problem by making heroin illegal, too. That will take care of everything. Oh, wait…

Citizens of this theoretically free country may not use certain medicines without the written permission of an officer of the state. Yes, doctors are officers of the state by virtue of their having been deputized by the state to grant, or withhold, such permission. That was not true before 1914. Until then, adult citizens could enter a pharmacy and buy any drug they wished, from headache powders to opium. They needed no one’s permission. They were, in a phrase, pharmacologically free.

That freedom was abolished as the paternalist ethic gained currency. People had to be protected from their own unwise choices. For their own good, they could not be allowed to prescribe medicines for themselves. At least, that is what they were told. In fact, we know otherwise. When Americans were pharmacologically free, they managed not to kill themselves with overdoses or inappropriate medicines. When they felt it necessary, they sought advice from physicians or others who had greater experience than themselves. Americans somehow knew not to swallow purported medicines without wondering about the consequences. (We know this because population and life expectancy grew all during the period.)

Then they lost this right. They were told they were no longer able to make those kinds of decisions. For some unfathomable reason, they surrendered their authentic right to health care without a bloody struggle.

They were lied to, of course. The doctors and the politicians did not really believe that Americans had suddenly become too benighted to medicate themselves. No, the doctors and politicians wanted power. The prescription law was just one piece of a larger conspiracy against the public. At about this time, the United States got its first laws to license doctors and accredit medical schools. The same paternalistic rationalizations were fed to the public. But the minutes of the medical societies’ meetings tell another story. Historian Ronald Hamowy has documented what was really on the minds of the doctors: income. They were concerned that free entry, and hence unrestricted competition, into the medical profession was driving down fees. Only government regulation could keep the doctors living in the manner to which they had become accustomed.

That regulation took several forms. Accreditation of medical schools regulated how many doctors would graduate each year. Licensing similarly metered the number of practitioners and prohibited competitors, such as nurses and paramedics, from performing services they were perfectly capable of performing. Finally, prescription laws guaranteed that people would have to see a doctor to obtain medicines they had previously been able to get on their own. The doctors and politicians succeeded in supporting the medical profession’s income; they also contributed to the infantilization of the American people. We have never recovered.

The same laws have also subverted the medical profession, since doctors can be-and have been-prosecuted for prescribing drugs “in amounts that exceed a legitimate medical purpose.” In some states, doctors must send a copy of prescriptions for certain drugs to a government bureaucracy. Government thus reserves the power to decide what is legitimate.

Some will say, things were simpler before 1914. Surely in our complex age, people cannot be expected to make those decisions for themselves. This is fallacious. Despite all the purported protection against self-treatment, the one thing that is supposed to activate the system for the individual is left entirely to his own discretion: the visit to the doctor. What protects a person against his decision not to see a doctor? Even the most extreme proponents of socialized medicine do not advocate compelling people to see a doctor against their will. The freedom to do without medical care, at least, is respected. If the paternalists were truly consistent, they would call for protecting us from that dangerous freedom by requiring periodic visits to the doctor. But perhaps that would bare their totalitarian talons a little too much.

However, your belief on prescription regulation is a common misconception. To see why, it’s easiest to turn the question around and ask rather why some drugs aren’t prescription-only. Generally speaking, drugs are allowed to be sold over-the-counter when two conditions are met: the condition being treated does not require medical supervision, and the drug can meet elevated safety standards. It’s not so much an issue of “abuse” in the pathological sense, it’s really more concern about people attempting to self-diagnose, self-treat, and thus perhaps self-harm.

Pseudoephedrine is a great example of this standard at work. With ARS there is no advantage to medical supervision, since the only effective treatment is the highly safe, highly effective symptom reduction effected by drugs like Sudafed, and it is rarely complicated by infection or serious illness. Also as I indicated above, empowerment of patients is important for the health-care system as a whole. After all, if it weren’t, why have any over-the-counter drugs at all?

Just as your opinion is colored by your roots, so is my opinion colored first by a lifetime as a daughter of a pediatrician slammed by colds and flus all winter long and now as an employee of Children’s Hospital, where emergency unit patients are literally being seen in tents in the parking garage because patient volume has increased over 100% this season. Of course these different perspectives are exactly why I think the key to finding solutions to the meth problem (and others) is interdisciplinary collaboration, rather than measures such as these that are almost entirely crafted by law enforcement and legislators.

1) Union is just south of my hometown, Washington, MO. (w00t).

2) Though your article was thorough and brought up some very good points, points which I had not thought of before, you neglect to balance the costs you mention with the costs of drug abuse plaguing our great state.

3) I fail to see the drastic results of making Sudafed prescription only. Yes, there will be increased costs to the economy, but how is Sudafed being prescription only and different than other drugs being prescription only. Am I wrong to assume drugs are kept by prescription only because they are easily abused and their threat to society by being readily available as over the counter medications outweighs the benefits they bring by being readily available? I would say Sudafed fits into this category of costs outweighing benefits. Yes, I admit it’s nice to be able to go to Walgreens and buy Sudafed when I’m really clogged up, up there. But I, like many, am willing to sacrifice that utility if it curbs meth production.

4) The Voss family has a few ties to this issue. The town in question, Union, is a small town indeed. I can’t imagine them having more than 6 pharmacies. The largest of which is the Walgreens on the corner of Hwy. 47 and Hwy. 50. My sister Laura and her husband are both Walgreens pharmacists and am fairly certain have both worked at that particular Wags. If anybody would have something to say on this issue, it would be my older sister, but unfortunately she isn’t picking up her cell phone and is thus unavailable for comment. But no worries. I myself at one point was a pharmacy tech at the Washington Walgreens. Honestly, this is as much as an issue there as in Union, or anyway in Franklin County for that matter. In my opinion, the current regulations on purchasing decongestants containing pseudoephedrine are too lax. If I remember correctly (and please correct my if I am wrong [Eric]), all that is necessary to buy Sudafed is a driver’s license, filling out a form detailing your name, age, address, and quantity of purchase, and I believe there is a maximum amount you can purchase, 2 boxes (I am unsure of the milligrams and frankly, do not feel like Googling it.)

So, in conclusion, I would support the measure to make a prescription requirement statewide. I enjoyed the article and look forward to hearing more about the issue as it progresses. Hopefully in the future I see more stories about Franklin County, specifically Washington, on this blog. It seems the amount of Washington related stories has dropped significantly since mine and Eckelkamp brothers’ tenures ended at the SMI.