To curb meth, a crackdown on cold medicines

For years David Niles, pharmacy manager at Sack-N-Save, has battled the nation's methamphetamine addiction - one pill at a time.

As fast as he can restock the shelves of his Gainesville, Texas, pharmacy with Sudafed and other cold pills, they're gone - stuffed under shirts and into backpacks on their way to meth labs.

So Mr. Niles moved the pills from Sack-N-Save's front door to cut down on theft. Then in April, when Oklahoma - just a few miles away - severely restricted the sale of cold medicine, business at his own shop soared. Now he's pulled the drugs from his shelves altogether: No one can access the pills without going through him.

"It's self defense," he says. "Meth labs have been a real problem in this part of the country."

His crusade is part of a growing crackdown on one of America's major drug problems.

Since Oklahoma became the first state to classify the popular cold tablets containing pseudoephedrine as Schedule V drugs (those with narcotic ingredients), meth cookers have been forced to leave the state in search of this key ingredient.

The apparent success has led a slew of states - especially those that share a border with Oklahoma - to consider more drastic measures. Even at the federal level, a Senate bill introduced earlier this month would make pseudoephedrine a controlled substance.

The measures are controversial. Drug-makers and drug stores say they are being unfairly targeted and argue that pharmacists are being turned into policemen who limit access to legitimate customers, while retailers confront a growing list of confusing laws.

But lawmakers are increasingly frustrated - and desperate - as they watch their budgets get funneled into the epidemic. Already, 28 states have restricted pseudoephedrine sales. In this legislative session at least 19 have introduced new or stricter measures on the cold tablets, seven of which would require pharmacists to make the sale.

The drug first appeared among California biker gangs in the 1950s, but didn't start to move eastward until the 1990s.

"States on the West Coast have been dealing with the methamphetamine problem for quite a long time," says Blake Harrison, a criminal-justice policy specialist at the National Conference of State Legislatures. "But now we are seeing it spread to the East Coast, and that has prompted many other states to address the problem."

Almost 80 percent of meth is still made in California's Central Valley or smuggled in from other countries. But homemade labs in neighborhoods, farms, and forests are overwhelming local law-enforcement agencies. Not only are they dangerous to dismantle - often resulting in toxic spills - but meth users can be extremely violent.

That's what spurred Oklahoma to act. Since 1999, three state troopers have been killed in meth-related incidents, and lab seizures rose from 10 in 1994 to 1,233 in 2003.

"During that time, we tried other laws," says Mark Woodward, a spokesman for the Oklahoma Bureau of Narcotics and Dangerous Drugs Control. "But people continued to find a way to cook it using these cold pills."

The new law limits the sale of the pills to pharmacies. It orders them placed behind counters, limits the sale to 9 grams per person in a 30-day period, and requires purchasers to show identification and sign a logbook. Since its passage in April, says Mr. Woodward, Oklahoma has seen an 80 percent drop in lab seizures.

"Now we are picking up meth cookers who say they are having to travel two hours into Kansas, Texas, and Arkansas to get cold pills. That in itself is a measure of the success of this law," he says. Passage of similar legislation in surrounding states will make it still more effective, he says.

But already drugmakers and drug stores have had some success in fighting the restrictive Schedule V legislation.

Last year, for instance, Iowa lawmakers were unable to pass a bill after lobbying from the Consumer Healthcare Products Association, representing the over-the-counter drug industry, and Pfizer, maker of Sudafed.

Pfizer this month is releasing Sudafed PE, which replaces pseudoephedrine with a chemical that can't be used to make meth. For its part, the Consumer Healthcare Products Association says it supports package limits, Meth Watch programs, increased education and treatment, and stiffer penalties for meth-related activities.

"There are alternatives to going so far as to putting pseudoephedrine on Schedule V status," says the organization's Virginia Cox.

Many large retailers already restrict sales by placing package limits on cold pills. But some in Oklahoma are finding it a real challenge to comply with the new law, says the National Association of Chain Drug Stores.

"Pharmacists were busy before this law took effect. Now they have to keep a logbook and monitor sales," says Mary Ann Wagner, vice president of pharmacy regulatory affairs at the association. "Pharmacists are highly trained to administer medications. They are not trained to be law-enforcement officers." In addition, she says, others point out that nothing is keeping someone from signing a logbook at one retailer, then hopping across the street to another. "So not only is it a very labor-intensive process, it's not solving the problem."

But Mr. Woodward, with the Oklahoma Bureau of Narcotics, says the state is building an electronic database to connect all pharmacies with the same information.

Most pharmacists, he says, "have been very willing to help."

Indeed, says pharmacist Niles, they may understand the problem better than anyone.