As a pharmacist serving thousands of patients every year, I am asked to offer advice each and every day.
Will this medicine make me feel better? What’s the best product for my child’s symptoms?
As a health care professional, I have a responsibility and duty to provide the best possible advice and assistance to my patients. Certainly one of the areas pharmacists are most concerned about is the problem of methamphetamine production and abuse. While it is true that some individuals come into my pharmacy and attempt to buy pseudoephedrine for illegal purposes, the vast majority of the people that I serve simply need a decongestant to combat seasonal allergies that are prevalent in this part of the country.
Due to the nature of independent pharmacy practice, I have a personal relationship with many, if not most, of my patients. Pharmacists believe that the illegal actions of a few should not cause an undue burden on law-abiding members of the public who are simply seeking safe and effective therapy for minor health conditions that can be safely and effectively treated with over-the-counter products available from a pharmacist. The fact is that the vast majority of illicit purchases of pseudoephedrine do not come from community pharmacies!
For a long time, my colleagues and I were completely in the dark to this activity. Pharmacies had no system in place that helped us track purchases and stop them when people attempt to buy too much. That all changed earlier this year when Tennessee implemented a state-of-the-art system that allows us to stop illegal sales in the same manner we deny a debit card with insufficient funds. All we have to do is simply scan the purchaser’s identification and then the system does all of the work. If a purchaser is about to exceed his or her PSE purchasing limit, the purchase is instantly blocked. Our friends in law enforcement also have access to the data and often arrest suspects based on evidence collected by the system.
Although this system is extremely burdensome to pharmacists and our legitimate patients, we utilize it because it helps solve the very problem it was designed to solve. We had to pay several thousand dollars out of our own pockets for this system, but we did it because we want to be a part of the solution to this problem.
Recently, I was troubled by an Op-Ed written by Sheriff Jim Ruth in the Cleveland Daily Banner. In the piece, Ruth harshly criticizes lawmakers for implementing our PSE tracking system and claims that it is a failure. I was taken aback when I read this because as a person who uses the system every day, I know it is far from the case. There is simply no way a patient can purchase pseudoephedrine in the amounts needed to produce significant meth through local pharmacies. These “smurfs” simply cannot go from one pharmacy to another in Tennessee because of this system.
As a law enforcement officer, the sheriff has complete access to the amount of pseudoephedrine purchased in Bradley County and surrounding areas. I would be interested to see those totals. My bet is that the pseudoephedrine that is used by the majority of meth producers is purchased via the Internet or in states where there are no controls or Internet tracking. What’s more, the technology hasn’t yet been used a full year in Tennessee so there is not enough data to make the statement that it was a mistake.
I do agree with the sheriff that something needs to be done, but making patients pay for a visit to already overworked physician offices just to treat an allergy is not the answer. Sorry, Sheriff Ruth, but there is no other decongestant on the market that works as well for allergy patients as PSE. Make no mistake, I do not like the time burden that the tracking system places on the pharmacist, the pharmacy staff and the patient, but it is at least providing a record of purchases made in each pharmacy and each county in the state.
The real answer to pseudoephedrine is not to make it a prescription, but to place it in a new category that puts it squarely under the control of the pharmacist. Pharmacists are not the problem, but we can be a key part of the solution. The real change needed to this system is to reduce the time that patients have to take to purchase a simple decongestant. This database can work, but there is no question that it needs to be simplified at the point of purchase.
We cannot go backward and operate in the blind any more than we can remove our access to patient-controlled substance records.
Sheriff, I invite you to visit my pharmacy to see how pharmacists can help you in this quest. My suggestion is that local law enforcement access the data that is being recorded and see what information is available. It might surprise them to see that purchases from local pharmacies are not enough to produce the amount of meth that is being made in these homemade labs.
— Terry Forshee, DPh