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Breaking Good: How to wipe out meth labs

Breaking Good: How to wipe out meth labs

methlabEarlier today I testified about methamphetamine laboratories to West Virginia Governor Earl Ray Tomblin’s Advisory Council on Substance Abuse. Like more than a dozen other states in the “meth belt,” my home state is suffering from a wave of explosions, fires, burns, poisonings and environmental destruction stemming from laboratories operated by small-time “meth cooks.”  Fortunately, as I told the Advisory Council, this is a problem that we already know how to solve.

Meth cooks make their drug using pseudoephedrine (PSE), which they extract from certain cold medicines such as Sudafed. The precise proportion of these cold medicines that are purchased to produce methamphetamine is not known, but it is clearly very large. A recent study published in JAMA found that per-capita consumption of PSE-containing medicines in counties with meth labs exceeds that of counties without labs by as much as 565-to-1.

In light of this connection, the states of Oregon and Mississippi returned PSE-containing products to prescription-only status, which was how they were regulated until 1976. Meth labs have virtually disappeared in both states.

Most state legislatures in the meth belt have introduced legislation to copy Oregon and Mississippi’s approach, but these bills have all failed. Part of the reason is intense lobbying by the companies that produce PSE-containing products, but another part is that some voters and legislators believe that cold and allergy sufferers will have a hard time getting relief if a prescription for PSE-containing medications is required.

This worry is not usually well-founded, as there are more than 100 over-the-counter cold medications available which provide relief to almost all people with stuffy noses, fevers and the like. However, in the rare case of an individual who truly needs a PSE-containing medication, innovative biochemistry has come to the rescue with the development of medications that contain PSE that is harder for meth cooks to extract.

These companies created cold medications (e.g., Zephrex-D) which use polymers or lipids to bond with PSE in a fashion that reduces the possibilities for conversions to meth. Even if the possibilities for PSE extraction are reduced by only two-thirds by these new medications, meth cooks would effectively be put out of business because their required materials would exceed the value of the drug they make. Meanwhile, consumers with chronic allergies do not suffer reduced access to PSE-containing products.

The public policy option available to meth belt states is thus something that should satisfy all parties. PSE-containing cold medications would be returned to prescription-status, with an exemption for such medications that independent laboratories prove yield only a de minimus amount of PSE for meth preparation.

It’s a rare opportunity for a clear win-win in public policy. That’s why I strongly encouraged Governor Tomblin’s advisors to pursue it with courage and enthusiasm.

Addiction expert Keith Humphreys, PhD, is a professor of psychiatry and behavioral sciences at Stanford and a career research scientist at the Palo Alto VA. He recently completed a one-year stint as a senior advisor in the Office of National Drug Control Policy in Washington. Dr. Humphreys has no financial or personal connections to any company that produces cold medications (extraction resistant or not).

Previously: Examining how addiction in the U.S. has changed over the last decade, Can an antidepressant help meth addicts stop using?, The Florida Governor’s questionable actions on drugs and Stanford Health Policy Forum focuses on America’s methamphetamine epidemic
Photo by 16 Miles of String

8 Responses to “ Breaking Good: How to wipe out meth labs ”

  1. A New Option for Eliminating Methamphetamine Labs « The Reality-Based Community Says:

    [...] from reduced access. However, new technologies in medication production render this argument moot. As I describe today at Stanford School of Medicine’s SCOPE Blog, it is entirely possible to write legislation in such a way that meth labs are choked off while [...]

  2. Emily Says:

    Thank you, Dr. Humphreys, for this terrific article and your work in drug control policy. I’m curious, if PSE extraction were more difficult and increased the cost of required materials for making meth, wouldn’t the going price for meth simply increase?

  3. Keith Humphreys Says:

    Thanks Emily,

    You are correct that the price of meth and meth production would increase. One impact would be somewhat lower meth use (but there will still be some). Another is that smaller shake-and-bake labs would not be economically viable because they do not have the economies of scale to overcome the higher cost of the raw materials. Large scale labs (e.g., in California) would still be viable, though they might have to raise prices to remain so.

    p.s. The Council voted strongly in favor of going forward
    http://www.wvgazette.com/News/201311060290

  4. Gabriella Says:

    Interesting article. I live in Australia and although we cannot now access PSE containing meds without id and being registered on a database, there still seems to be no end to meth labs and use. I do believe those that make the meth just pay other users to get the supplies for them. That way no individual is flagged in the system as obtaining an excessive amount of PSE meds. My daughter is a user, and I hate this drug so much as it has destroyed my family. Anything governments can do to try and stop this epidemic (which is worldwide) I am supportive of.

  5. Jen Says:

    I’m no expert, but in my opinion PSE should just be taken off the market. I know the drug companies don’t like the idea, but that’s strictly business. I’m willing to bet that PSE ruins more lives than it benefits! Meth use not only destroys the user, but tears apart families too. It’s just not worth it and its sad that lawmakers stand behind the drug companies because they don’t want to hurt their businesses. Corporate greed is obviously valued over human welfare.

  6. bibi hahn Says:

    Thank you for this profound, yet easy-to-read article. I hope you don’t mind that I share it on our Facebook page, StoptheMethWV. We are working hard to make sure WV adopts this law, but see evidence of the Consumer Health Products Association, a lobbyist for the drug companies that make PSE cold medicine among other things, hard at work already to defeat it. Ads for “MedsNotMeth” are popping up all over Facebook pages.

  7. JW Says:

    Couldn’t amagine meth being worse than it is here in alabama

  8. Honored Says:

    The makers of this Zephrex-D needs a medal pinned on them for their breakthrough.this can slow down progress, that buys more time to figure out the next step. This is a war. We all need to wake up and fight responsibly. This plague is taking over our country. You love it ?… FIGHT !!! The key really is in the ingredients. The war against the users only leaves the burden on minorities and leaves little accomplishments in learning lessons or even gain for our society when costs are considered, but the law is the law and people are aware of the laws regarding meth making. Good job guys.

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