Searching for solutions

Legislation to control the sale of cold and flu medicines containing pseudoephedrine – the main ingredient in the illegal production of methamphetamine – started in July, but whether it will be enough still is unknown.

CVS Pharmacy Manager Christopher Day said his job is harder than ever because he’s effectively profiling customers who want to buy cold medicine. He’s hoping the legislation – Senate Enrolled Act 80 – makes it more difficult for those who want to use pseudoephedrine for illegal activity to get.

“With that bill, we tried to balance the needs of people who are legitimate users of pseudoephedrine with the need for law enforcement to have another tool to slow down the use of meth,” said Rep. Sue Errington, D-Muncie.

With the number of meth lab busts climbing in Delaware County, authorities and policymakers are searching for solutions. Delaware County leads the state in number of meth lab busts. In one year, 2014 to 2015, the number of meth lab busts skyrocketed nearly 40 percent.

Pseudoephedrine sales are limited to behind-the-counter transactions, so it’s Day’s job to question customers to determine whether they will use the drug for its intended purpose.

What are your symptoms? What have you used in the past? Are you draining or coughing? 

“No one likes to be profiled, but that’s what you end up having to do,” he said. “It seems to be a certain demographic and certain socioeconomic group that comes in that we tend to profile a little bit more.”

Day, who works at the CVS on Tillotson Avenue, uses his best judgment about whether to make the sale. He said the law wants pharmacists to say they don’t feel comfortable selling the product, but it’s difficult when customers become upset.

“So [pharmacists] end up saying ‘we don’t have any in stock or we’re just not able to sell it today because our system is down,’” Day said. “We don’t like lying but it’s just become what the norm is going into pharmacies because we recognize that [pseudoephedrine] is a problem.”

He also offers an alternative medicine. When that exchange occurs, nine out of 10 customers decline and walk away, but not without some harsh reactions.

“I’ve been called every name you can think of,” Day said. “My goal is to help them on a path to better health, one way or another.”

Pharmacists use the National Precursor Log Exchange (NPLEx) to track pseudoephedrine sales. They swipe each customer’s photo ID, which records the purchaser, date, time, location and amount purchased. Customers are limited to 3.6 grams per day, 7.2 grams per month and 61.2 grams per year.

In addition to NPLEx, Day said he supports requiring a prescription for pseudoephedrine.

“Every pharmacist you would talk to would say that they would want it to be a prescription,” Day said. “If we’re really focusing on solving the meth crisis, I think that’s a good solution.”

Article continues after video.

State Representatives Sue Errington and Ben Smaltz talk about fighting meth from the state government level. The latest piece of legislation passed was a bill that helps keep pseudoephedrine, an essential ingredient for meth, out of the hands of meth cookers. Tony Sandleben reports.

Delaware County Prosecutor Jeff Arnold agrees. After just three years in office, Arnold declared a zero tolerance policy against meth users in 2014. He planned to prosecute whomever he caught and ask for prison time. Between 2012 and 2015, meth lab busts tripled and Arnold soon realized zero tolerance didn’t work.

“This shows how stupid zero tolerance can be sometimes,” he said. “Zero tolerance means I have no clue what to do, or I have no better idea what to do.”

During the 2016 legislative session, Arnold said the Indiana Prosecuting Attorneys Council supported a prescription-only pseudoephedrine bill. Instead, the Indiana General Assembly passed what Arnold labeled a “hybrid bill.”

State Rep. Ben Smaltz (R-Auburn) sponsored Senate Enrolled Act 80, which was signed into law on April 28, 2016 and went into effect on July 1. It allows people who have a history at a pharmacy to get medications containing pseudoephedrine without a prescription. For those without a history, customers will need a prescription, or pharmacists can provide them with an extraction-resistant product or deny the sale completely.

Errington said the bill passed by a large, bipartisan majority. The new law is in addition to the Indiana Scheduled Prescription Electronic Collection and Tracking Program, which were enacted by the Indiana General Assembly in 2005. INSPECT tracks a patient’s prescriptions, the practitioner who prescribed them and the pharmacy where the patient bought them.

“The idea of seeing who is getting [pseudoephedrine] is one way that [pharmacists] can, if someone is going from place to place, they can try to put a stop to that,” Errington said. “It didn’t seem to be enough.”

Errington said SEA 80 has not been in effect long enough to know whether it is the answer or if there’s more to do.

“I think this is something where we all have to do something,” she said. “Legislation is part of it. It’s not everything.”

Errington said the root causes of drug use – poverty, unemployment, hopelessness – are something everyone needs to be focused on to address the meth epidemic within Delaware County.