Over-the-counter cold pills may be removed from store shelves across much of the Southwest and Midwest this year as officials struggle to crack down on methamphetamine, a highly addictive stimulant that can be brewed from decongestants and other common household items.
At least 20 states are considering tight restrictions on access to Sudafed, NyQuil, Claritin-D, Tylenol Flu and hundreds of other cold, allergy and sinus remedies that contain pseudoephedrine.
Details vary, but in many states only pharmacists or their assistants would be allowed to dispense the medicines.
Customers would have to show identification -- and even enter their addresses in a law enforcement database. Some states may also restrict purchases to as few as two to three boxes a month.
In most cases, the controls would apply only to pseudoephedrine tablets; gel caps and liquid formulas are generally exempt because it’s much harder to convert them to illegal drugs.
The pharmaceutical industry strongly opposes the proposed restrictions, arguing that they would inconvenience legitimate customers, especially in rural areas, where the nearest pharmacy may be 40 miles away and open only on weekdays. The trade association representing chain drugstores also plans to lobby against the legislative action. So do some convenience store owners.
Despite this opposition, lawmakers in state after state say they are confident that the measures will pass with broad bipartisan support. Two Republican and two Democratic governors have promised to press for the restrictions.
“I absolutely have high hopes we’ll get it done,” said Minnesota state Sen. Julie Rosen.
In southwest Iowa, Sheriff Terry Baxter needs more than hope.
“We have to do something,” Baxter said. “Meth is just taking over.”
Also called crank, crystal, speed and ice, methamphetamine comes in many forms: It can look like rock salt or chalk dust. It can be amber, white or translucent, even red or brown. Users inject, snort, smoke or swallow it.
The stimulant produces an exhilarating rush. Within a few hours, though, it wears off, inducing deep depression and paranoia, leaving users frantic for another hit. Addicts often ride speed highs for days, not pausing to sleep or eat.
Meth can cost as much as powder cocaine; prices nationally range from $80 to $250 for a .06-ounce bag, according to the U.S. Department of Justice. But it’s also a do-it-yourself drug, easy to make in a bathtub from one of more than 100 recipes.
It’s popular among women -- who sometimes try it because they’ve heard it will keep them thin -- and among young adults. A federal survey in 2003 found that half of recent users were younger than 18.
As much as 80% of the methamphetamine available in the U.S. comes from organized crime rings cooking up huge quantities of the drug in California or across the border in Mexico. Restrictions on sales of Sudafed would do little to stop them.
The controls are aimed, instead, at meth brewed in small makeshift labs, primarily in the Midwest.
Using chemicals extracted from decongestants, rubbing alcohol, starter fluid, drain cleaner, lithium batteries, matches and paint thinner, the drug is routinely made in cornfields and hotel rooms, in roadside ditches, in suburban estates and in national forests.
The addicts who run the labs are not big-time drug dealers. They make just enough to keep themselves and maybe a few friends high.
Even so, they’ve left a devastating trail.
Rural states such as Missouri, Iowa, Kansas and Oklahoma are pocked with thousands -- some officials say tens of thousands -- of illegal labs.
Explosions are common. The gases emitted in the cooking process are so toxic that the fumes can corrode metal -- and scar lungs. The waste produced is so hazardous that cleanup crews must wear full protective suits.
Tracking down the labs consumes enormous resources: In Missouri, detectives raided an average of nearly eight labs a day in 2003. It costs thousands of dollars to clean up a single site.
Officials see a tremendous social cost too; they frequently find young children breathing the toxic fumes, abandoned without food in filthy cribs as their parents cook up their next hit.
In Oregon over the last two years, virtually every case where the state permanently took children away from their parents involved meth.
Several states have tried to shut down labs by restricting how many decongestants a shopper can buy in any one purchase. (In California, the limit is three packages, or nine grams of pseudoephedrine.) Some chain stores, including Wal-Mart, voluntarily limit transactions.
But meth cooks can easily -- and legally -- evade such restrictions by driving from store to store to store to pick up the thousands of pills they need to make a few ounces of stimulant. One suspect arrested in southwest Missouri carried a hand-drawn map of every store in the area that sold cold pills.
A few states considered tougher restrictions on pseudoephedrine last year. Just one -- Oklahoma -- adopted them.
The Oklahoma law classified pseudoephedrine as a Schedule 5 narcotic, similar to cough syrup with codeine, to be dispensed only by a pharmacist. Since it took effect last spring, law enforcement has reported a huge drop in meth labs. By the fall, raids were down 80%, said John Duncan, chief agent with the state’s Bureau of Narcotics and Dangerous Drugs.
Duncan expects that number to drop even more as pharmacists bring online a new computer program to track every purchase of cold pills. The program will flash an alert if a customer has tried to buy decongestants from any other store in the state in recent weeks.
“Right there on the computer screen, it will authorize or deny each purchase,” Duncan said.
Mike, a former addict from Omaha, said he was skeptical that such restrictions would work long-term.
A member of Crystal Meth Anonymous, Mike, 36, said he used to buy as many as 10,000 cold pills a day to brew meth. “If I had to strong-arm a drugstore to get the pills, I probably would have,” he said.
Strung-out meth addicts can be fiercely aggressive; many law enforcement agencies consider the drug the primary reason for violent crime in their regions. Mike said he feared the violence would rise if addicts couldn’t legally buy what they need to cook up a hit.
“Addicts will do pretty much anything to get what they need,” he said.
But officials across the country, facing an epidemic of meth abuse, seem willing to take the risk, especially now that they’ve seen the “tremendous results” Oklahoma’s law has produced, said Iowa’s director of drug control policy, Marvin Van Haaften.
Oregon Gov. Ted Kulongoski enacted restrictions similar to those in Oklahoma this fall. In states as diverse as Idaho, Alabama, Texas and Minnesota, lawmakers are working on proposed legislation.
“The train’s on the tracks and it’s starting to roll,” said Cpl. Jason Grellner, a detective with the Franklin County Sheriff’s Department in rural Missouri. He recently held an anti-meth strategy session; it drew officials from 14 states.
“We’ve all decided that this is the year,” Grellner said.
A spokesman for Pfizer Inc., which makes Sudafed, said the company would not fight the proposed laws.
But other powerful opponents stand ready to make their case.
Mary Ann Wagner, a vice president of the National Assn. of Chain Drug Stores, attributes the apparent drop in Oklahoma meth labs to better law enforcement -- in particular, efforts to deny bail to suspected addicts and dealers. She decried the “unnecessary burdens” of new controls on decongestants.
Virginia Cox, a vice president of the Consumer Healthcare Products Assn., said states should focus primarily on reducing demand for meth by preventing and treating addiction. Her group also promotes a “Meth Watch” program that teaches retailers how the drug is made and urges them to report suspicious purchases.
“We really feel there are alternatives out there” to locking up decongestants, Cox said.
The federal drug czar, John P. Walters, also urged caution.
He pointed out that Oklahoma was not the only state to report a big drop in meth lab raids. A dozen others also had “substantial declines” last year, he said.
“There is promise in [tight controls], and if states want to do it, they’re free to do it,” said Walters, director of the Office of National Drug Control Policy. “But we’re trying to make sure we’re not blinded by Oklahoma’s results to the point where we say this is it, nothing else works.”
Baxter, the Iowa sheriff, knows locking up decongestants won’t put an end to the meth epidemic. Already, new recipes are circulating among meth cooks -- recipes that don’t require pseudoephedrine. Still, he figures it’s worth a try.
“Am I going to get this stopped? No,” Baxter said. “But I’m going to make it as damned hard to cook this stuff as I possibly can.”