5 Dec 2023

What's the fuss over pseudoephedrine?

From The Detail, 5:00 am on 5 December 2023

Rejoicing for the sinus sufferers and soldier-on types, but a nervous time for pharmacists as the demonised ingredient in effective cold medicines, pseudoephedrine, is allowed back in chemist shops.

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Photo: RNZ /Dom Thomas

In 2009 the then-Prime Minister John Key declared war on methamphetamine with a plan to ban over the counter sales of cold and flu drugs containing pseudoephedrine.

Those were the days when ram raids and armed hold-ups were aimed at chemist shops, the perpetrators looking for the main ingredient used to cook up methamphetamine. 

The ban came into force two years later with the reclassification of pseudoephedrine as a Class B2 prescription-only drug. 

Key said at the time he was worried about his teenage children getting involved with methamphetamine, or P, and in an interview with Paul Holmes he said his own home was robbed by a man with a P habit. 

"It is a $1.5 billion problem, it is wrecking lives, and it is wrecking families," Key said. "It is something ... as a parent I can tell you, obviously you worry about your children," he said. 

The ban ended the ram raids and burglaries on pharmacies but it did not stop crime associated with P. The gang-run imported methamphetamine market is thriving and it is still wrecking lives and wrecking families.  

But soon people will be able to buy cold and flu medicines containing pseudoephedrine over the counter again, under a new ACT policy it got over the line during coalition negotiations. 

"Since 2011, New Zealanders haven't been able to find over the counter cold and flu medicine that actually helps," leader David Seymour said. "Pseudoephedrine was banned because of fears it would be used for P production and following assurances there would be alternatives. Instead, the evidence shows that gangs continue to produce P, and there are no viable alternatives for people who are unwell."

Pharmacists worry that the change will make them a target of criminals again.

Associate professor at the National Addiction Centre, University of Otago, Simon Adamson says his first reaction was as a customer wanting cold and flu medicine that works.

He says the methamphetamine market has moved on from the clandestine meth laboratories that were prevalent when Key's government bought in a P fighting plan, but it is too soon to say if the move will make chemists vulnerable to crime.

He describes how people would previously collect the packets of pills by going pharmacy-to-pharmacy before on-selling them at a hefty profit to the clan lab operators. "There's a bit of a knack to it," he says. "You needed to be a good chemist." 

Now, the drug is shipped in from overseas, into the hands of criminal enterprises making a fortune from it. 

Pharmacy lecturer at Auckland University Rhys Ponton explains what is in pseudoephedrine that makes it so desirable as the precursor for illegal drugs and an effective treatment for colds and flu. 

"The important thing about pseudoephedrine for clinical use is that it's quite an effective nasal decongestant, so that's why it's been available on the market previously," says Ponton.

"The problem with it is that the chemical compound pseudoephedrine is quite easy to manipulate and turn into methamphetamine." 

In itself it's not addictive, but it's more or less the only drug that can be used for that purpose. 

At the time of the ban, it was said other products would do the job that pseudoephedrine would. They contain a different drug, phenylephrine.

"Earlier this year we saw that the FDA announced the results of a review they've conducted which has confirmed what we already knew in that phenylephrine really is not effective as a decongestant. So we're really left here in New Zealand with the options of phenylephrine which doesn't work, and then products which can be used, particularly the nasal sprays. They can be effective, but the problem with them is they have significant risks attached." 

Although legal sale will now be allowed, it will take some time to stock up on the product since we've effectively stopped using it, and Ponton says packaging for New Zealand use will have to be set up again. 

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