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The return of pseudoephedrine – Expert Reaction

A just introduced bill aims to bring back over-the-counter sales of a cold and flu drug in NZ pharmacies.

Drugs containing pseudoephedrine were restricted in 2009, as they can be used to manufacture methamphetamine in clandestine labs.

The SMC asked experts to comment.

Professor Chris Wilkins, SHORE & Whariki Research Centre, Massey University, comments:

“The ban of pseudoephedrine in flu products sold from pharmacies was part of the Prime Minister’s Action Plan on Meth from 2009. It was a response to small/medium scale meth production in New Zealand at the time (closing an easy source of precursor supply).

“Much has changed in methamphetamine manufacture since then in terms of international supply (scale and global connectedness) and the business focus of organized crime groups involved in manufacture and wholesale (e.g. “501” deportees from Australia).

“Nevertheless, drug markets are dynamic and resilient and will no doubt pivot again to new opportunities and policy change needs to address potential risks of diversion.”

No conflict of interest.

Dr Rhys Ponton, School of Pharmacy, University of Auckland, comments:

“Pseudoephedrine was removed from community pharmacy sale in 2011 due to concerns that it was used as a precursor to the manufacture of methamphetamine. However, the restriction on this precursor has not reduced the availability or stopped the use of methamphetamine in New Zealand as demonstrated by Police and Customs seizures data.

“The restriction on the availability of pseudoephedrine has largely impacted the population at large who are pushed to suffer from congestion when a potential treatment, pseudoephedrine, exists. Pseudoephedrine was replaced in tablets and capsule formulations by the drug phenylephrine. Phenylephrine has been known to be very poor in treating congestion for decades and the Federal Drug Administration (FDA) in the US officially determined this to be the case last year. Nasal sprays are available, whilst these work well to reduce congestion over the short term, they can have a ‘rebound’ effect causing more congestion when their use is stopped and long term use will lead to significant damage of the nasal lining. The return of pseudoephedrine will offer an effective and safer product.

“It is unclear if the return of pseudoephedrine will lead to changes in the criminal supply of methamphetamine. Ten years of the pseudoephedrine ban has disrupted manufacturing processes and networks, with suppliers importing methamphetamine directly from overseas, or importing ephedrine as a precursor for methamphetamine manufacture. A carefully introduced process to monitor and restrict large scale sales of pseudoephedrine should enable a fair balance allowing consumers with congestion to obtain a drug on the rare occasions that they require treatment, whilst identifying and stopping any methamphetamine manufacturing related purchases.

“Concerns from pharmacists surrounding potential security risks should be listened to, and any such events should be closely monitored. The reintroduction of pseudoephedrine should be accompanied by a commitment from Police to aggressively follow up any such events. Such events will inevitably be linked to methamphetamine manufacture which should be a key priority for Police investigation and action.

“At the end of the day, it is difficult to argue that the majority of the law abiding population should have to suffer and be prevented from seeking relief from the pain and discomfort of congestion, due to the illegal activities of a very small section of society.”

No conflict of interest.