Editorial: Perspective Needed on OTC or Behind the Counter
By George Anderson
Rachelle Cohen, an editorial writer for The Boston Herald, writes that things may be getting out-of-hand when politicians are requiring that boxes of Sudafed be sold from behind the counter while allowing pharmacists to sell Plan B, the emergency contraceptive, to women without a prescription.
Seven states to date have authorized pharmacists to distribute Plan B, aka The Morning After Pill, because the Food and Drug Administration has failed to act for nearly two years after its own independent board of scientific advisers recommended it be approved for over-the-counter sale.
Ms. Cohen questions why restricting the sale of Sudafed or other medications containing pseudoephedrine, the primary ingredient used to make methamphetamine, is necessary when other obviously apparent options exist. “God forbid we should just try busting the illegal labs – which, by the way, stink to high heaven and, therefore, ought not be difficult to find,” she writes.
Products containing pseudoephedrine are not the only ones that pose potential risks to consumers, writes Ms. Cohen. “The fact of the matter is there’s no end of dangerous stuff on drugstore shelves. An intentional overdose of Tylenol can be as deadly as a handful of prescription pills. Mouthwash can – and has been – abused by alcoholics.
“Where do we draw the line? And when does common sense play a role in this debate?”
Moderator’s Comment: Do you agree with Rachelle Cohen that common sense is often times set aside when it comes to
deciding what products get placed behind the counter or are sold OTC? What is your answer for coming up with a system that finds the right balance between commerce and the government’s
responsibility to protect its citizens?
– George Anderson – Moderator
Common sense is often not common. Some politicians may be pandering to the lowest common denominator because that’s where some think the votes are.
The US tried prohibition, found it didn’t work, and abolished it. But there are some counties where prohibition is alive and well. I remember visiting the Jack Daniels distillery in Tennessee 20 years ago, and they served iced tea and lemonade because that county was DRY.
Well, prohibition never left us! Pot is illegal but is easily available, just like liquor during Prohibition. The whole “doctor prescription” system is just like prohibition. I visited Spain, walked into a pharmacy, and got a prescription drug I needed without any “doctor’s note.” The USA prescription system is a huge waste of time and money, not just for birth control pills or antihistamines. Why should someone have to pay a doctor (or why should the insurance company have to pay a doctor) to write a prescription for anything?
BTW, I do not expect to be elected to any office on this platform.
Ms. Cohen has no idea of the realities of meth. I work for a company that owns c-stores in Missouri- the ‘meth capital’ of the United States. It is a terrible problem. Missouri is one of the states that require medications containing pseudoephedrine be sold only behind the pharmacy counter. It will hurt our sales, but it is totally the correct thing to do. The meth problem leads to so many other crime related problems; mainly the shoplifting of medications containing pseudoephedrine to make the drug.
Ms. Cohen states that the ‘apparent option’ is to bust the drug labs. They are being busted at record rates. The real problem is that the drug is readily processed by anyone who can get their hands on pseudoephedrine. You bust one guy today and his friend is the ‘cook’ tomorrow. I truly believe that you have to stop the problem by eliminating the ingredients while at the same time busting as many people as possible, which is what they are currently doing.
To relate the meth problem to pharmacists selling Plan B is ridiculous. They don’t relate.
Thank you, James! This is indeed a spurious debate. One thing has nothing to do with the other. Take each item on its merits. As a young reporter just out of college, I was chasing a story on a developer who had filled in wetlands for an apartment complex. When I finally got him on the phone, he baffled me with bs and told me that a young upstanding guy like me should be spending my time on more serious things, like ending the Vietnam war and all that. It was a full half hour after we hung up before I realized I’d been buffaloed. Now here’s a newspaper columnist trying the same ugly trick. Golly.
Ah, James found the word I was looking for: “spurious.” The author is trying to grab readership by trying to turn an anti-crime issue into a “values” issue. Or at least I hope she was going for sensationalism, because if she believes the two cases are actually comparable she should just be fired.
Spray paint is locked up in a cage at Home Depot, too. I agree that addressing these inputs to a criminal activity is a far cry from addressing the actual crimes or, heaven forbid, the actual root causes of crime, but it’s pretty easy and if it works, why wouldn’t you do it? The Sudafed case seems pretty awkward given how common a medication it is, and I would think if nothing else it is a real issue for store traffic flow. There are so many products with pseudophedrine, someone could tie up a pharmacist for 10 minutes trying to decide what to buy.
Debating these regulatory issues is exhausting. Lawmakers are just doing what lawmakers do. Finding ways to create the appearance of action without offending too many people or having to take a real stand on principle.
Apologies, first, for not taking this one too seriously. It has degenerated, like so many other things, into putting people into the teensiest little boxes anyone can find, trying to protect as many as possible from whatever mischief the few are likely to get up to. What we generally forget – or ignore – is that the few who are determined to do something will ALWAYS find a way to do it.
So here’s a thought (and no, it isn’t a serious one and I am even less likely to run for public office than Mark) – create a citizen’s medical card which can be purchased from a physician and updated regularly (at huge expense, of course) with a list of what the person may or may not ever be permitted to buy from a pharmacist. Hey presto, no more prescriptions needed, just flash your card. Which should, of course, have a means of biometrically identifying the carrier. THEN…create a database which can be mined and sold and incur even more huge expense, so that anyone crossing a state line can still be tracked and their purchases (or attempted purchases) monitored. If they try to buy anything they shouldn’t, lock them up and throw away the key. But whatever you do, do not, under any circumstances, permit anyone to buy anything without permission (including condoms which of course do not prevent either pregnancy or HIV).
Pseudoephedrine, when used as an ingredient in methamphetamine production, is no longer an OTC drug – it’s a chemical ingredient. Keeping an eye on its large-scale purchase is prudent, because the people who make and traffic in meth are dangerous criminals.
Comparing this cautious new practice with the moral controversy over a form of birth control medication is spurious, in my book. There may be room for debate about the use of “morning-after” pills, but I am certain that nobody is buying them in quantity with the intention of converting them into a more dangerous, illegal substance.
I agree that there is a time and place for “supervision,” however I think we’re over the top when we ask already over-burdened pharmacists to police what consumers do with their meds or take time to dictate what a pharmacist can or cannot make available in their pharmacy. As a nation, we have much bigger issues to resolve when it comes to this country’s healthcare — I’d love to believe we will begin focusing on the real issues soon!
I agree with Rachel that the line needs to be drawn by common sense. Retailers can not be held accountable for the odd ways products are used and consumed.