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Capito suggests states might consider pseudoephedrine legislation

CHARLESTON, W.Va. -- Policy makers and law enforcement continue to search for weapons in the battle against methamphetamine.

If use continues to rise in West Virginia, U.S. Rep. Shelley Moore Capito said state lawmakers here and elsewhere could consider legislation that would require a prescription to purchase products with meth's main ingredient: pseudoephedrine.

"If the problem continues without... attempted solutions, I think that's something that probably would be considered," Capito said.

See also: Association pushes for broad approach to meth problem

On Tuesday morning, Capito - who is back in the state during the congressional recess -- visited a Charleston branch of Fruth Pharmacy. She met company president Lynn Fruth at the store to learn more about a medication that contains pseudoephedrine but is harder to use in producing meth.

The product, Nexafed, is marketed as a tamper-resistant medication used to treat allergy symptoms. While the effect might be similar to other popular medications -- like Sudafed -- other ingredients in the product make it much harder to use to produce meth.

Fruth pharmacies plan to use the product at each of its 27 stores, Fruth said.

"I think that for us as a pharmacy any time that we can do anything -- whether it's a positive cash flow or a negative cash flow - any time that we can say, 'This is something that's going to be helping the problem,' then we need to be on board with it," Fruth said. 

She said her pharmacists do a good job of policing their own sale of products containing pseudoephedrine, and the small chain doesn't turn a massive profit from the sales anyway.

Fruth and Sam Arco, a pharmacist at the downtown Charleston store, don't think requiring a prescription for such products is the right way to address the problem. Both said there could be increased costs of visiting a doctor, and questions as to whether there are enough physicians to meet the hypothetically larger number of visits from patients in search of pseudoephedrine.

Recently the West Virginia Legislature passed a law that requires pharmacies to keep all products that contain pseudoephedrine behind the counter. Those who purchase the products must show identification, and the purchases are tracked through a computer-based system.

Some officials question the efficacy of the system, known as NPLEx. West Virginia law enforcement has already busted more meth labs this year than all of 2012, with more than 100 found in Kanawha County, according to West Virginia State Police records.

The problems prompted state lawmaker Delegate Don Perdue, D-Wayne, to ask Attorney General Patrick Morrisey to look into whether pharmaceutical companies could be at fault. Perdue, a retired pharmacist, has asked Morrisey to investigate or at least ask about the practices of companies who produce products with pseudoephedrine.

Morrisey has repeatedly said he is not allowed to say whether his office is conducting any investigation.

Pharmaceutical companies and others are opposed to requiring a prescription for pseudoephedrine sales. Opponents say it would require extra trips to the doctor, adding to the cost and inconvenience of buying the product. 

The drug is not a perfect solution to the meth problem: right now, it only comes in 30-milligram doses, Arco said. The pharmacy chain will continue to offer other products that contain higher concentrations of pseudoephedrine, Fruth said.

There's also little incentive for a consumer to switch to using a tamper-resistant product. Fruth admitted it's going to take the average allergy sufferer to make the conscious choice not to buy a product that can be used in meth production.

"I have to be honest: I think there's probably some amount of revenue that we will lose," Fruth said.

"I mean, when you talk about business decisions that's always a consideration, but we feel like as a company, we decided we really need to do what's the best thing for our customers, for our community. And if that means you make a little bit less money, because you're not selling Sudafed to people who are using the drug illegally, I think we're OK with that."

A box of 24 Nexafed pills sells for $6.99 at Fruth. That's comparable to similar products with similar amounts of pseudoephedrine, Arco said.

Right now Oregon and Mississippi are the only two states to require prescriptions to purchase pseudoephedrine-based products. Meth lab busts have dropped substantially in the states.

Capito said she thinks it's more appropriate for states to individually decide what works best for their situation. Nationally, she said Congress can consider measures to address drug abuse in general and ways to reward the role of the "community pharmacist." She said pharmacists play an important role in helping people determine the proper medications for their individual health regime, and they are not always rewarded adequately through repayments systems outlined in Medicare. The congresswoman did not elaborate on potential steps Congress could take to address national drug abuse issues.


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