Bad Medicine

Locking up cold medicine makes the politicians feel good -- but it won't put a dent in Arizona's meth habit

The new medication has earned Pfizer plenty of good ink. In press interviews, Terry Goddard and other politicians have praised Sudafed PE as an alternative to regular Sudafed.

In their telling, the new option is the perfect example of why ordinances like Phoenix's won't hit consumers too hard.

"It's a new product that has no meth-producing ingredients," Goddard told KAET-TV's Michael Grant on air in April. "Those will be available if this bill passes, no problems for consumers. They have exactly the same diagnostic or medicine effect."

Attorney General Terry Goddard
Attorney General Terry Goddard
State Senator Barbara Leff
State Senator Barbara Leff

But Sudafed PE is actually the perfect example of why ordinances like Phoenix's will hit consumers.

Because, despite what Goddard says, there's good indication the new stuff doesn't work.

Pfizer tried for years to develop a form of pseudoephedrine that couldn't be made into meth, spokeswoman Erica Johnson says, spending millions of dollars in the process. But that effort proved impossible, and the company abandoned it, as Johnson confirms.

Only then did Pfizer roll out Sudafed PE.

Not because the development process worked.

But because it didn't.

To make PE, Pfizer simply replaced pseudoephedrine with an agent called phenylephrine. Like pseudoephedrine, phenylephrine has been approved for use since 1972, when the Food and Drug Administration first set the rules for over-the-counter medications.

It's been rarely used in oral decongestants since. And there's good reason why.

Leslie Hendeles, a doctor of pharmacy at the University of Florida, says the existing research indicates clearly that it doesn't work.

Hendeles, who compared phenylephrine and pseudoephedrine for Pharmacology in 1993, says the studies are clear: Phenylephrine is absorbed rapidly into the liver. Only 38 percent of the medicine makes it into the bloodstream -- which is key for it to work.

Plus, the FDA only allows a dose of 10 milligrams of phenylephrine in any over-the-counter product. That's one-sixth of what's allowed for pseudoephedrine.

At that level, Hendeles says, phenylephrine is no better than a placebo.

"In my scientific opinion, at the allowable dose, not enough gets into the bloodstream to be effective as a decongestant," he says. "As a topical nasal solution, it's very effective. But as an oral product, it's not going to work."

Pfizer spokeswoman Erica Johnson acknowledges that the company has no scientific studies showing that the new Sudafed PE works. (Anecdotally, she says consumers claim "comparable relief.")

Because the new product is sold over the counter, the FDA confirms, the company won't have to do any studies.

But most customers don't know that. And that gives Sudafed PE an enviable place on the shelves: In Phoenix, it will be one of the only decongestants that customers don't have to request from clerks or sign a logbook to purchase.

Its development may be one reason Pfizer -- far from trying to block pseudoephedrine restrictions, as some politicians have suggested -- actually supported ordinances like Phoenix's.

Pfizer says the company's position on laws like Phoenix's is a matter of fairness.

"Our position has always been, 'If you're going to put pseudoephedrine products behind the counter, you've got to put all pseudoephedrine products behind the counter,'" says spokeswoman Johnson. "All forms. Tablets, gels, and liquids."

It's a strategy that seems to be working. In April, Target became the first company to voluntarily put all products behind the counter. Walgreens followed suit later this spring, spokeswoman Carol Hively says.

Johnson says the company will continue to offer regular Sudafed behind the counter. "Some customers may not find enough relief with Sudafed PE," she says. "They can choose to return to the stuff with pseudoephedrine."

But in some cases, they may not have the choice.

A number of drug companies, including Tylenol's maker, quickly realized the benefits of making a pseudoephedrine-free product. They plan to reformulate their products to take out pseudoephedrine in time for next year's cold season, says McNeil spokeswoman Kathy Fallon.

"They realize customers are not always going to think to ask for this stuff if it's behind the counter," says Jenny Van Amburgh, a doctor of pharmacy at Northeastern University.

"It's definitely an access issue."


The inaugural meeting of the Phoenix City Council meth task force attracted serious media attention.

No fewer than eight television cameras were packed into the small conference room. At least a half-dozen print journalists scribbled into their notebooks.

The membership included all the right players: representatives from the police department, treatment community, and politicians.

Attorney General Goddard spoke about the "crisis in our midst."

He repeated that statistic about how Arizona is number one in meth use for kids ages 12 to 17. "I don't think we've even got an idea of how prevalent it is in our communities," he said.

The task force members were seated around a table, and each one got a chance to speak. Each talked about the ravages of meth. Each expressed hope that the new legislation would help.

And then Jeffrey Taylor spoke. Outreach coordinator for the Phoenix Rescue Mission, he sees the poorest and most desperate meth users every day.

He talked about needing more treatment options in jail. He talked about how Arizona needs more inpatient rehab centers.

And everyone nodded, and smiled, and then went back to pseudoephedrine.

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2 comments
jay
jay

I am currently writing a story about my brothers meth addiction in Arizona, currently he is in a mental institution as he is convinced people are trying black mail him for murder and money, they have all these micro devices around him tracking his every move, they can threaten him through this devices if he does not do what they tell him, there is plenty more, but my main issue is that alot of the in Arizona comes from the Indian Reservations and law enforcement can not do a thing and the goverment will not help, this is simply crazy, those reservations should be raided once its proved the meth has come from it, 1/2 the goverment must be on the stuff because CRYSTAL METH IS MORE OF THREAT TO THIS COUNTRY THEN TERRORISM,

jay
jay

I am currently writing a story about my brothers meth addiction in Arizona, currently he is in a mental institution as he is convinced people are trying black mail him for murder and money, they have all these micro devices around him tracking his every move, they can threaten him through this devices if he does not do what they tell him, there is plenty more, but my main issue is that alot of the in Arizona comes from the Indian Reservations and law enforcement can not do a thing and the goverment will not help, this is simply crazy, those reservations should be raided once its proved the meth has come from it, 1/2 the goverment must be on the stuff because CRYSTAL METH IS MORE OF THTREAT TO THIS COUNTRY THEN TERRORISM,

 
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