Parliamentarians don’t support Reclassification of Pseudoephedrine

Below is copied a press release issued jointly by two all party parliamentary groups (drug misuse and primary care and public health) this week calling for the MRHA not to reclassify over the counter medicines containing ephedrine and pseudo ephedrine as prescription only.

This follows on from the recent kerfuffle about the dangers of cold remedies, such as Lemsip and Sudafed which contain the drugs in question (albeit in relatively tiny doses), being used in the illicit manufacture of meth amphetamine. As discussed here the recent War on Lemsip blog such a move would be largely gesture politics, and have no discernible impact on the production supply and use of meth amphetamine. As we have seen over the past century's experience of trying to prohibit drugs that are in demand, such moves will always fail. If there is profit to be made then illicit markets will always find a way to produce and supply.

Curiously though, in the UK at least there is no such demand. Methamphetamine use is relatively insignificant, with demand for stimulants being more than met with the more familiar amphetamine market (as well as other stimulants like cocaine and crack). Indeed the difference from a public health perspective between amphetamine and meth amphetamine is very little. Meth may be more potent and longer acting but of course there is nothing to stop the amphetamine user taking bigger doses more often. If banning lemsip etc is supposed to nip the problem in the bud then policy makers in the Home Office and MHRA are deluding themselves. Such moves have been tried in the US and shown to be completely ineffective. Similarly making the drug Class A as happened recently in the UK will be entirely ineffective as discussed on the blog here.

There is a danger here that we are buying into a classic drug panic. It is interesting to note that the language and discourse of the nascent meth panic is almost identical to previous drug panics, indeed apart from the drug name itself the latest accounts of misery, addiction, depravity and death associated with meth are virtually indistinguishable from those in the 90s associated with crack, the 70's and 80's with cocaine and PCP. Going back further still they are not that different from cannabis in the 30's and even alcohol in the 20's.

The parliamentarians are to be applauded for having the pragmatism not to throw the baby out with the bath water, and prevent legitimate access to everyday medicines because of a largely politically driven panic about an as yet non-existent problem.

Meth: coming soon to a drug den near you (maybe)

ALL PARTY PARLIAMENTARY GROUPS
Primary Care and Public Health
And
Drugs Misuse

Joint inquiry: Proposals to restrict the availability of medicines containing ephedrine and pseudoephedrine


Parliamentarians don’t support Reclassification of Pseudoephedrine

The Joint Inquiry Report into proposals to restrict the availability of medicines containing pseudoephedrine and ephedrine by the All Party Parliamentary Group on Primary Care & Public Health and the executive members of the All Party Parliamentary Drugs Misuse Group has been submitted to the MHRA in response to their consultation MLX 337. It has also been sent to Health Ministers and the Home Office.

The inquiry, which also held an urgent oral session on 18th April 2007, received evidence from multi-stakeholder organisations including patient and consumer groups, Drugscope (the drug charity), law enforcement agencies, MHRA, medical bodies and industry. Organisations that supported the MHRA proposal to reclassify medicines to POM were the BMA, Nursing & Midwifery Council, ACPO and of course the MHRA, the majority of evidence received however were opposed to the reverse switch.

In the Inquiry Report, the two Groups concluded that the evidence received by the law enforcement agencies and MHRA was not sufficient to justify the reclassification of medicines containing ephedrine and pseudoephedrine to prescription only. This is especially the case, according to the Groups, because the controls that are currently in place in the UK are similar to those that exist in countries where there is an acknowledged methylamphetamine problem.

The Groups recommended a mixture of statutory and non-statutory controls:

• reduce OTC medicine pack sizes to contain a maximum of 720mg through statute
• limit the sales of products to one pack per person
• tighten the pharmacy control of these medicines by working with the pharmacy profession to strengthen their vigilance in sale and supply
• ensure the monitoring of the situation on a regular basis by a stakeholder group including law enforcement agencies, MHRA, pharmacy and industry, enabling a quick response should the situation change to a high risk of harm.

The Groups also feel it is essential that the Department of Health and the Home Office consider using the Misuse of Drugs Act to add further controls, similar to those implemented in the US, to criminalise the possession or supply of quantities of pseudoephedrine greater than those required for normal use.

For further details please contact Libby Whittaker who provides the secretariat for the All Party Parliamentary Group on Primary Care & Public Health on 020 7421 9318 or email libby.whittaker@pagb.co.uk

Nitrous - No laughing matter

In their press release today the Medicines and Healthcare products Regulatory Agency (MHRA) and LACORS, the Local Authorities Coordinators of Regulatory Services warned: Clubs warned that ban on gas is no laughing matter.

It laughably suggests that: "The ‘rush’ users experience is caused by starving the brain of oxygen." No, actually that would be the effect of the gas on the brain, why it is used in child birth and by dentists as a disassociative anaesthetic. Apparently nitrous can also "cause the user to collapse and injure themselves when falling", a problem, they fail to point out, that is solved fairly easily by what is technically known as 'sitting down'.

It all comes across as little more than the latest in a very long line of drug scare stories. Laughs aside, Transform would like to see better regulation of nitrous vending (a briefing on this very subject will be online very soon), but much more pressing, you would imagine, for UK Health agencies would be effective regulation of alcohol and tobacco in venues frequented by young people. Try reading the MHRA press release linked above with 'nitrous oxide' substitued with 'alcohol' (and a couple of other minor changes):

Clubs warned that alcohol is no laughing matter

Nightclubs and festivals that sell alcohol may face prosecution, the Medicines and Healthcare products Regulatory Agency (MHRA) and LACORS, the Local Authorities Coordinators of Regulatory Services have warned today.

Although alcohol can be legally purchased and used for food related purposes (i.e. tiramizu), the supply of alcohol for drinking (i.e. recreational drug use) is strictly illegal, as it can only be supplied in this form by a registered pharmacist.

Vendors, who supply alcohol for drinking purposes or allow it to be supplied, are committing an offence under Section 52 of the Medicines Act 1968 of selling and/or supplying a pharmacy medicine not under the control of a pharmacist.

LACORS has written to councils across the UK, recommending that they warn nightclubs, festival organisers, and bars in their municipality of the status of alcohol. Councils that find venues to be in breach of this warning would then report them to the MHRA, and potentially prosecute them.

Whilst the drinking of alcohol may be perceived by some as 'harmless activity' – there are a number of health risks associated with its ingestion. The 'rush' users experience is caused by alcohol. This can cause the user to collapse and injure themselves when falling. Repeated ingestion increases the risk.

There are also long-term dangers to health (including chirrosis, bowel cancer, liver failure and poisoning of the central nervous system). These risks are likely to be exacerbated if the drug is combined with other narcotics. The risks are particularly severe for pregnant women.

According to LACORS Chairman Cllr Geoffrey Theobald OBE, nightclubs and other public venues have an important duty-of-care to protect their customers.

"The recent deaths last year of 10 000 people in the UK underlines to the community just how dangerous alcohol can be when it is used inappropriately.

"Councils clearly have a mandate to protect the safety of the public, and notifying venues in their areas of the danger posed by alcohol is an important part of that.

"We expect that the majority of venues once they get this warning will take steps to immediately withdraw this gas from public consumption.

"However to the small number that may not be warned, not only do you risk being prosecuted by your local authority, you are also risking the health and long term wellbeing of the public."

enough said?