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Jail Doc: arguments can be made both ways about pseudoephedrine

Posted on Tuesday, June 25, 2013 at 6:31 am

Will making medicines like Sudafed harder to obtain curb the production of methamphetamine? Or will it only do harm to law-abiding citizens who have allergy problems? 

Those are the questions facing local elected officials as they will soon be faced with a tough decision – whether or not to ban over-the-counter sales of pseudoephedrine in the Manchester City Limits.

An ordinance that would make pseudoephedrine a prescription-only drug here passed the Manchester Safety Committee Thursday. The next stop will be before the Manchester Board of Mayor and Aldermen, where it will need to pass three readings.

If approved, over-the-counter medicines containing pseudoephedrine, namely Sudafed, would be available by prescription only inside the Manchester City Limits.

“I’m disappointed that our state legislature hasn’t taken this in a serious way,” Manchester vice mayor Ryan French told the Manchester Times last week.

“The passing of [statewide] law in Oregon and Mississippi have shown big improvements in meth labs,” French added. “Those types of improvements are so significant that it is a no brainer to pass something like that.”

Pseudoephedrine is a decongestant and is prominent in sinus medicine such a Sudafed. It is also a necessary ingredient in the manufacturing of methamphetamines.

Dr. Jay Trussler , who practices in Manchester and also serves as the Manchester Police Department SWAT team doctor and the doctor for the Coffee County Jail, said the argument can be made for and against such a ban.

“One of the major ways to curtail meth is by making it more difficult to acquire Sudafed,” Trussler told the Times Monday. “Look at what has happened … the labs have changed. When they restricted the sale [of Sudafed], when you actually had to sign, it became difficult and the smaller labs came about.”

Sudafed is a relatively cheap allergy medicine. Manchester pharmacist Ray Marcrom said a month’s supply of the medicine over the counter is “less than $10.”

Trussler said those costs likely wouldn’t go up for his patients.

“If someone who is an established patient of my practice called and wanted me to call in their Sudafed without coming in and paying a $25 co-pay, I wouldn’t have a problem with that,” Trussler explained. “It isn’t a scheduled drug. With certain narcotics the patients have to return each month.

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“I’ve seen the arguments on Facebook that people are saying, ‘well, the docs will be happy because it will increase income.’ I don’t know a single doctor who wants more people coming to their office for that reason. We are all busy enough. But I don’t want that taken out of context and it look like I’m against this legislation.”

Trussler did caution that some doctors could use the ordinance as a “money maker.”

“There are a lot of good doctors in this town who are diligently trying to do the right things,” explained Trussler. “But there are doctors in this town who would certainly use this as a money maker that would do more to contribute to the meth problems.”

The proposed ordinance comes in the wake of municipalities in Franklin County passing similar measures. Winchester and Huntland have already passed similar measures and Cowan has passed the measure through two of three readings. Decherd and Estill Springs have also passed the measure through two of three required readings. Currently, statewide regulations track all pseudoephedrine sales into a centralized database. 

It’s a good area for the over-the-counter ban to start spreading, according to Tommy Farmer, Director of Tennessee Meth and Pharmacy Taskforce with the TBI, who called this area “ground zero” for meth production.

“That whole region of Lincoln, Franklin and Coffee County – that’s ground zero for Tennessee,” said Farmer. “People don’t realize this unless you’ve been in the meth game.”

Of the 2,157 reported in Tennessee in 2010, 86 were in Coffee County, 99 in Warren County and 70 in Franklin County. Those numbers from the Tennessee Methamphetamine Intelligence System (TMIS) do not include federal or misdemeanor convictions for methamphetamine related offenses, according to a report by the Tennessee Comptroller.

Farmer said a push for an over-the-counter ban from multiple cities would be symbolic if nothing else.

“There isn’t a better example to show the will of the people than city-by-city and county-by-county,” Farmer said.

The past 12 years have been an ongoing effort to combat the problem without taking extraordinary methods, Farmer said.

“We have 12 years of trying everything we can possibly do and spent millions of dollars trying to rid this and combat this,” he said. “We have legislation where we have taken incremental steps to limit access and amounts. We have done everything we can do.

State representative Judd Matheny said the state legislature could be next to act if enough municipalities initiate the ban.

“I think that next year the state will [make it prescription only] once we get 20 or 30 municipalities doing it,” said Matheny, who pledged his support for banning over-the-counter sales of pseudoephedrine. “One thing that was going to hurt us by banning it before was at the time no other border states were looking at it. Since that time, several of our border states have taken measures and seen great results.”

Coffee County Sheriff Steve Graves admitted that inmate medical costs have skyrocketed over the past few years.

“We went from about $300,000 a year in medical costs to actual bills being over $800,000,” said Graves, who added that after negotiations with hospitals that the department was out $472,186 in medical bills last year.

“I can’t say it’s all meth,” added Graves. “But we average anywhere between 75 percent and up [incarcerated] from meth and drug related offenses … a little over 75 percent of our inmates are in jail for drug related charges.”

Trussler , who has been the jail doctor for the past two years, said witnessing first-hand what meth has done to people changed his mind regarding pseudoephedrine …

Read the complete, in-depth story in this week’s print edition of the Manchester Times. Click here to subscribe to the print and/or online edition of the paper.