Any pharmacist who works in the retail environment knows that the restriction on pseudoephedrine (PSE) sales in the United States has been ongoing for a couple of years now. PSE is a necessary ingredient in the making of methamphetamine—likely the most addictive and dangerous drug on our planet.
Because of the restrictions, law enforcement was required to expend money and work overtime toward cleanup. Of most concern, however, was the potential danger of the production of clandestine methamphetamine causing toxic fumes and/or explosions. This endangers residents, neighbors, and those who are tasked with the job of dismantling and cleaning up these laboratories and sites.
Both state and federal regulations require PSE products to be stored behind the counter, with a limit on the amount an individual can purchase each month and a requirement to show photo identification and sign a log when PSE products are purchased. This made a considerable dent in the illegal production of methamphetamine, until the problem began to surface again in the past year.
Multiple individuals—some crossing state lines on a continuous basis— were going to multiple retail outlets and purchasing PSE products illegally. These individuals managed this without detection or pursuit by law enforcement, especially because a new method of production surfaced that reduced the amount of PSE needed for small batches. Extraordinary time and effort by law enforcement is required to track these sales, even within one state. Logs must be collected from each retail outlet and compared; if the violator is crossing state lines, this job becomes even more difficult, if not impossible.
The National Association of Drug Diversion Investigators (NADDI) took steps to assist law enforcement, health professionals, and retail establishments. NADDI issued the following press release:
“The National Association of Drug Diversion Investigators (NADDI), on November 20, 2009, announced a new initiative in the war on methamphetamine. The National Precursor Log Exchange (NPLEx) is a multi-state electronic tracking program that enforces purchase limitations on over-the-counter (OTC) medicines containing [PSE] in real-time at the point of sale. The technology for NPLEx is based on a system that was developed and tested in Kentucky in 2005. The program was expanded statewide in Kentucky in late 2007 as Governor Steve Beshear came into office…Kentucky, Illinois, and Louisiana [have executed] agreements with NADDI to become the first 3 states to adopt NPLEx as their electronic tracking program. NPLEx provides law enforcement agencies across the country with free access to the multi-state electronic log of cold and allergy medicine purchases. The system helps retailers and consumers stay in compliance with state and federal laws that place restrictions on these medicines. These OTC cold and allergy medicines contain [PSE], a key ingredient diverted to illegally manufacture methamphetamine. The program has been modeled after the successful efforts in Kentucky to combat domestic meth production. The cost of deploying and supporting the NPLEx system has been covered by a private/public partnership that NADDI negotiated with the leading manufacturers of these medicines. Consequently, states that are offered NPLEx can deploy and support the system without the use of government funds.”
How does this work for the retail pharmacist? Once adopted within a given state, PSE purchasers would be entered into the database either by swiping identification or manual entry into the computer. The system would ultimately search nationally, and if the patient is over the 9-g limit, it would block the sale, and law enforcement would be notified. Safeguards would be employed, so that in extreme situations, employees would be able to override the system and complete the sale. Once again, law enforcement would be notified.