CHARLESTON - Despite the previous failure of two similar pieces of legislation, one state legislator is hopeful that a new bill requiring a prescription for over-the-counter medicines containing pseudoephedrine - like Sudafed and Allegra-D - has a better chance of passing both the House and Senate this legislative session.
Del. Don Perdue, D-Wayne, is the chair of the House Health and Human Services Committee. At the West Virginia Press Association's Legislative Lookahead Monday at Marshall University's South Charleston campus, Perdue said he thinks legislators have learned more about the dangers of meth labs, and will consequently be more likely to support the bill he's currently drafting - one that requires people to obtain a prescription before they can purchase decongestants containing pseudoephedrine.
Pseudoephedrine is a main ingredient used in the manufacture of methamphetamine.
"The more information we've been able to gather about the depth and breadth of this problem, the more legislators are willing to accept all the robo calls and the negative advertising and the extraordinary amount of money that's being spent to keep us from doing what's right," Perdue said during a panel on prescription drugs at the Lookahead, which previewed issues likely to come up during the 2014 regular legislative session, slated to begin Wednesday. "Legislators now more than ever are willing to take that step. In the House, it passed the first time by a large majority. The second time, people wanted to give NPLEx a chance to work."
NPLEx stands for National Precursor Log Exchange and is a system used to track individuals' purchases of pseudoephedrine-containing products. According to state code, consumers are not permitted to purchase more than 7.2 grams a month or 48 grams a year.
Dr. Dan Foster, a former state senator also on the panel, said the development of tamper-resistant versions of pseudoephedrine-containing products - which yield a much smaller amount of methamphetamine - is another factor likely to increase the odds of prescription-only legislation passing.
"There's been the introduction of new technology over the last few years that has led to the development of tamper-resistant drugs like Nexafed and Zephrex, and actually in the legislation that's being drafted - at least what I've seen of it - the 'prescription-only' wouldn't apply to those products."
Foster said prescriptions would only be required for "less safe" versions of pseudoephedrine-containing medicines.
"That needs to be clarified because I think that is a different dynamic in this legislative cycle," Foster added.
Foster and Perdue, who is trained as a pharmacist, believe prescription-only legislation is the only way to curb the production of meth in West Virginia and the dangers that production poses.
Earlier Monday, Attorney General Patrick Morrisey gave a presentation in which he advocated decreasing the annual amount of pseudoephedrine-containing products from 48 grams to 24 grams. Perdue said that hasn't worked elsewhere.
"They have done that in a few states. The one that's probably demographically similar to us is Kentucky," he said. "The number of meth labs dropped minimally - only about 5-10 percent over the last couple years." Other methods aimed at slowing and stopping meth production - like placing products behind the counter and implementing logging systems such as NPLEx - work for a short time but have not proved to be an effective, long-term solution.
"The only policy that's been successful in sustaining a decrease in meth labs is prescription-only initiatives in the states of Oregon and Mississippi and also some other jurisdictions around the country," Perdue said.
However, Carlos Gutierrez, senior director and head of state government affairs for the Consumer Healthcare Products Association, said the organization is opposed to a prescription-only bill and believes the NPLEx system is working. He said CHPA "fully supports" the development of a methamphetamine offender registry, an idea also presented earlier in the day by Morrisey. A meth offender registry would bar people who have been convicted of meth-related crimes from purchasing products containing pseudoephedrine for a certain number of years or possibly for the rest of their lives.
When combined with a logging system like NPLEx, a meth offender registry has proven to significantly reduce the number of meth labs, Gutierrez said, noting that the number of meth labs seized in Oklahoma has decreased by 50 percent with the implementation of the two-prong approach.
Gutierrez said CHPA, which supports consumer choice, doesn't support further limiting the amount of pseudoephedrine-containing products a person may buy annually. He also suggested that taking a prescription-only approach would merely result in meth manufacturers crossing state lines to purchase pseudoephedrine.
"Rather than targeting the entire population, we support measures that target criminals," he said. "The reduction in the annual limit to 24 (grams), we do not support. If you border many, many states, when a criminal wants their product or when a criminal wants their precursor, they're going to get it, whether it's a prescription law that you have in place or whether it's a reduction in a limit."
Gutierrez said excluding tamper-resistant medicines - ones formulated with "lock technology" - from a prescription-only bill could be construed as the government giving an unfair advantage to one type of pharmaceutical manufacturer over another. He also noted that the U.S. Drug Enforcement Administration has not declared Nexafed or Zephrex to be tamper-resistant, although the makers of the drugs have applied for such status.
"For us, until the DEA says it's tamper-resistant or it's tamper-proof, it's a marketing firm saying that or it's the company saying that," he said. "It takes away choice from the consumer and I do think that's important. If some pseudoephedrine-containing medicines with lock technology are excluded from a prescription-only bill, that could be interpreted as the government sponsoring one product over another."
Perdue said the legislation is not intended to target a specific brand.
"We don't speak to a specific product," he said, "What we speak to is a product that cannot be converted to greater than 10 percent."
"It's actually not a choice issue, it's a health issue," Perdue continued, "not only in terms of an individual who is taking this drug chronically and shouldn't be, but it's a public health issue with what's happening out there on the street."
Foster said meth labs - especially portable "shake-and-bake" or "one-pot cook" labs wherein meth can be made in a pop bottle - pose health risks to children, adults and first responders because of the volatility of the ingredients, which can easily cause fires and chemical explosions. Clandestine laboratories also increase costs for property owners who have to absorb the cost of meth abatement, Foster added.
Perdue said the spread of meth labs is also extremely costly to the state of West Virginia. Not only has the problem "depleted" the state's Crime Victims Fund, a large chunk of which has been spent to clean up meth labs, but it has also resulted in the state supporting more children who enter the foster care system as a result of the actions of their parents.
"There's been an increase in the number of foster children being accepted into the system because they're there when mom and dad get busted for making meth, and they become the state's responsibility," he said. "Millions of dollars have been expended and millions more will be expended (on issues stemming from the manufacturing of meth) and as a member of the lawmaking body in the state of West Virginia, it's incumbent upon myself and others to respond to that.
"Keeping a smoking fire going when you could put it out is just unconscionable," Perdue stressed.
Gutierrez maintained that mandating prescriptions would place a financial burden on consumers, who would not only have to pay for doctor's visits to obtain those prescriptions, but who would also have to take time off from work to see a doctor.
"Someone's got to pay, whether it's the end consumer, health insurance or the employer, someone is paying for that doctor visit and that eventual copay," he said.
But Foster dismissed claims that the general public would be opposed to a prescription-only approach, saying the level of understanding about the dangers of meth labs has dramatically increased among consumers.
"It isn't more expensive. The public accepts it. They have seen how it happens, how it affects communities," he said. "The children, the first responders, the cost for cleanup of real property. There are very few types of public policies that can make this much difference this quickly."
CHPA "takes it very seriously when our products are diverted into meth," Gutierrez said, noting that's one reason the organization funds NPLEx.
"We think about 18,000 boxes were not sold because of that system. These are sales we could have benefitted from, but we understand we have to be a part of the solution," he said. "What we have a problem with is the criminal minority dictating the lives of the law-abiding community."