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Comment by patwolf | Hacker News Reader

I would consider voting for a politician with a platform of eliminating phenylephrine and making it easier to obtain pseudoephedrine, i.e. not having to get it from behind a counter while showing ID and signing a logbook. Although perhaps I'm naive about the seriousness of the methamphetamine epidemic and the positive impact the additional restrictions have had to society.

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Beware pseudoephedrine. People have been known to abuse it, and it has dangers especially for those with heart issues: People with heart disease or hypertension should watch out for any legitimate drug that contains pseudoephedrine. See, pseudoephedrine doesn't just constrict the blood vessels in your nose and sinuses; it can also raise blood pressure and heart rate, setting the stage for vascular catastrophe. Over the years, pseudoephedrine has been linked to heart attacks and strokes. "Pseudoephedrine can also worsen symptoms of benign prostate disease and glaucoma," http://www.nbcnews.com/id/24777955/ns/health-health_care/t/d...

I remember years ago I was at the gym with a work buddy and we decided to try one of the drinks offered there, since we forgot our water bottles. We had the most amazing workout. We both executed personal bests, and after the workout we felt great. Much less tired than normal. At that point, I turned to the empty bottles and found it was chocked full of pseudoephedrine. It was a little scary to us, so we never did that again.

Yes, it is a powerful drug.

That's interesting. I never gave much thought to the fact that pseudoephedrine is a stimulant and can be harmful/abused in its own right. I just know it helps me breathe when I'm congested.

I feel like the dichotomy between OTC and prescription medications tends to make me assume that prescription drugs are potentially dangerous while anything available OTC is harmless.

You used to be able to buy ephedrine at truck stops. It was widely abused as a stimulant.

Where can you buy beverages with pseudoephedrine added?

"Years ago" I'm guessing

More common would be ephedra, though this has been mostly illegal to sell as a food/drink ingredient in the US since 2004. Ephedra contains ephedrine and pseudoephedrine.

This was in the early 00's. It was banned sometime after the episode discussed.

If I recall correctly several studies have shown that phenylephrine has similar blood pressure risks. Combined with having lackluster (if any) impact on the condition it’s specifically designed to treat could actually lead to a worse impact on those with high blood pressure since you’ll take more of it, hoping it’ll finally work.

So yeah, people need to be aware that pseudoephedrine has side effects, but it’s arguably equal to if not better than the alternative that’s being pushed as “safe”.

Agreed. Had some irregular heartbeats with it as well that spooked me. I do love the energy boost it gives you though, it’s mildly nootropic

yes it definitely increases my vocabulary a little bit while I'm taking it heh heh. from the side effects though, it doesn't seem worth it. PPA (Phenylpropanolamine) was similar, but less speedy and spacier. Its is now banned bc it harms people with fragile vasculature.

OTC pseudoephedrine packaging makes it clear you should ask your doctor if you have high blood pressure, heart disease, enlarged prostate or several other conditions. I might prefer that it say why, but this is at least enough to get me to google it if I have reason to be concerned about any of those things.

I want to be trusted with medicine that actually works, and that means I need to take some responsibility for understanding the dosing and side effects before I take it.

You are trusted this way. Sudafed (and other pseudoephedrine meds) don't require prescriptions. You don't have to justify your purchase when you ask for them. The reason they're behind the counter is to prevent bulk purchase, since pseudoephedrine is basically a few household-chemical steps away from being methamphetamine. Despite that fact, you're still allowed to buy them for any or no reason, in quantities sufficient for any practical use.

The annoyance is that there's an ineffective medicine taking their place on the shelves in front of the counter, and no sign saying "don't bother, just ask the pharmacist for the real thing". But you know that now, so this isn't so much a problem for you.

The OP you're responding to is just saying, be careful with pseudoephedrine, independent of the law. And they're right; it's been linked to heart attacks and strokes.

The problem is: it actually works. Really really well. Unlike phenylephrine.

The biggest effect of the ban has been to largely push production from independent producers in the US to drug cartels in Mexico. It has been a failure at actually reducing usage.

Not just Mexico, but also countries in Africa with very sophisticated production facilities.

But I have to go begging for working cold medicine.

And the hostile suspicion of pharmacy techs when you ask for it!

I swear they all believe in phenylephrine and think the only reason someone would buy psueudafed is to do meth.

Hmm, I never get this reaction, I suspect it has to do with the thousand-yard stare that fairly clearly conveys, "I'm way too sick to care about your judgment cuz I ran out of Sudafed and now I'm dealing with you."

I can't imagine one giving me any actual lip, but my escalation strategy there is to look them dead in the eye and ask them whether they're going to give me my perfectly-legal cold remedy or not.

https://xkcd.com/1618/

> "Seriously considering buying some illegal drugs to try to turn them back into cold medicine."

Now that sounds like a project.

A Simple and Convenient Synthesis of Pseudoephedrine From N-Methylamphetamine[1]

[1] http://heterodoxy.cc/meowdocs/pseudo/pseudosynth.pdf

I’m convinced that the location of your pharmacy plus whatever class signals you’re silently emanating strongly influence how pharmacists respond to requests for pseudoephedrine. I’ve also never had any issues getting it, but I’m an upper-income guy in a wealthy area of Seattle. I have family members in the rural Midwest who, to put it gently, do not signal upper-class status, and they have told me that pharmacists give them lots of hassle regarding cold medicine. You can sort of understand the logic but it’s a pretty ugly display of naked classism.

I have six kids, so it can look suspicious when we all get a cold, but I go to a pharmacy I use regularly and never get hassled.

If that's the case for OTC cold medicine, it makes you wonder how it is for prescription products like ADHD medication or, God forbid, opiate-based painkillers. My sympathy is stirred up for anyone in chronic pain who happens to exude lower-class status signals!

If that's the case for OTC cold medicine...

If you follow along with the thread, you'll realize this isn't about OTC cold medicine.

What? It's about psuedoephedrine which is available without a prescription; but is subject to mandatory tracking. Not too many years ago, it was available off the shelf.

Two states ban pseudoephedrine without a prescription, and you can’t buy it across state lines.

This isn't even an anecdote about someone being refused sudafed; it's a conjecture that there might be such an anecdote.

Not so much that, just a bit of curious wonder / hope / sadness about the fact that I personally have interpersonal resources that took careful observation to learn that other people do not.

By other people I am including my mother, who is the nicest lady you could imagine, but regularly gets shamed and embarrassed by the medical establishment. This stuff affects her.

It doesn't affect me. I will either escalate all the way to a physical fistfight if I have to or just suddenly decide all of a sudden it's not worth my time and just walk away and forget about it. Usually a bit of both because I typically find that the dynamics I thought I was dealing with going in weren't really there and I'm just acting silly.

Either way I get answers, darnit, and I don't stop until I get them. Same hacker mentality applied to the interpersonal realm. I don't really know how to articulate this mindset, that you really don't have to put up with this behavior, that you can have power over the situation, not even to my own mother.

Where I'm coming from is just that the statistical base rate of pseudo->meth cooks is so low, I presume even if you account for "smurfing" (because nasal congestion is such a universal ailment) that dragnetting sudafed sales can't be productive, and pharmacists will quickly lose interest in scrutinizing customers buying in normal amounts. I'm prepared to be wrong, my suspicion is that most of the concern about disapproving looks from pharmacists is imagined.

I bought some sudafed a week ago and got offered more of it by the pharmacist (they sold me a package with twice as many pills as the one I brought up a card for). And I am a pretty scruffy looking dude; on my better days my fashion sensibility and grooming approaches "possibly homeless".

I usually approach with something indicating disdain for the restrictions like "I'd like as much store-brand pseudoephedrine as the ninnies will let you sell me". I've never had any pushback.

I used to think this, but now I just go ask for the sudafed. It's usually quicker to buy, since you end up checking it out at the pharmacy rather than at the regular checkout. As long as I can reliably buy it --- and I've never had a problem --- I'm not sure why I'd be up in arms about the fact that sudafed is approximately as hard to buy as a pack of cigarettes.

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