Legislative Efforts to Combat

Pseudoephedrine Misuse: Kentucky’s

Experience William C. Thornbury, M.D.,

F.A.A.F.P. Gerry Stover, Executive Director

KAFP

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The Problem

PSE Synthesis Methamphetamine 2009 Rand Corp: $23.4B/yr

(U.S.Gov’t)

Kentucky 2007 2008 2009

2010 (294) (416) (736)

(1100)

Cost KSP $32M/2010 Law Enforcement 1,100 Incidents, Up 40% from 2009

(OK St Police: $350K/Incident All Factors)

Net Cost KY: $385M/2010 or $8-92.00/pers/yr

2007EPIC TOP TEN METHAMPHETAMINE INCIDENTS

Map includes Laboratories, Chemical/Equipment/Glassware seizures, and Dumpsites that have been received by the MSHPfor entry into NSS as of 12/31/2007

1. Missouri – 12852. Indiana – 6203. Tennessee – 5594. Illinois – 3605. Arkansas – 3096. Kentucky – 2787. California – 2738. Michigan – 1729. North carolina – 15510. Mississippi – 152 Ohio - 152

2009

Solution I. PSE by Rx in KY II. Support Colleagues in

Surrounding States Rx III. Educate Federal Support PSE

Import Ban IV. Encourage Pharm Manfn Change

Delivery

PSE by Rx

Oregon Data: 98% Reduction from 20062009 Meth Lab Incidents: 47210

PSE by Rx

Mississippi Data:65% Global Reduction July-Dec 201090% Reduction Labs: Harrison Co

(22528)90% Reduction Lab: Jackson Co

(53/mo5/mo)(July-December 2010, WLOX 12/28/10)

KAFP Resolution KAFP Exc Director, Gerry Stover KNOA President, Stanley Salyards KSP Major Joe Wilson

KMA Resolution Warren Co Drug Task Force/KSP Barren County KMAKMA KMA Legislative Committee

Legislative Effort KY Board of Pharmacy KPhA KYAAP State Legislators Federal Legislators Press KAFP Journal Article

Legislative Antagonists

Retail Pharmaceutical Industry

METHCHECK (NPLEx): Electronic Monitoring

KY Sherriff’s Assoc

PSE by Rx KY SB-45 $350,000 Lobbying 2010 Legislative

Yr “Robo-Calls” Legislative “Green

Sheets”

PR Campaign in Metro Areas

PSE by Rx KY SB-45 $350,000 Lobbying 2010 Legislative

Yr “Robo-Calls” Legislative “Green

Sheets”

PR Campaign in Metro Areas

[Keep Doing What You’re Doing, It’s Working Fine.”]

PSE by Rx KY SB-45

DEFEATED

Fall 2010 CVS Fine: $75M (PSE to

Criminals/25 States)

Fall 2010 CVS Fine: $75M (PSE to

Criminals/25 States)

Spring 2011 AAFP 10-State in WI (Encouraged

COD)

Summer 2011 KY Mainstream Press Moves

Storyline

Fall 2011---September

KMA-HOD Committee Meeting Exempt Select Isomers from

Rx Policy “Guests” Educate on PSE

AAFP-COD Committee Hearing PSE by Rx

Calls for Amendment Concerned Delegates

News > Local

Cain: What I say is not for saleBy James Mayse, Messenger-InquirerPublished: Wednesday, February 16, 2011 12:08 AM CST

Daviess County Sheriff Keith Cain, who has been an advocate of electronic tracking system for pseudoephedrine purchases, said Tuesday he is compensated for his time and expenses when he travels out of state to talk about electronic tracking.Cain said he was compensated for his time and expenses three or four times last year when he traveled out of state to discuss electronic tracking. On those occasions, he was paid for time and expenses by the pharmaceutical lobbying firm that opposes making pseudoephedrine a prescription.

On Tuesday, Cain traveled to Indianapolis to discuss electronic tracking before a Senate committee of the Indiana General Assembly. Cain's compensation and expenses for the trip will be paid by the Consumer Healthcare Products Association -- a lobbying firm that supports electronic tracking as an alternative to making pseudoephedrine a prescription drug. Cain said Tuesday his compensation depends on what is involved but varies from $500 to $1,500 per day.

News > Local

Cain: What I say is not for saleBy James Mayse, Messenger-InquirerPublished: Wednesday, February 16, 2011 12:08 AM CST

Daviess County Sheriff Keith Cain, who has been an advocate of electronic tracking system for pseudoephedrine

purchases, said Tuesday he is compensated for his time and expenses when he travels out of state to talk about electronic tracking.Cain said he was compensated for his time and expenses three or four times last year when he traveled out of state to discuss electronic tracking. On those occasions, he was paid for time and expenses by the pharmaceutical lobbying firm that opposes making pseudoephedrine a prescription.

On Tuesday, Cain traveled to Indianapolis to discuss electronic tracking before a Senate committee of the Indiana General Assembly. Cain's compensation and expenses for the trip will be paid

by the Consumer Healthcare Products Association -- a lobbying firm that supports electronic tracking as an alternative to making pseudoephedrine a prescription drug. Cain said Tuesday

his compensation depends on what is involved but varies from $500 to $1,500 per day.

News > Local

Cain: What I say is not for saleBy James Mayse, Messenger-InquirerPublished: Wednesday, February 16, 2011 12:08 AM CST

Daviess County Sheriff Keith Cain, who has been an advocate of electronic tracking system for pseudoephedrine purchases, said Tuesday he is compensated for his time and expenses when he travels out of state to talk about electronic tracking.Cain said he was compensated for his time and expenses three or four times last year when he traveled out of state to discuss electronic tracking. On those occasions, he was paid for time and expenses by the pharmaceutical lobbying firm that opposes making pseudoephedrine a prescription.

On Tuesday, Cain traveled to Indianapolis to discuss electronic tracking before a Senate committee of the Indiana General Assembly. Cain's compensation and expenses for the trip will be paid by the Consumer Healthcare Products Association -- a lobbying firm that supports electronic tracking as an alternative to making pseudoephedrine a prescription drug. Cain said Tuesday his compensation depends on what is involved but varies from $500 to $1,500 per day.

Kentucky Registered Legislative AgentsOctober 27, 2011

Acquisto, James 502-xxx-xxxx Address XXX, Louisville KY 40223 Appriss

Myth vs Fact1. OR: PSE is on the Increase.

Myth vs Fact1. OR: PSE is on the Increase.From: Rob Bovett <RBoet@co.lcon.or.us>To: stanley stanley <jutstan@yahoo.com>Sent: Wednesday, October 19, 2011 4:40 PMSubject: Re: OR meth lab numbers

Stan,

Oregon is at 7 for this year.  We had 13 last year.

Take care,

Rob

Myth vs Fact2. PSE by Rx Would Increase Health

Care Costs $12 OTC ------ > $110 Rx

Myth vs Fact2. PSE by Rx Would Increase Health

Care Costs $12 OTC ------ > $110 Rx Move to Rx: Generic Competition More Likely: Gel Caps OTC for

Cheap

Myth vs Fact3. Only 2% of PSE Purchases are

Illicit.

Myth vs Fact3. Only 2% of PSE Purchases are

Illicit.

OK 2008 Baseline: 250K PSE tabs 6 mos into “Shake-N-Bake”

Method 600K Tabs 750K Today

(300%) Increase in: Meth Labs, Addicts,

Deaths.

Myth vs Fact4. NPLEx (E-Tracking) Fixes the Problem at

the Source

Myth vs Fact4. NPLEx (E-Tracking) Fixes the Problem at

the Source Cannot Stop “Smurfing” Cannot Stop Fake I.D.’s Law Enforcement Don’t Have

Resources to Combat the Problem at the Point-of-Sale.

Myth vs Fact5. PSE by Rx Would Inconvenience Law-

Abiding Citizens

Myth vs Fact5. PSE by Rx Would Inconvenience Law-

Abiding Citizens

OR: No Consumer Mandate to Reverse Law

OR: No Physician Mandate to Reverse Law

OR: No Political Mandate to Reverse Law

Myth vs Fact5. PSE by Rx Would Inconvenience Law-

Abiding Citizens

PSE for Sx Relief……DN “Cure” any disease process.

Phenylephrine, Topical Decongestants, Antihistamines OTC

Myth vs Fact6. PSE “Behind-the-Counter” hasn’t solved

the problem; it’s a Law-Enforcement Issue.

Myth vs Fact6. PSE “Behind-the-Counter” hasn’t solved

the problem; it’s a Law-Enforcement Issue. Yes. (Smurfing, Fake I.D.’s, etc.) Meth Use, Meth Labs are different

issues. (Law Enforcement needs to shift

resources.) Physicians: Are we guardians of

public health?

Myth vs Fact7. Insufficient Data: Need “Evidence-Based

Policies”

Myth vs FactMississippi Bureau of Narcotics:  

7/1/09 - 8/5/10: 1,002 labs, rescued 226 children.7/1/10 - 8/5/10:   351 labs, rescued   53 children.

A reduction of 65% in labs and 77% in children.

The Mississippi Bureau of Narcotics indicates that their methods of response and investigation have not changed since the scheduling law began.  They simply do not get as many meth lab complaints since MS requires PSE by Rx.

Meth Lab Seizures

2004 2005 2006 2007 2008 2009 2010

812

334

194148

213

743

818

472

189

5522 21 13 12

600 589

309 309

428

741

1078

OK OR KYOR & OKPSE MovedBehind –the-Counter

Combat Meth ActAll states:Behind-the-Counter

OR Schedules PSE (OK E-Tracking)

KY E-Tracking (Methcheck)

OK Driver’s License Data into E-Tracking(to find fake DL)

OK Adds Meth Laboffender block listTo E-tracking

Meth Lab Seizures

2004 2005 2006 2007 2008 2009 2010

600 589

309 309

428

741

1078

KY

Kentucky

Meth Lab Seizures

2004 2005 2006 2007 2008 2009 2010

600 589

309 309

428

741

1078

KY

Kentucky

2011 Data

1458 Labs

Controlled Substance

“The basis for control and regulation is the danger of addiction, abuse, physical and mental harm (including death), the trafficking by illegal means, and the dangers from actions of those who have used the substances.”

THANK YOU

Kentucky Academy of Family Practitioners

Gerry Stover, Executive Director