On selling pseudoephedrine.

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NaOH

NaOH

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I'm facing something of an ethical dilemma these days over the large number of people coming into the pharmacy looking to buy products containing pseudoephedrine. I've noticed that most of the people at my store are extremely reluctant to sell it at all, typically keeping most of what we have on a shelf facing away from the out window and falling back on the 'gosh, it looks like we're sold out :eek:' routine constantly.

I see their point, certainly. Even while trying to be non-judgmental, you do get a feel for who probably doesn't really have a serious allergy problem. Walking up to the counter and immediately asking for the Wal-phed 96ct doesn't exactly help either. And I'd rather not abet their misappropriation, though honestly if they want to rot their brains I do sort of feel it's their own issue. I'd feel worse about denying medication to someone who legitimately needed it.

Basically I'm just waiting for the day I called out by a pt for lying about our stock on hand and catching hell over it.

Anyone have any suggestions for ways of delicately handling these individuals?
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Don't you have some kind of a log book (worthless) in your state/at your pharmacy? At my pharmacy we use a site called meth check (awesome) that instantly tell us whether the buyer is compliant with state reqs (6 grams not the 9 grams allowed nationally). And I guess selling psudoephedrine is just like the people who want their vicodin early. These drugs are there for a reason but of course there are people who abuse it.
 
we don't hide stock, and from the sounds of it you're at walgreens, those people could get in huge trouble with corporate. They already have a system in place to measure the amount of pseudophed bought by 1 person, there's no reason to "hide stock" so no one can buy it. That's just losing customers-it's dumb. I'd sell those even if they were "hiding stock." I'm not there to decide who's a meth addict and who isn't.
 
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NaOH said:
I'm facing something of an ethical dilemma these days over the large number of people coming into the pharmacy looking to buy products containing pseudoephedrine. I've noticed that most of the people at my store are extremely reluctant to sell it at all, typically keeping most of what we have on a shelf facing away from the out window and falling back on the 'gosh, it looks like we're sold out :eek:' routine constantly.

I see their point, certainly. Even while trying to be non-judgmental, you do get a feel for who probably doesn't really have a serious allergy problem. Walking up to the counter and immediately asking for the Wal-phed 96ct doesn't exactly help either. And I'd rather not abet their misappropriation, though honestly if they want to rot their brains I do sort of feel it's their own issue. I'd feel worse about denying medication to someone who legitimately needed it.

Basically I'm just waiting for the day I called out by a pt for lying about our stock on hand and catching hell over it.

Anyone have any suggestions for ways of delicately handling these individuals?
Click to expand...

I was at the pharmacy the other day and actually saw the pharmacist recommend a pseudoephedrine product. I was too far away to see which, exactly, but she described some symptoms (sinus pressure) and then he asked if she had her driver's license with her and brought up something from the back. She was a postal worker, though, and I don't think she even knows what meth is.

If you take them as directed, Sudafed, etc., are great OTC meds. I think where you run into trouble, potentially, is when someone asks for one, you're out of it, and they ask for a more or less unrelated drug. Or if they just walk up and say, "hey, do you have any pseudoephedrine?" But the drug itself isn't illegal, and I don't think you need to worry yourself any more than following local, state, and federal laws. Also, you might be surprised how many people freak out when you call them out on it. "96 of these babies, huh? That's a lot of meth..."
 
Ethical dilemma for selling PSE? Wow people really need to get off their high horse and just conduct business. Not everyone is making meth, and the people buying it in the store would need such mass quantities that it isnt worth their time going from store to store to buy it. Maybe I'm biased because it isnt a problem at my store or in my neighborhood but my opinion is that you should just sell it and move on.
 
Ethical dilemma? Sell the fricken product. Its legal under the law to sell it, so why not? Are you also against making money?

You need quite a lot of it to make meth anyway- its not your place as a technician to judge people for buying a nasal decongestant- the ONLY nasal decongestant that works for many people.
 
charfdorn said:
I was at the pharmacy the other day and actually saw the pharmacist recommend a pseudoephedrine product. I was too far away to see which, exactly, but she described some symptoms (sinus pressure) and then he asked if she had her driver's license with her and brought up something from the back. She was a postal worker, though, and I don't think she even knows what meth is.
Click to expand...

:eek: lol. Hiding your psudophedrine is irresponsible. My pharmacists always recommend sudafed because its the best otc decongestant. I've heard from multiple pharmacists that phenylephrine doesn't even work. I always have sudafed around the house. For the life of me I cannot figure out why this is a big deal. Especially with the systems for measuring compliance. The only person I've seen and felt uncomfortable selling sudafed to was denied by our system anyways.

Oh but I have heard of people going from store to store buying up sudafed. Meth users will spend the day criusing the city and then trade their sudafed directly for meth. But again the main people who buy it from my store are soccor moms and bankers. Just sell it and let your computer make the decision for you. I don't even feel like this is an ethical problem.
 
pr33st said:
Our pharmacy has its own tracking system for psuedoephedrine products. What always makes me nervous is selling syringes. We've had an "insulin user" storm out before screaming that we spread HIV by not giving him clean needles. For his insulin.
Click to expand...

I hate selling syringes too. One pharmacist I worked with once asked him if he had a diabetic dog lol. And I'm usually not of the enabling mindset but its true. We will sell 10 packs and I guess the idea is that they are going to get needles one way or another so might as prevent them from swaping HIV.
 
trailrider400 said:
I hate selling syringes too. One pharmacist I worked with once asked him if he had a diabetic dog lol. And I'm usually not of the enabling mindset but its true. We will sell 10 packs and I guess the idea is that they are going to get needles one way or another so might as prevent them from swaping HIV.
Click to expand...

One particularly out-of-it looking guy came in and asked for syringes. The pharmacist put him through the usual battery of questions. His final answer?

"It's for steroids. I'm beefing up my dog." "Steroids?" "Yeah. Beef up my dog."

"Get out."
 
pr33st said:
One particularly out-of-it looking guy came in and asked for syringes. The pharmacist put him through the usual battery of questions. His final answer?

"It's for steroids. I'm beefing up my dog." "Steroids?" "Yeah. Beef up my dog."

"Get out."
Click to expand...

lol was it michael vick? No but my friend had to give his dog steroid shots for his allergies. Are you sure he wasn't talking about a different steroid and trying to be cute? Or was he wearing a dog fighting club member tee shirt?
 
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pr33st said:
Our pharmacy has its own tracking system for psuedoephedrine products. What always makes me nervous is selling syringes. We've had an "insulin user" storm out before screaming that we spread HIV by not giving him clean needles. For his insulin.
Click to expand...

pr33st said:
One particularly out-of-it looking guy came in and asked for syringes. The pharmacist put him through the usual battery of questions. His final answer?

"It's for steroids. I'm beefing up my dog." "Steroids?" "Yeah. Beef up my dog."

"Get out."
Click to expand...

lolol :laugh:
 
Erm, I am probably one of the people you are selling your 96-ct Walphed to. I am allergic to the desert come around December - March-ish (depending on how much rain) - seriously, can't even leave a window cracked anywhere in the house overnight. We also go camping in February every year. Pseudoephedrine is just about the only thing that works. Also, I want to save money (hence the 96-ct, lasts me the whole season or darn near close).

Sell the OTC drug. If you don't, someone else (multiple someone elses) will. I like chafdorn's suggestion of slipping it in in conversation, see if the person freaks out. If you don't like it, write your congressman or your corporate office.
 
Well, like I said personally I don't really care. I figure if the state tells me they can buy it then it's not my business one way or the other.

Then it's just peer pressure I guess? :confused:
 
NaOH said:
Well, like I said personally I don't really care. I figure if the state tells me they can buy it then it's not my business one way or the other.

Then it's just peer pressure I guess? :confused:
Click to expand...

Yeah how paranoid is your store lol? I know doctors who are apprehensive about prescribing pain meds to some people who seem a little iffy. And thats just what happens. You want to take care of a person's needs and unfortunately there will always be someone abusing the system. And does an employee's paranoid attitude effect availability for people who really need the medication? (lol this does not apply to the person who calls me every 20 minutes to see if their vicodin has been okay'd) Whenever I buy sudafed from where I work they always give me **** and say I look shady. Smart asses!
 
BearDown said:
Ethical dilemma for selling PSE? Wow people really need to get off their high horse and just conduct business. Not everyone is making meth, and the people buying it in the store would need such mass quantities that it isnt worth their time going from store to store to buy it. Maybe I'm biased because it isnt a problem at my store or in my neighborhood but my opinion is that you should just sell it and move on.
Click to expand...

Actually "meth heads" WILL go from store to store and from town to town buying the max amount of pseudo they can get from each store. And, it doesn't take an "enormous" amount of pseudo to make meth. As a police officer working narcotics I have made meth arrests and found mobile meth labs from just sitting in the Walgreens parking lot and watching for known meth addicts coming out with boxes of pseudo.
Also, while I agree that meth is a big problem that doesnt mean that there is anything "un-ethical" about selling pseudo (the legal amount). I mean, the guy at Walmart doesn't feel bad when he sells isopropyl alcohol, brake cleaner, HEET or any other meth ingredient to someone who looks "iffy". And, just like those products, there are perfectly legitimate reasons to buy pseudoephedrine products.
From what I've seen, the restrictions on purchasing pseudo has helped to slow the manufacture of meth but, it has also spawned a whole new need to break the law. I.E. Since people can only buy so much pseudo at a time then they start stealing driver's licenses and breaking into pharmacies and forging ID's.
I guess my point is....regular folks shouldn't have to feel like they are buying crack when they go to Walgreens to buy some allergy medicine. I just think the only laws that will stem the meth use/manufacturing in this country is making sentences stouter and anything short of that is a waste of time/money and energy.
OK, sorry for the dissertation.
 
As someone who sees the effects of Methamphetamine first hand (I work in a detention facility), I believe the steps taken to hinder it's availability are in the right direction. However, if anyone wants something bad enough they will go to desperate measures to get it, which opens up a new crime aspect.
 
fuCl said:
Ethical dilemma? Sell the fricken product. Its legal under the law to sell it, so why not? Are you also against making money?

You need quite a lot of it to make meth anyway- its not your place as a technician to judge people for buying a nasal decongestant- the ONLY nasal decongestant that works for many people.
Click to expand...

Exactly, Just sell the friggin product. Why should you question whether it is an addict or not? Its not your job to question. Your job is to dispense within the constraints of the law. Just follow the state regulations and you will be ok. If the state doesnt require you to restrict them, sell the friggin thing and make more profit. I will be damn happy to sell more to make profit. I dont think my job is to begin suspecting my clients for something that neither concerns me nor assuming my customers are addicts. Do your job and you will be fine.


Note: I dont believe you are in an ethical dileema. Selling pseudo.... does not mean you are doing something unethical. I think you just bother too much that people are abusing it and you wanna do something to stop it. However, thats not your job buddy.
 
We also pass legislature putting bartenders responsible for over-serving if the customer causes trouble or an accident later on.

Just selling the product might not be so clearcut anymore as things get more complicated.
 
You have an issue selling pseudoephedrine? Get over yourself. It's one of the few truly helpful OTC products available and it should be treated as such.

There are well-defined federal laws in place to aid in the prevention of methamphetamine manufacture. Follow these laws and you have nothing to worry about. It isn't your place (nor your ability) to act as an agent of the DEA or ATF. You're a pharmacy clerk.
 
Nexafed will be a new pseudoephedrine tablet designed to help curb methamphetamine production. It turns into a thick gel when the tablet is dissolved making it harder to extract to make meth...looks like BREAKING BAD is going to have to do a season finale! Of course, it will still be limited to 146 tabs max/day or 366/month and be kept behind the counter in a locked cabinet.
 
JNP said:
Nexafed will be a new pseudoephedrine tablet designed to help curb methamphetamine production. It turns into a thick gel when the tablet is dissolved making it harder to extract to make meth...looks like BREAKING BAD is going to have to do a season finale! Of course, it will still be limited to 146 tabs max/day or 366/month and be kept behind the counter in a locked cabinet.
Click to expand...

They use methylamine to cook their meth, not pseudo.
 
NaOH said:
I'm facing something of an ethical dilemma these days over the large number of people coming into the pharmacy looking to buy products containing pseudoephedrine. I've noticed that most of the people at my store are extremely reluctant to sell it at all, typically keeping most of what we have on a shelf facing away from the out window and falling back on the 'gosh, it looks like we're sold out :eek:' routine constantly.

I see their point, certainly. Even while trying to be non-judgmental, you do get a feel for who probably doesn't really have a serious allergy problem. Walking up to the counter and immediately asking for the Wal-phed 96ct doesn't exactly help either. And I'd rather not abet their misappropriation, though honestly if they want to rot their brains I do sort of feel it's their own issue. I'd feel worse about denying medication to someone who legitimately needed it.

Basically I'm just waiting for the day I called out by a pt for lying about our stock on hand and catching hell over it.

Anyone have any suggestions for ways of delicately handling these individuals?
Click to expand...


Just do the check with the national system and sell it if it doesn't deny the sell. Just make sure you do what you are supposed to do and don't worry about it. That's my opinion on selling it.
 
I think this is silly if you use a tracking system. I need the Zyrtec D to handle my allergies. Just taking cetirizine helps with sneezing, but I am stuffed up. The pseudoephedrine makes it so I can breathe through my nose. I don't know about you, but I like to be able to breathe through my nose.
 
pharm B said:
One particularly out-of-it looking guy came in and asked for syringes. The pharmacist put him through the usual battery of questions. His final answer?

"It's for steroids. I'm beefing up my dog." "Steroids?" "Yeah. Beef up my dog."

"Get out."
Click to expand...

I used to feel the same way about syringes.. the fact is though that you aren't enabling them as they WILL find a way to get it into their system. Hell there are areas in the US now where you can go to a location and cook up right there and they will give you a clean needle and they guarantee that you won't be arrested. The flip side is that they get HIV and then guess who gets to pay for all those expensive antiretrovirals? Mr and Mrs Taxpayer.
 
icevyne25 said:
I can understand syringes because it's hard not to be skeptical with the kind of stories we hear or excuses. However at Target pharmacy we just swipe their driver license to see if they have reached their limit.
Click to expand...

Ya I think the DL scan is getting to be pretty universal at chain stores. As far as the syringes.. my GF used to sell them and then they had to call the police 3 times to come get used drug paraphernalia out of their store bathroom. So she decided she wasn't going to sell them from their store anymore as their immediate need for the safety of their employees came first.
 
Skrumpy said:
Ya I think the DL scan is getting to be pretty universal at chain stores. As far as the syringes.. my GF used to sell them and then they had to call the police 3 times to come get used drug paraphernalia out of their store bathroom. So she decided she wasn't going to sell them from their store anymore as their immediate need for the safety of their employees came first.
Click to expand...

Sounds like she's overreacting calling police to remove that. Just put it in the sharps box. Exposure to bodily fluids? I've gotten drenched in blood giving chest compressions. i think a pharmacist can handle a syringe. IV drug users are going to inject drugs, be it a dirty or clean needle. You are this addict's health professional too, and have an obligation to promote good health behavior. Providing them with clean needles, or at least researching where they an obtain them (local needle exchange program) and directing them there, is a responsibility of ours as health professionals. Do what is best for the patient. For the "they're going to OD" counter argument-- they will OD with your needle or the dirty one they use instead. IV drug users need needle exchange programs/clean needles and rehab, so as a health professional, help the patient obtain these services.
 
Blackboxrx said:
Sounds like she's overreacting calling police to remove that. Just put it in the sharps box. Exposure to bodily fluids? I've gotten drenched in blood giving chest compressions. i think a pharmacist can handle a syringe. IV drug users are going to inject drugs, be it a dirty or clean needle. You are this addict's health professional too, and have an obligation to promote good health behavior. Providing them with clean needles, or at least researching where they an obtain them (local needle exchange program) and directing them there, is a responsibility of ours as health professionals. Do what is best for the patient. For the "they're going to OD" counter argument-- they will OD with your needle or the dirty one they use instead. IV drug users need needle exchange programs/clean needles and rehab, so as a health professional, help the patient obtain these services.
Click to expand...
:thumbup:
 
I catch hell over the whole clean needles thing sometimes (basically anytime the RPh catches me selling them without playing detective). That's one thing I like about floaters - they aren't going to care who I sell needles to.

Our newest RPh is especially strict about it. Most that I have worked with have given me some leeway, but now I really am supposed to be refusing to sell them without a script for insulin or I get in trouble. I hate it personally. :thumbdown:

What do you guys think, aught I do whatever they tell me to do or I should I be able to sell clean needles?
 
Blackboxrx said:
Sounds like she's overreacting calling police to remove that. Just put it in the sharps box. Exposure to bodily fluids? I've gotten drenched in blood giving chest compressions. i think a pharmacist can handle a syringe. IV drug users are going to inject drugs, be it a dirty or clean needle. You are this addict's health professional too, and have an obligation to promote good health behavior. Providing them with clean needles, or at least researching where they an obtain them (local needle exchange program) and directing them there, is a responsibility of ours as health professionals. Do what is best for the patient. For the "they're going to OD" counter argument-- they will OD with your needle or the dirty one they use instead. IV drug users need needle exchange programs/clean needles and rehab, so as a health professional, help the patient obtain these services.
Click to expand...

I'd rather personally give them clean needles than have them get HIV and then become a further burden on society. However, it is not only the staff.. what if a child went into the bathroom and got a hold of a used syringe/etc? Who is liable? The pharmacist that sold the needle? The store? The cleaning staff? etc. I know if I was the cleaning staff I wouldn't want to be cleaning up used needles from known drug users every shift. She had upwards of 30+ drug users coming in on a daily basis. Would you like to clean up hazardous waste as a full time job? That wasn't in anyone's job description and the cleaning staff doesn't make enough for that IMO. I think it's pretty easy to judge the action but not quite as easy to deal with it yourself. In general I agree with your assessment but there are some definite grey areas there and not a lot of easy solutions.
 
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