Wednesday, September 2, 2009

The Dumbest Law

I absolutely hate that we're required by federal law to keep track of pseudoephedrine sales. For one, I don't see how people turning Sudafed into methamphetamine is a problem for me. Honestly, I couldn't care less if people are getting high off the stuff. Shit, they can make all the Meth they want. It's never affected my life one bit.

I have the same attitude towards the whole "war on drugs." Do I think people should do drugs? Absolutely not... except if they're getting prescriptions drugs at MY pharmacy. I think it's important to educate people on the dangers of drugs, but, in my opinion, that's the best we can do. If after learning the dangers, people still want to get high, then I say we let them. They were warned. If they still choose to do drugs, then they can only blame themselves for fucking up their lives.

Moreover, I hate how we pick and choose which drugs against which we stage this "war." We're made to keep track of Sudafed, a drug that's been sold over the counter for fucking decades, but when it comes to alcohol, nobody cares. What the fuck is that? Alcohol has killed more people and ruined more lives than methamphetamine, heroine, and cocaine combined, but we have commercials for Budweiser before every fucking sporting event. It's especially weird when you compare it to a drug like marijuana, which has an adverse effect profile that pales in comparison to alcohol. But judging from commercials, if you get drunk, no matter where you are, you'll probably be surrounded by models in bikinis, whereas smoking pot will destroy your life. If we're going to fight a war against drugs, then I say we should be consistent and fight against all drugs.

I digress... Besides the above reasons, the biggest reason I hate the "Combat Methamphetamine Epidemic Act" is that it's completely unenforceable. I'm a firm believer that a law can only be a law if you can enforce it. The whole Sudafed log book thing is really just designed to be a speed bump to try to deter people from buying massive amounts of pseudoephedrine and making methamphetamine, and like most speed bumps, there are plenty of ways around it.

First of all, there's no central pseudoephedrine database that all pharmacies can access. I have no idea if the person that just bought 2 boxes of regular Sudafed from me has a stuffy nose, or if he's bought 2 boxes of Sudafed from every pharmacy within 5 miles over the last 24 hours. A person can literally go from pharmacy to pharmacy buying Sudafed, and as long as he stays within the daily limit at each store, no one would think twice about it.

Secondly (and this is the reason for this post), some pharmacies do not even have a good system for tracking pseudoephedrine sales. For example, my pharmacy keeps a log book. This log book is a simple, old-fashioned binder where we write down the customer's name and address along with the product he bought. In a slow store, this might work fine. However, when you're filling 400 scripts per day, and there's literally 5 or 6 different employees who might be at the register during the course of the day, it's really hard to keep track of who bought what and when. I'll admit, we generally do not look through the log book to check if the person is within the monthly limit of pseudoephedrine. In fact, a customer could probably come at 9 in the morning, buy 2 boxes of Sudafed, and then come back 8 hours later and buy 2 more boxes from a different cashier, and we wouldn't even realize it. We're just too busy, and it takes too much time to always check.

This became clear to me over the weekend when one of our clerks thought that one of the pseudoephedrine-purchasing customers looked a little sketchy and decided to look back through the log to see if he had a history. Well, she found out that he had purchased Sudafed 12-hr about 15 times during the months of July and August. Technically, he was within the legal monthly limit. However, after reading the article The Angriest Pharmacist mentioned, I decided that some asshole undercover narcotics agent might consider these sales "reckless" and arrest me on felony drug charges.

I brought the issue up to my pharmacy manager, who kind of laughed it off. I don't think it's funny though. A paper log book is not a good enough on-the-fly tracking method. Sure, we can look back and see who got what, when, and how much if we were alerted to someone who might be buying a heck of a lot of pseudoephedrine. However, it's very unlikely we'd ever deny someone the sale on the spot because we just wouldn't have the time to thoroughly analyze the book. I suggested that we try to bring our situation to corporate (along with a copy of the article to which Angriest linked) in order to try to get an electronic tracking system.

Upon calling the closest Walgreen's in order to ascertain if our Sudafed Guy had been getting it at other pharmacies too, I was told by the Walgreen's pharmacist that even though they have an electronic system that monitors and makes sure no one is sold more than the legal limit, the pharmacist cannot actually access the records and search for a particular customer's purchasing history. Therefore, he could not tell me if our Sudafed Guy was getting Sudafed from them too. He just knows that if they did sell it to him, he would be within the monthly limit at Walgreen's.

What good is that? Just like I said, even with the electronic tracking system, there's nothing stopping someone from going pharmacy to pharmacy purchasing the legal limit. Therefore, like I said, the law is simply meant to be a deterrent making it a little bit harder for someone to acquire enough pseudoephedrine to make methamphetamine.

While I think a law as a deterrent is pretty stupid, it wouldn't upset me so much if not for the fact that, judging by the Oklahoma Bureau of Narcotics actions against that pharmacist, the federal government takes the law very seriously... so seriously that they're arresting pharmacists because they're selling perfectly legal quantities of pseudoephedrine to "suspicious" customers.

If you want to have your stupid law, fine. Just don't pretend that it makes a difference. Yes, it seems that ever since the law has gone into place, there have been far fewer methamphetamine labs in the United States. However, despite fewer labs, the supply of methamphetamine on the streets has stayed roughly the same. The reason? Mexican producers have noticed the increase in U.S. demand of their methamphetamine and have increased shipments into the country using the cocaine shipment routes from the '80's. Therefore, just as many people are getting high on Meth now as they were before the act was implemented. Doesn't sound too successful to me.

All the federal government is doing now is taking the focus off the real methamphetamine dealers and putting it on pharmacists, thus adding another responsibility to our ever growing pile. When will this shit end? We get so bogged down in following the stupid laws that we forget the whole point of the law in the first place. It's the COMBAT METHAMPHETAMINE EPIDEMIC ACT. The new law didn't do a damn thing to stop the epidemic. It's now simply inconveniencing pharmacists and possibly turning them into felons for selling a drug that has been perfectly legal for decades. The stupidity never seems to end.


Anonymous said...

I work at walmart and our system lets us look up individual patients who buy and we have stat cops coming in once a week for a printout of every sale that week. Its a pain.

Anonymous said...

All of this from a guy who thinks the government should run our healthcare system...just boggles my mind. It sounds almost as stupid as a scientist who believes in god.

Anonymous said...

The walgreens system is computerized and will not let you sell the product if it is over the daily or monthly limit and the data is readily retrieveable.

Pharmacy Mike said...

"All of this from a guy who thinks the government should run our healthcare system...just boggles my mind. It sounds almost as stupid as a scientist who believes in god."

What's stupid is basing an argument on such poor logic.

Yes, if we enact stupid laws like this for every part of the health care system, we'd have a problem. However, if we follow the examples of just about every single country in Europe, and pretty much copied a system like France's, we'd have a system that costs less, performs better, and covers everyone.

Everything I write about health care is based off facts. It is a fact that France pays far less money for health care per capita than the U.S. It's a fact that every citizen in the nation is covered whereas we have nearly 50 million uncovered. It's a fact that they have lower rates of chronic diseases, have lower infant mortality rates, and longer lifespans.

If all you're going to bring to the table is speculation about what you think MIGHT happen (even though pretty much every other industrialized country in the world shows it doesn't happen), then you're making an awfully weak argument.

If nationalized health care works perfectly well (which is far better than here) in other countries, then the only argument that can be made against it is that we Americans are too stupid to enact that kind of superior system... That it's beyond our mental and organizational abilities.

I'd like to think we're not dumber than the rest of the world. However, with comments like this, I could be wrong, and your stupidity could be proving your own point. I hope that's not the case.

Anonymous said...

I don't know if individual states have access to area databases for CS prescriptions, but here in IN we have a program that keeps pretty good tabs on who gets what from a legitimate script. Individual providers don't always keep it up to date, but it helps our prescribers out in the boonies when a seeker rolls into town.

As for meth, there's rumor that production methods may only require a few doses, so tighter control is necessary. My concern is for the 'innocent' victims; the kids whose folks are addicted and get bashed, or the lab that explodes and requires the 5:1 to 10:1 total care at a burn unit, or car wrecks, etc.

And, yes, I totally agree about alcohol, but it's too broad a topic to host a 'but'. Until the day comes when therapeutic kudzu is as accessible as ethanol, then there's no level playing field.

Anonymous said...

I work in Oklahoma and they have a database that is required by law to track the person with their id number. You put their id number and full name and it will tell you if they have exceeded their daily or monthly limit. It will only approve a sale if it is under the limit. This system is required in the state of OK. Its really good to have because then the druggies cant just hop from store to store to buy. And the system is for all stores to use not only the chains. It for the mom and pops as well.

Anonymous said...

I fail to see how you see fault in my logic as I am using the most positive correlation available, the current programs our government runs. If they can not make something simple work, how in the hell do you expect them to make something this complicated work?

Now let's get one thing out of the way right now, I agree that health of the people in this nation is terrible and heathcare costs too much, but have you really considered why? Our citizens eat out an average of 7-10 meals per week, have $10,000 in credit card debt and are overweight if not obese.

It is not the health care system that is stealing the soul of this nation, that is only a symptom. The real problem in the United States is our culture, and until we can change that no system will ever fully work for us, and when we change it the system we have will not really matter.

So yes I do think we are not smart enough to make universal healthcare work in the United States, and no one is.

I just ask that you think about it.

Pharmacy Mike said...

I have thought about it, and I'll agree with you that the people of the United States most certainly need to make changes in their lifestyles in order to be healthier. I actually do believe that this will come with time.

It might be hard to believe when you look around and see one fat ass after another, but we are starting to become more health conscious. For example, we're dramatically reducing the amount of trans fats we consume mostly because restaurants and other food producers are not using them to make food. Just about every fast food restaurant now has healthier (though I would still not consider thm "healthy") options to choose from. They're also starting to reduce portion sizes, which might be more of a price control thing, but it's positive either way. Sort of like "going green," eating and living a healthier lifestyle is becoming a popular trend.

My view on nationalized health care is that, for one, ensuring no one in this country has to die or go bankrupt from lack of health insurance is a moral imperative. It's simply the right thing to do. We all should want to live in a society where we seek to help each other.

Secondly (and it ties into the first point), the current system is decidedly immoral. I don't understand how everyone is not outraged by the fact that our health care is being controlled by corporations that only care about increasing profit margins and stock values. The whole goal of these insurance companies is to deny as many claims as possible. How awful is that? It's sickening to me.

Even if nationalized health care in this country runs into a few snags in its first few years, we still need to implement it. When it comes to fighting pointless wars, we spare no expenses, but when it comes to providing health care for every citizen in the country, we decide it'll cost too much.

Honestly... I'd like to see Obama pull a George W. Bush and just say, "fuck all of you who oppose me; I'm dragging this nation into national health care whether you all like it or not." It's what Bush did with the Iraq war and just about every decision he made afterwards, except Bush is a moron and his ideas suck.

We voted Obama as our President because we loved his talk about change and hope as well as being incredibly intelligent. What was the point of voting him in if we're all just going to stick with the status quo.

Fuck it... It can't possibly be worse than what we have now. We should all be willing to give it a shot.

Anonymous said...

"What's stupid is basing an argument on such poor logic"

Why do you assume that it is logical that somehing that "works" in one country will work in another. The U.S. assumed after WWII that democracy would work in every country. Obviuosly this was not the case. The first writer was simply making a point that the same goverment you do not trust to police the silly PSE laws you do want running your health care. Do you not see the irony here?

You also say it can't be worse than what "we" have now. Most pharmacists I have ever met have pretty decent health insurance unless they opt out. Exactly what "we" then are you referring to?

Pharmacy Mike said...

It's not that it worked in one other country. It's that it worked quite well in just about every other industrialized country. We're practically the only assholes that haven't converted to a national health care system. It's kind of like we're the only assholes not using the metric system. Just like how 184 other nations have ratified the Kyoto Protocol, the United States still hasn't. We seem to always be the last ones on board with everything

And, like I said, it's an absolute moral imperative.

Yes, being that I make $120,000/yr and work in a pretty good profession (at least for the time being), I have pretty good health insurance... as far as I know. I'm one of the fortunate ones. There are a hell of a lot of people that aren't as fortunate to be in this profession and to be making the kind of money I am.

I think I should get the same value of health care as every single citizen in the country. It shouldn't be, "Oh, he's a pharmacist, so if he gets cancer, he'll get treatment, but this guy can only find part time work as a handy man, so if he gets cancer, fuck him, he deserves to die."

The notion that simply because you or I might have good coverage (at least we think we do), doesn't mean that there isn't a MAJOR problem with the insurance system in this country.

Anonymous said...

A moral imperative to you. Just as it is a moral imperative for Al Gore to save the planet or a moral imperative for the Christian right to end abortion. Everyone has their particular something that Americans "must" pay for or we are all doomed/immoral/unethical/whatever.

So yes the system is not perfect but most people in this country who are employable have some means of accessing health care. The ones who are completely un-employable I would argue have some of the best healthcare. I would not mind some sort of plan for those in between but I would not want to give up my plan to have some government issued BS.

Pharmacy Mike said...

I would argue that Global Warming is a scientific imperative being that if we don't do something soon (and it might already be too late), we're all fucked.

Abortion... I won't go there, except to say that at least my moral imperative (health care for all) actually serves people who are already in this world.

And you go ask around and see how many people are satisfied with their employer sponsored health insurance. Shit, that's all I hear all day at work is everyone complaining about their damn insurance. I'm too lazy at the moment, but if you'd really like, I'm sure I can go dig out polls about the percentage of people not satisfied with their insurance.

Anonymous said...

Completely unnecessary. I am sure I could do the same and we could run these circles on any hot button issue all night.

Again where do we stop? All this government control over everything was tried out in Russia. It prevents people from having any desire to acheive something as it will simply be handed to them. What's next? Toilet paper will be a fundamental right in your mind as everyone must have it. Why not soap? toothpaste? Does everyone deserve straight teeth? If so we better start saving now orthodontia is very expensive.....

Pharmacy Mike said...

I would like to see you find polls that say people love their health insurance.

We're talking about health here. I'm not talking about government takeovers of companies (I was and still am 100% against the bailouts). I think that it's kind of important that a person shouldn't have to die or go bankrupt because he happend to be so unlucky as to develop a life threatening illness and can't afford a health insurance policy. Or because he had a "pre-existing condition" that made him lifetime declineable.

It's called the fallacy of the slippery slope. It's the reasoning that one simple step (that just about every other industrialized country has already taken) will cause a land slide and send us straight into full-blown socialism. It hasn't worked like that in all the other European countries. Why would the same thing happen here?

I don't think it's unreasonable that everyone should have the right to see the doctor and get appropriate treatment if they are ill. I think that's just slightly different than government sponsored toilet paper.

Anonymous said...

The concept of the slippery slope will become more evident and real to you as you age.

On a lighter note, free TP would be pretty cool.

Pharmacy Mike said...

Just gotta make sure they get the soft 2-ply TP.

PharmacyJim said...

"It can't possibly be worse than what we have now. We should all be willing to give it a shot."

While there are some things I disagree with you on (Bush and his moron status), and some I agree with you on (the insurance industry being many times more concerned with profits than patient care), your quote above gives me much pause. While our system needs much improvement, I am not ready to throw it out and start over. I really believe it could get worse.

Chip said...

There was support for the Iraq War at the time we entered it, hence the Authorization for Use of Military Force that was passed by Congress. While it's true that the support waned as the war dragged on (but I don't hear much complaining now, even though we're still there- it almost seems as though the complaints are more politically motivated than they are morally), the support was there. That being said, the support is NOT there for Nationalized Health Care, because most reasonable people believe that Obama has been lying about it from the first word he uttered, with all the 'cutting costs" and "bending the cost curve" mumbo-jumbo.

Keith said...

Here is what Anonymous said:

"Again where do we stop? All this government control over everything was tried out in Russia. It prevents people from having any desire to acheive something as it will simply be handed to them. What's next? Toilet paper will be a fundamental right in your mind as everyone must have it. Why not soap? toothpaste? Does everyone deserve straight teeth? If so we better start saving now orthodontia is very expensive....."

Just where does government control start and stop in our lives? Once government gets its foot hold into one area of our lives, it just keeps expanding and moving onward into other areas. Government has not limits. The Constitution is completely ignored. We have these regulatory "agencies" that act like Gestapo headquarters. Retulations on Pseudoephedrine turns pharmacists into "cops". What few people seem to realize is that a democratic, capitalistic system can run its self. It does not need "dictators", "czars", or regulatory agencies. Most of the problems with healthcare today is a result of too much intervention by government, and insurance companies getting special favors because they can buy Congress.

New Norwegian said...

America's system is so weird, and even compared to ours, pretty sub-par.
Here we have a program called "Project Stop" that is an online database connected to every store in the country, and police offices. When someone requests a psuedo product, we take their license, passport, etc. and input the license number, and the product, online, and within seconds we will know if they have gone to another store, if that store ended out supplying the product, or if the store felt 'pressured' (threatened, a 'safety sale') into giving the Sudafed. From there we can deny the sale or allow it, and so on. It's a fast and effective solution, though in reality, if someone wanted to make meth they would probably just bust into the store and steal it.

Still, this is a system they should enable in America, it would be a lot easier than your current one.