COLD AND FLU season is under way, but finding a remedy for the ailments may be tougher this winter.
To help police and others better control the sale of an ingredient used in an illegal drug, many stores have removed nonprescription cold medicines containing pseudoephedrine from store shelves and put them behind the pharmacy counter.
Affected are all the popular cold medications such as Sudafed, Actifed, Dimetapp, and Nyquil, and even store brands promising the same relief.
Some stores even have restricted how many packages of the cold medicine can be purchased at one time and are requiring purchasers to provide picture identification. Some may carry fewer products containing pseudoephedrine and more containing a different drug, which may be less effective in fighting cold symptoms.
Restrictions vary by store in Ohio, but getting medicine to fight colds this winter will be less convenient and perhaps more confusing for consumers.
"I understand why they're doing it, but it's irritating the first time you go through it," said Dani Smith, of Oregon, who was at the Target store in Rossford on Thursday to pick up Sudafed for her chest cold.
"I was intrigued by all the little cards. But I wasn't sure what to do with it next because there were no signs. I actually had to ask [someone]," she said.
Among the national chain stores, Target Inc. probably has the most restrictive policy.
It removed all drugs containing pseudoephedrine from its stores without pharmacies, two of which are in the Toledo area. At stores with pharmacies, of which there are two locally, those drugs were removed the shelves and placed behind the pharmacy counters.
Cards advertising the drugs are on display, allowing a customer to choose one to hand to the pharmacist.
Ms. Smith said that to obtain the Sudafed at the Target pharmacy, she had show an ID and then had to pay for the drug there - resulting in a separate transaction in the store later for other items.
"I told my husband afterwards it was kind of a pain in the butt."
Many stores acted last spring after law enforcement authorities sought to make the over-the-counter medicines containing pseudoephedrine less available. The ingredient is a stimulant used in the manufacture of methamphetamine, also known as speed, ice, or crank - a drug that is illegal, dangerous, and highly addictive.
There has been a significant rise in the number of meth labs around the country, with authorities making nearly 16,000 seizures last year.
Meanwhile, sales of over-the-counter cough or cold and related medicines have been healthy. Sales reached $3.4 billion last year, nearly a fifth of all non-prescription drug sales, according to the Consumer Healthcare Products Association.
The measures taken varied by retailer. For example, Sudafed, a common decongestant widely available for decades, has been removed from some stores, is monitored by a pharmacist at others, and is kept in limited quantities on shelves at other stores. But many gasoline stations or convenience stores which sell the medicine have imposed no restrictions.
It is unclear whether the restrictions will hurt sales of the products containing pseudoephedrine or whether cold sufferers will avoid stores that don't readily display all the brands.
A recent study of effects of a restrictive law in Oklahoma found that the number of available pseudoephedrine items fell by a third, and a year after the law was enacted, sales of such products dropped 16 percent.
However, in an indication that customers would rather buy another remedy than go to through the pharmacy, sales of non-pseudoephedrine products rose 24 percent, according to the marketing firm International Research Inc., of Chicago.
Jackie McGhee, of Toledo, said last week she wasn't aware that some stores had placed pseudoephedrine products behind pharmacy counters. But she knew why.
"It's being controlled," she said. "They're keeping it out of the hands of young people so that they can't use it make that drug. What's it called, ice?"
She said the restriction was a good move, but one that would cause problems for pharmacists.
Carol Hively, a spokesman for Walgreen Co. drug store chain, said many people probably haven't noticed the differences, as the cold and flu season has just begun and this is the first winter of the new policies.
Walgreen, among the retailers using strong restrictions, has placed 162 items behind its pharmacy counters and restricts purchases to two packages of 24 tablets, not to exceed 6 grams.
Wal-Mart Stores Inc. followed Target's lead. Rite Aid drug stores put pill medicines behind the pharmacy, but left liquids and gel caps products containing less than 30 milligrams of pseudoephedrine on the shelves, said spokesman Jody Cook. The store limits purchases of the shelf items to three packages, she said.
"The feedback we've gotten from customers is they understand there is a problem with people using pseudoephedrine to make meth."
In Ohio, Meijer Inc. puts products with pseudoephedrine as its sole ingredient behind pharmacy counters, limits sales to two packages, and requires buyers to be 18, a spokesman said. However, drugs that contain pseudoephedrine as one of several ingredients remain on shelves, she said.
But Pharm discount drugstores in the Toledo area keep all products on their shelves. "As far as we're concerned, it's business as usual," said Mary Dechow, director of government and regulatory affairs for the company.
The chain, owned by Spartan Stores Inc. of Grand Rapids, Mich., monitors inventories and sales and would question someone buying a large quantity of the drug, she said.
Control also is less restrictive at local independent pharmacies. At least two pharmacists said they still keep the product on the shelf, but limit the quantities available.
Brent Kahler, owner of Kahler Pharmacy in Toledo, said his store formerly carried three sizes of Sudafed, including a box of 96 pills. But not anymore.
"We started seeing an increase in sales of it right off the get-go, so we decided to decrease what we carry," he said.
At Glenbyrne Pharmacy in Toledo, owner Bill McCall also limits pseudoephedrine products on the shelves.
"You can't buy three or four bottles of 100 pills. The most you can get is one box," he said.
The meth labs, he explained, are a problem, but people wanting the pseudoephedrine can get it elsewhere, such as at non-pharmacy stores.
A random check at gas stations, carry-outs, and small grocery stores locally found the product easily available on shelves, albeit more expensive and sometimes in limited quantities.
At least 37 states have passed laws restricting sales of pseudoephedrine, but Ohio has not. A Michigan law effective Dec. 15 requires the product be sold from behind a pharmacy counter or from a locked case.
One federal bill on the subject has been passed by the Senate and another version is being considered in the House.
The sales restrictions could spell trouble, said Ernie Boyd, president of the Ohio Pharmacists Association.
For consumers, it means waiting for a simple and high-demand product. For pharmacists, it means more work, he said.
If reasonable legislation can be crafted, that's great, but if too much liability falls on pharmacists, Mr. Boyd explained, pharmacists may simply stop carrying pseudoephedrine items.
Instead, they likely will start carrying and promoting medicines that use a different drug, called phenlyephrine.
"It's not as effective as pseudoephedrine, but it's not as much of a problem," Mr. Boyd said. "It can't be used to make meth," he said.
Already, pharmaceutical firms are introducing more cold and flu remedies that use phenlyephrine, known as PE, instead of pseudoephedrine, he said.
On its Web site, Pfizer Inc., the maker of Sudafed, said that although consumers have used the drug safely for 40 years, the company has moved quickly to launch Sudafed PE and is working on other phenlyephrine products as an alternative to pseudoephedrine.
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