Kentucky has joined a growing national debate on whether to require a prescription for some cold and allergy medicines in an attempt to eliminate dangerous methamphetamine labs.
At issue is pseudoephedrine, the ingredient in some over-the-counter remedies. Meth "cookers" amass piles of tablets that contain the drug, then convert it to meth in small, homemade labs often fashioned from plastic bottles, using a chemical process that involves toxic substances such as drain cleaner and starter fluid.
The Kentucky Narcotics Officers' Association recently voted in favor of requiring a prescription to get medicine containing pseudoephedrine.
The association is looking for a state lawmaker to sponsor the prescription proposal in the 2010 legislative session, which starts in January, said Stan Salyards, president of the association.
Products containing pseudoephedrine used to require a prescription in the United States, said Salyards, a Louisville Metro Police sergeant.
Requiring a prescription would cut down the number of meth labs in Kentucky, a benefit not only because the labs contain hazardous waste that can threaten the environment and is expensive to clean up, but because the fumes endanger people and can set off explosions, narcotics officers say.
"It's just a matter of time before we have an innocent citizen or a child killed in one of these meth lab fires," Salyards said.
People often cook meth in houses where there are children or in motels, endangering unsuspecting people in other rooms.
There have been more than a dozen people hurt and two killed the last four years in meth lab fires in Kentucky, and more than 250 children found near labs in houses or vehicles, according to a database maintained by the U.S. Drug Enforcement Administration.
In one disturbing case, a 20-month-old boy in Wayne County died in May after accidentally drinking drain cleaner police said was being used in cooking meth.
It's time to try something else in the fight against meth production, some Kentucky police argue, because other measures haven't worked.
The state is on track to have a record number of meth labs this year despite having various controls in place.
Products with pseudo ephedrine must be kept behind pharmacy counters, and buyers must show identification and sign a log. In addition, there are limits on the number of grams of pseudo ephedrine people can buy, and the state has an electronic system called MethCheck that pharmacists have used to block thousands of attempts to buy more than the legal limit.
The controls helped knock down the number of meth labs for a while, but cookers and addicts found a way around them.
One common tactic is called "smurfing," in which meth cookers organize groups of people to buy cold tablets for them to defeat the limit on pseudoephedrine sales, said Col. Mike Sapp of the Kentucky State Police.
"It's getting worse," Sapp said of homegrown meth production.
MethCheck figures show a significant rise in the amount of pseudoephedrine sold in some Kentucky counties from mid-2008 to mid-2009.
In Laurel County, for instance, the number of grams of pseudoephedrine that were sold more than doubled from August 2008 to August 2009, from 3,978 grams to 8,459. In Wayne County, the number rose from 865 grams to 1,402 during the same 12 months.
It's clear that some portion of the pseudoephedrine sold is being diverted to illegal meth production, police said.
Backers of the proposal to require prescriptions for products used in making meth point to Oregon to show why.
In the early years of this decade, police there found far more meth labs than police in Kentucky: 587 to 175 in 2001, for instance, according to data tallied by the DEA.
In 2008, the numbers had reversed dramatically: 428 labs in Kentucky and 21 in Oregon, most of them no longer operational, according to the Oregon Alliance for Drug Endangered Children.
Oregon, like Kentucky, has a number of controls on pseudo ephedrine. One key difference, however, is that Oregon is the only state to require a prescription for pseudoephedrine, said Rob Bovett, an Oregon prosecutor.
"We've virtually eliminated meth labs" with the law, said Bovett, who wrote the Oregon measure and pushed to get it passed.
The issue of requiring a prescription for pseudoeph edrine is gaining attention in a number of states besides Kentucky, including California and Missouri, Bovett said.
Proposals to require a prescription for pseudoephedrine are sure to meet strong opposition, however.
In Oregon, it took three legislative sessions and a lot of wrangling to get the prescription law passed, said Bovett.
The Consumer Products Healthcare Association, which represents makers of over-the-counter medications, opposes requiring prescriptions for pseudoephedrine, spokeswoman Elizabeth Funderburk said.
It would inconvenience consumers and mean higher costs for them, including the need to see a doctor to get cold and allergy medicine, Funderburk said.
The group fought a proposal in California this year to require a prescription for pseudoephedrine. The measure was not approved but probably will be reconsidered.
Funderburk said the industry group supports efforts to stop the use of pseudoephedrine in making meth but considers electronic monitoring like that used in Kentucky a more effective way to do that.
The National Association of Drug Diversion Investigators in November announced creation of a multistate system to track pseudoephedrine sales, modeled on the MethCheck program developed in Kentucky.
Companies that make medication containing pseudo ephedrine will pay the costs of the system, the association said.
Kentucky narcotics officers, however, said tracking pseudoephedrine sales won't end the problem of homemade meth production.
They point out that the number of meth labs found in Kentucky has continued to rise even with a system in place to monitor pseudo ephedrine sales, as it did in some other states with tracking systems.
Meth abuse will continue even if the state requires a prescription for pseudoephedrine because much of the meth comes in from large producers in Mexico, police said.
The proposal is more about ending the dangers caused by labs.
"We're wanting these explosions to stop," said David Gilbert, head of the Lake Cumberland Area Drug Task Force.
Some question whether Kentucky could expect as much success as Oregon in driving down the number of meth labs if no surrounding state requires prescriptions.
State Sen. Tom Jensen, a Republican from London who chairs the Senate Judiciary Committee, said that if someone files a bill to require a prescription for over-the-counter remedies, the committee would look at it closely.
Jensen said that meth has been a disaster for Kentucky and that he wants to control it but would be reluctant to do anything that would cause higher costs for people who legitimately need cold and allergy medicine.
It might be more appropriate to try to persuade manufacturers to revise their products so they don't include pseudoephedrine, Jensen said.
There are decongestants that don't use the ingredient needed to make meth.
Bovett, the Oregon prosecutor, said lawmakers there heard a range of arguments against requiring prescriptions for pseudoephedrine, including that it would inconvenience people and drive up costs for consumers and Medicaid.
However, he said, the Oregon law didn't cause problems or a public outcry. Most people simply switched to a cold remedy without pseudoephedrine, and the state's Medicaid cost went up only a fraction, Bovett said.
On the other hand, the number of meth labs plummeted, and there have been reductions in meth use and the state's crime rate, Bovett said.
"It just has worked phenomenally well," he said.