COLD MED LIMITS TO GET MORE STRINGENT

Buyers Must Show ID in Effort to Stall Production of Illegal Drug

Stuffed up from allergies or a cold and looking for relief from
decongestants such as Sudafed, Dimetapp or PediaCare?

Federal law now limits how much of these and other over-the-counter
medications containing pseudoephedrine you can buy. And as of Sept.
30, all such products must be behind the counter and you must show
photo identification and sign a store logbook to purchase them. (The
only exception is for a single, two-tablet package -- such as you
might find at a gas station -- of no more than 60 milligrams of
pseudoephedrine.)

The law, part of the Patriot Act, is intended to combat production of
methamphetamine, a highly addictive illegal stimulant made with the
decongestants' active ingredient.

Meth causes more damage to the brain than alcohol, heroin or cocaine
and is associated with aggression, violence, hallucinations and more,
according to the U.S. Drug Enforcement Agency.

The toxic chemicals and vapors generated in its production make homes
uninhabitable, damage the environment and endanger police and others.
The drug is cheap and easy to make -- starting with just a few boxes
of pseudoephedrine -- and the DEA cites an unprecedented rise in meth
use, manufacture and trafficking. The DEA made 5,870 methamphetamine
arrests in fiscal 2005 and seized more than 5,000 pounds of the drug.

Many local pharmacies are already complying with the law. For
customers, the changes may mean inconvenience, confusion and even
mistaken purchases of reformulated and possibly less effective
products that have replaced some pseudoephedrine-containing medicines
on store shelves.

Gowan Marshall of Greece, who has used Sudafed for allergies, predicts
that a lot of shoppers will just look for a substitute still on the
shelves, either because they don't want a hassle or don't like showing
ID. "Some people might say that's an invasion of my privacy," he says.

The new limits may especially frustrate families full of allergy
sufferers. If a mother and her 12-year-old child regularly take
12-hour Sudafed, for example, the parent will not be able to buy
enough of the medication within the 30-day limit to cover the family's
needs.

In one day, the adult could buy up to three boxes of 10 tablets,
reaching the federal limit of 3.6 grams of pseudoephedrine -- which
would cover the two of them for about a week.

Over the course of a month, the mother with allergies could buy only a
17-day supply, for a total of 8.4 grams, the closest she can come to
the 30-day limit of 9 grams with current packaging. The child couldn't
buy any of the medicine under the new law unless she has a state or
federal ID card, such as a passport. The number of pills or amount of
liquid medicine allowable varies depending on the type of product and
its strength.

Joan E. Hagen, pharmacy manager at the Walgreens in Irondequoit, says
the purchasing limits shouldn't be a problem because people generally
don't need a decongestant long-term. A cold lasts about a week.

Allergy sufferers may need a decongestant such as Sudafed temporarily,
but typically they have a longer need for an antihistamine -- such as
over-the-counter Claritin or Alavert (both of which contain
loratadine) -- for their runny nose, sneezing and itchy, watery eyes.
For persistent stuffiness, talk to your pharmacist or doctor about
other options.

One challenge: When the pseudoephedrine medications are behind the
counter, you may not be able to buy them when the pharmacy within a
store is closed. Unless a store keeps the pseudoephedrine products
behind the front counter (as CVS does), for late-night stuffiness
you'll have to find a 24-hour pharmacy.

Customers might buy something they've used in the past, such as
NyQuil, without realizing it's been reformulated to no longer contain
pseudoephedrine -- so it no longer relieves congestion. Other products
have second formulations -- such as Sudafed PE -- that use a different
decongestant, called phenylephrine, which can't be used to make meth.

Phenylephrine was approved by the Food and Drug Administration in 1975
as safe and effective for relieving congestion. But pharmaceutical
researchers at the University of Florida cite studies showing that
while phenylephrine does work in nasal sprays, it isn't well-absorbed
in pill form. In a letter to the editor in the July issue of the
Journal of Allergy and Clinical Immunology, Leslie Hendeles and Randy
C. Hatton recommend that people stuffed up with a cold use a nasal
decongestant spray. But don't use them for long; after a few days,
they can have a rebound effect that makes congestion worse.

Pfizer, which makes Sudafed PE, maintains that the drug relieves nasal
and sinus congestion like original Sudafed.

Marian Sanders of Rochester, who says original Sudafed has worked the
best for her colds in the past, sees the potential for customer
confusion in stores. Sudafed PE boxes look much like Sudafed boxes.

"You'd pick up the first one you'd find that said Sudafed," she
says.

She also doesn't like the idea of having to go the counter, show ID
and give her signature. "Why should you have to go through all of that
to buy something?"

But William Masterman of Perinton, who recently bought Sudafed for a
visiting friend, supports the new law.

"If it's going to stop illegal drugs, that's good," he
said.

Whether the changes will reduce meth production is unclear. The law
doesn't stop someone from traveling from pharmacy to pharmacy, buying
one box of Sudafed at each. Pharmacies must keep the logbooks and law
enforcement officials could look at them, but no agency is regularly
collecting and monitoring the data.

Some stores, such as Rite Aid, say their pharmacy registers are
networked so they can catch customers trying to exceed the limits at
multiple locations. Other stores use paper logs.

Customers have generally gone along with the new rule, although
they're surprised by the change, local pharmacy employees report.
"After 9/11, I guess they're more prone to obey," says Nadia Deskov,
pharmacist at the Rite Aid at 12 Corners in Brighton.

The law means extra work for her and her co-workers, who now must
fetch the boxes for customers, sometimes going back and forth as the
customer decides between brands, tablet strengths and prices.

Stores vary in how they're handling the new law. Eckerd, Walgreens,
Target and CVS stores, for example, have cards hanging in the
cough-and-cold aisle that customers carry to the desk. The cards show
a picture of the package, including dosage and warning information,
which can help customers choose which kind they want.

Maurice Landesberg, a pharmacist at Tops Friendly Markets on Upper
Falls Boulevard in Rochester, sees one plus to the law putting
pseudoephedrine products behind the counter: "It's good in that it
gives me a chance to speak to people."

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WHAT'S CHANGED

The Combat Methamphetamine Epidemic Act, part of the Patriot Act
passed March 9, limits how much pseudoephedrine and
ephedrine-containing products an individual can buy per day and per
month. The limits are an effort to combat production of meth, a highly
addictive illegal stimulant.

The second phase takes effect Sept. 30, and many local pharmacies have
already made these changes:

Off the shelf: Stores must keep decongestants containing
pseudoephedrine -- such as Sudafed, Dimetapp, PediaCare and Claritin-D
- -- behind the counter or in a locked cabinet. The law also applies to
ephedrine, which is used in some topical drugs, such as nose drops, to
temporarily relieve congestion. Ephedrine is also used orally for
temporary relief of asthma symptoms. To purchase the products,
customers must show photo ID and sign a logbook. Stores must maintain
a written or electronic logbook listing purchasers' names and
addresses, product name, quantity purchased, date and time and keep it
for at least two years.

Staying on the shelf: Some decongestants -- such as Sudafed PE --
contain a different ingredient, phenylephrine, that isn't regulated
under this law. Some products such as DayQuil and Tylenol sinus,
allergy and cold medicines once contained pseudoephedrine but have
been reformulated to instead contain phenylephrine, to keep them on
shelves. Others, such as NyQuil, no longer contain pseudoephedrine or
a replacement and no longer relieve congestion.