LIMITING PRODUCTION OF CRYSTAL METH

I read with interest the recent Public Health piece on methamphetamine
hydrochloride (crystal meth).1 Two subsequent articles on the same
topic provided more details, but there were no comments on prevention
programs or on limiting production of this drug.2,3

I had a distinct sense of deja vu. Forty-five years ago, I reported in
CMAJ the first North American case of addiction to diethylpropion.4
This drug is chemically distinct from amphetamines, but the symptoms
resulting from abuse are identical to those described by Buxton and
Dove.1 The only difference is one of degree.

My hospital colleagues and I believed that limiting availability was
the best way to deal with the abuse problem. We persuaded the
manufacturer to have the product made available by prescription, not
on demand. This reduced the problem significantly.

I would suggest the same approach be used to address the illegal
manufacture of crystal meth. It is clear that the manufacturing
process is widely known. Is there any chemical used in the production
of crystal meth that could be made subject to licensing if it were
purchased in large quantities?

JOSEPH CAPLAN

Honourary Consultant Psychiatrist

North York General Hospital

Toronto, Ont.
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Footnotes Competing interests: None declared.

REFERENCES

1. Buxton JA, Dove NA. The burden and management of crystal meth use.
CMAJ 2008;178:1537-40.

2. Cronkwright Kirkos W, Carrique T, Griffen K, et al. The York Region
Methamphetamine Strategy. CMAJ 2008;178:1655-6

3. Kish SJ. Pharmacologic mechanisms of crystal meth. CMAJ
2008;178:1679-82.

4. Caplan J. Habituation to diethylpropion (Tenuate). CMAJ
1963;88:943-4.