LIMITING PRODUCTION OF CRYSTAL METH

[One of the authors responds:]

Joseph Caplan's suggestion that the chemicals involved in the
synthesis of methamphetamine hydrochloride be regulated is highly
relevant to the prevention of crystal meth use, but this issue was
outside the scope of my review article.1 Canada's Precursor Control
Regulations include requirements, as Caplan recommends, to control
precursors and other substances used in the production of
methamphetamine, including ephedrine, pseudoephedrine and red
phosphorus.2 Before 2003 these regulations did not exist and there was
much concern, especially in the United States, about the export of
precursors from Canada for illicit methamphetamine production.3 It can
be argued that the Canadian legislation should be strengthened by
requiring more frequent reporting by the chemical industry of the sale
of precursors, by requiring licensing of end-users and by other
approaches such as requiring that anhydrous ammonia (a nitrogen
fertilizer used in methamphetamine synthesis) be stored in
government-approved containers.4

There is also the controversial (at least in Ontario) question whether
cold medications containing pseudoephedrine should be sold only in
pharmacies (i.e., not in corner grocery stores) and only behind the
counter so that the extent of use can be better monitored. Because of
a severe problem with methamphetamine abuse, Oklahoma has required
that such cold medications be sold only behind pharmacy counters in
this state. Curious about the availability of pseudoephedrine in
Canada, I contacted a Canadian Internet pharmacy and visited a major
Canadian drugstore: the Internet pharmacy would sell customers only 60
tablets of a medication containing pseudophedrine whereas in the
drugstore the quantity that customers could purchase was limited only
by the availability of the drug.

It is obvious that methamphetamine precursors used for legitimate
purposes must be tightly controlled. However, it now appears that
precursors smuggled from outside of the country are often used to
manufacture methamphetamine in Canada.5 Drug prevention using
precursor control thus remains a challenge.

STEPHEN KISH

PhD Human Neurochemical Pathology Laboratory

Centre for Addiction and Mental Health

Toronto, Ont.
-------------------------------------

Footnotes

Competing interests: None declared.

REFERENCES

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

2. Office of Controlled Substances. Regulatory requirements under the
Controlled Drugs and Substances Act (CDSA): precursor control regulations
(PCR) international. Ottawa: Health Canada; 2007. Available:
www.hc-sc.gc.ca/dhp-mps/substancontrol/chem-chim/international-eng.php
(accessed 2008 Aug 7).

3. Office of the Press Secretary. US releases annual narcotics certification
report [press release]. Washington: The White House; 2003 Jan 31. Available:
www.usis.it/file2003-01/alia/a3013106.htm (accessed 2008 Aug 7).

4. Government of Manitoba. Safeguard your supply of anhydrous ammonia.
Winnipeg: Government of Manitoba; 2008. Available:
www.gov.mb.ca/agriculture/news/crystalmeth-en.pdf (accessed 2008 Aug 7).

5. National Drug Intelligence Center. National drug threat assessment 2008:
methamphetamine. Johnstown (PA): The Center; 2007. Available:
www.justice.gov/ndic/pubs25/25921/meth.htm (accessed 2008 Aug 7).