MISSOURI CONSIDERS MAKING IT HARDER TO GET MEDICINES USED TO MAKE METH

JEFFERSON CITY - Amid a national push to make health care cheaper and
simpler, Missouri is considering legislation that intentionally makes
it a little more cumbersome.

State lawmakers have filed several bills for the 2010 session that
would require a doctor's prescription to get certain cold and allergy
medications that currently can be bought over the counter. Supporters
hope that creating a new barrier to the medication will make it harder
to get the pseudoephedrine used to make methamphetamine.

That Republicans and Democrats, House members and a senator all are
proposing an extra step for Missourians seeking relief from colds and
allergies, highlights the extent of the state's meth problem.

Missouri this year again is leading the nation by a large margin in
meth lab incidents, which counts arrests, dump sites and seizures.
Through late October, Missouri reported 1,099 incidents -- that's
nearly 20 percent of the national total and almost 1 1/2 times the
number of second place Indiana.

Since 2005, Missourians buying medications such as Sudafed, Claritin-D
and Aleve Cold & Sinus that contain pseudoephedrine already have been
required to sign a log book and have been restricted in how much they
can buy. In 2008, lawmakers tried to go another step by setting up an
electronic tracking system, but they did not immediately fund it.

Now several lawmakers are seeking more restrictions.

The Missouri State Medical Association, a critic of the legislation,
contends requiring prescriptions would be a burden for both doctors
and patients and would increase health care costs.

"To get one of these prescriptions, you have to go to see the
physician," said Tom Holloway, a lobbyist for the organization. "The
physician cannot write a prescription for a controlled substance
without an in-person encounter."

Many patients with insurance would have to make copayments, and
doctors would have to see people who otherwise could treat symptoms
themselves. For those without insurance, critics say the prescription
requirement would force the state Medicaid program to pay for cold
medicines.

Supporters in Missouri, which have included state organizations for
police chiefs and sheriffs, contend a prescription is a minor burden
for getting healthy but promises to cut meth production. Testifying
before a Senate committee last year, a Franklin County deputy sheriff
brought several cold medications that would still be available on the
shelves.

So far, only Oregon has blocked the sale of the pseudoephedrine-based
medicines without a prescription through a law that took effect in
2006. In 2005, there were 141 meth lab incidents in Oregon, and this
year, there were nine through late October.

Rob Bovett, a leader in Oregon's efforts who is now a local
prosecutor, said that making it harder to get pseudoephedrine helps
eliminate meth labs. He said the disruption for law-abiding consumers
with stuffy noses doesn't limit access to health care because drug
stores are lined with medications that do not contain
pseudoephedrine.

"It's unnecessary, it doesn't cure cancer, it doesn't cure anything,"
Bovett said. "It's about a decongestant, and there are plenty of
alternatives. The toll that meth takes on our nation -- and
especially a state like Missouri -- is phenomenal. The lives and
families it destroys every day, as opposed to easier access to one
decongestant -- the balance swings heavily in favor of doing the
right thing."

Two eastern Missouri cities in particularly hard-hit Franklin County
have joined Oregon in erecting their own barriers. Union and
Washington, Mo., -- about 50 miles west of St. Louis -- this
summer each enacted local ordinances requiring prescriptions for
certain cold and allergy medications. Local officials said problems
from meth had gotten bad enough to do something new.

So Missouri officials must try to balance the popular idea of reducing
crime with the less favorable prospect of inhibiting access to a medicine.

Democratic Gov. Jay Nixon campaigned last year on a promise to
increase access to health care and the bona fides of serving as the
state attorney general for 16 years. He told newspaper editors and
publishers earlier this year in Kansas City that he applauds the
cities that have tried requiring prescriptions, but he stopped short
of endorsing a statewide requirement.

"We look forward to crafting a bill that helps us fight meth, but I do
want to also make sure that every Missourian has an opportunity
through some method to get relief from the common cold," he said.

Chris Blank has covered state government and politics for The
Associated Press since 2005.