Ephedrine should not be banned (personal opinion)

TONY@IGLOU.COM (TONY SAFINA) 2003-07-30 07:20:30

First, an anecdotal story (not originally part of this post):

Pharmacies in Louisville, KY will actually lie to customers and tell
them ephedrine is illegal. The last time I visited a chain store
pharmacy here in Louisville, the druggist did not do as many
Louisville pharmacists do - say outright that it is illegal - but he
said he thought it was illegal, did not have any in stock and he did
not know any distributor in Louisville which kept it in stock.
Imagine, all this information right off the top of his head!

I was enraged by his condescendence but did not let on.

I thanked him (only semi-sarcastically) and calmly left his store.

I then went home and called the Louisville office of the DEA. I asked
to speak with an agent about ephedrine and asked for his name and
asked him for permission to quote him later. I explained my situation
and why I take ephedrine. Then I asked him to fax the current law
regarding ephedrine in the state of Kentucky.

The DEA agent was friendly, understood my concern, and he faxed me the
law regarding ephedrine in Kentucky at that point in time (circa
2000).

As soon as I got the DEA's fax I called the national headquarters of
the chain drugstore I visited earlier. I asked for the name of the
person in charge of the Kentucky pharmacies, then when this person
came to the phone I explained to her everything I explained to the
DEA, got her fax number, and faxed her all of the information I
received from the DEA.

`Lo and behold, in less than 20 minutes, the local pharmacist whom I
spoke with earlier in the day called me and he was extremely
apologetic. He said he got very few legitimate requests for ephedrine
and he was not entirely certain of the status of the law, he only
thought it was illegal and he only thought he could not order it for
me. He told me he was aware I had spoken with his supervisor and she
informed him of the status of the law and that he could, should, and
would order it for me. It arrived the next day.

The pharmacist obviously thought he was talking to a drug crazed
country bumpkin.

I only relate this story because ephedrine has gotten a bad name and
pharmacists think people who want to buy it only want it for
illegitimate purposes. It takes a very unfair effort to counter this
sometimes erroneous belief.

= = = = = = = = = = = = = = =

Original newsgroup post:

There is a public propelled movement going on to get products
containing ma huang (ephedra) or ephedrine products (e.g., ephedrine
hydrochloride [HCL]) off the market. In part this is understandable
only in regard to the fact the Drug Enforcement Agency (DEA) has
determined that ephedrine is one precursor of methamphetamine (speed),
meaning that large quantities of the substance ephedrine are used by
people running illegal laboratories to make illegal substances like
methamphetamine for sale and personal gain. The DEA has declared the
sale of large quantities of unadulterated ephedrine illegal,
quantities which are many times larger than one person could
legitimately consume in a month (or even longer). I support this
regulation and fully approve of the DEA's efforts to keep amphetamines
off the streets and out of any child's possession.

I will not speak of ma huang (ephedra) because I do not use it; for my
need it does not work.

I am only writing to speak of ephedrine hlc and the fact many states
are banning the drug.

I suspect the federal government will follow suit as well within the
next five to ten years.

Why are they trying to ban it? It is not because kids are trying to
make methamphetamine in their basement --- the allowable quantities
for sale are far too small for that sort of thing. The reason is
because ephedrine has very strong stimulant effects, almost as strong
as amphetamine (in those with zero tolerance of the drug). If people
do not read the instructions on the label (one 25mg tablet every four
hours, not to exceed six tablets in 24 hours) and if they take excess
amounts to realize the potent stimulant effects of the drug - doing
this, and not following the instructions can kill people with
defective cardiovascular physiology. This has happened in the United
States and other countries a very small number of times, but every
time this happens the news media creates huge media publicity (ala Don
Henley's "Dirty Laundry") and as a result many people incorrectly
assume that ephedrine is even more toxic than pure nicotine (one of
the most toxic poisons around), or for that matter, ordinary aspirin.

If people do not read the instructions on any medicine bottle,
regardless of whether it is a prescription drug or OTC (over the
counter) serious adverse effects can and do occur.

For example, the Uchee Pines Institute
(http://www.ucheepines.org/pain_and_fever.htm) says:

* Aspirin is a major cause of death in children up to 6 years of age,
accounting for more than 500 deaths from overdoses each year.

* About 10,000 Americans each year lose their lives because of taking
aspirin. These deaths are entirely separate from accidental overdose
in children.

The Pittsburgh Post-Gazette (http://www.post-gazette.com/healthscience
/20030422hpainpills1.asp) states:

* McNeil officials testified that Tylenol and other forms of
acetaminophen are safe if used as directed. They noted that about 100
deaths from accidental acetaminophen overdose are reported annually.

The Post-Gazette also reports that when all OTC pain killers including
aspirin are considered:

* [A]n estimated 160,000 Americans end up in hospital emergency rooms
and about 16,000 die from complications related to the use of OTC
painkillers.

On the other hand a lawyer related website
http://www.ephedrine-ephedra.com/ states [in the entire recent history
of the marketing of ephedrine or ephedrine-based products]:

* The FDA believes that ephedra may be related to more than 50
deaths. Most of the serious injuries involve high blood pressure that
can cause bleeding in the brain, a stroke or a heart attack.

What they fail to mention is the fact the drugs are taken in excess of
the directions on the label; they are also taken by people with weak
hearts.

Why is this of any concern to me? It is of concern to me for the very
reason stated on the bottle of "Mini-thins" sitting on my desk:

[Ephedrine] is a bronchodilator and it helps breathing without
drowsiness.

Why should this matter to me?

I was a smoker from age 13 to age 34. Smoking had affected my
breathing drastically and I was on the verge of developing emphysema.

Even after I quit smoking, from age 34 until my present age of 52, I
have a lot of trouble breathing on high ozone days which frequently
occur on hot days in the summer months. Lacking health insurance and
distaining long waits in public health clinics, I try to self-medicate
whenever the medications to do so are available over the counter.

One day I was in a convenience store and I saw a display of Mini-Thins
(ephedrine HCL 25mg. tablets) for sale. I read on the package "helps
breathing without drowsiness," and decided to try it. It worked. It
still works. It is wonderful and I can breathe easily and I have
avoided a $120 initial visit doctor bill as well as expensive
prescription medications.

I have been taking ephedrine regularly, AS DIRECTED, for almost two
decades with no adverse effects. Not only that, but heart disease is
rampant in my family and despite my use of ephedrine for nearly twenty
years, I am in good physical health at age fifty-two and it is my
considered belief that my use of ephedrine products, taken as
directed, do not cause any harm whatsoever.

Abuse any drug and you may suffer negative consequences - be it
aspirin, other OTC pain killers, or even ephedrine - but do not punish
the educated and well-read on account of the misinformed and/or
illiterates. An illiterate cannot read "Walk / Don't Walk" signs
either, yet we do not put a uniformed traffic director on every
corner.

Educate yourself before you attempt to pass laws and ban products
without any conception of what you are doing or why you are doing it.

Aspirin killed many more children last year than ephedrine did in the
entire course of recent history.

Why don't you work to ban aspirin?

Why? Because you like it and it helps you?

Well, did you ever stop to consider ephedrine may help some people
too?

Think about it and let me know your thoughts on this. I am interested
in hearing what intelligent well-read people have to say on this
subject.

Tony Safina
Louisville, Kentucky (vicinity)
tony@igloo.com

Change igloo to iglou to email me directly (and help keep spam out of
my mailbox)

Thanks.

= = = = =

Only as an afterthought did I send this poating to the FDA's CDER
public ombudsman. He wrote back and told me I had made some excellent
arguments and he would forward my message to the relevant idividuals.

I wrote him back and thanked him immediately (for not being like that
Kentucky pharmacist I mentioned at the start of this post.)