In a Battle Against Meth, Fenton Considers a Prescription-Only Pseudoephedrine Law

The has become the newest focal point in the battle against methamphetamine as the Board of Aldermen considers making pseudoephedrine medications only available by prescription.

But the battle is as much about competing philosophies and use of statistics as it is about finding and busting meth labs.

Pseudoephedrine, which is contained in such sinus relief products as Sudafed and Actifed, is a key ingredient in the manufacture of meth.

One statistic is clear cut: Three of the top seven retailers in Missouri for the sale of pseudoephedrine products are located in the Fenton area. The at 1001 Bowles Ave., which is just over the City of Fenton's border, is No. 1 in the state, with 1,813 boxes of medications sold last month.

Within the city limits, the at 701 Gravois Bluffs Blvd. sold 1,499 boxes to rank fourth on the statewide list, and the at 657 Gravois Bluffs Blvd. claimed seventh place with 1,210 boxes sold last month.

That's 4,522 boxes of pseudoephedrine products sold in the Fenton area in the last month alone. The city's population is 4,022. Either everyone in town has sinus congestion, or meth makers are flocking to Fenton to purchase pseudoephedrine.

The density of sales in Fenton gained the attention of Sgt. Jason Grellner, a well-known meth crusader of sorts who is president of the Missouri Narcotics Association and Unit Commander of the Franklin County Narcotics Unit. He appeared before the Fenton mayor and aldermen last week to urge them to pass a prescription-only pseudoephedrine ordinance.

One local company calls Grellner a meth "rock star" because of the vast amount of research and first-hand experience he has with meth labs and their effects on public health. Grellner has waged his crusade in local and state government venues, trying to convince legislators at all levels to pass prescription-only pseudoephedrine laws.

Currently, those prescription-only laws are in place in Jefferson County and in such nearby communities as Wildwood and Eureka. It's one reason Fenton, which doesn't have such an ordinance, is a popular destination for those who want to buy pseudoephedrine medications.

Grellner is pushing local, county and state lawmakers to approve laws that require a doctor's prescription to buy pseudoephedrine. If approved, a doctor could prescribe up to three boxes with a single prescription. Currently, those who need sinus relief can only purchase one box.

To support his position, Grellner asks a compelling question: "Does anyone remember any meth labs prior to 1976?" And then he provides the answer: "Neither do I. That's because prior to 1976, you needed a prescription to buy pseudoephedrine."

Grellner said pseudoephedrine today is a $1.2 billion business for the drug companies that make it. There were 16,000 meth labs seized in the U.S. last year, and just over half of them were in Missouri, Grellner said. 

And although some municipalities and counties have passed prescription-only ordinances, Grellner said a statewide law is going nowhere in the Missouri General Assembly.

Why?

"They (drug companies) want to keep selling pseudoephedrine as fast and furious as they can," Grellner said. "It is 100 percent about the money. ($1.2 billion) amounts to a lot of money available for lobbying legislators to prevent prescription-only laws from being passed."

Opponents argue for consumer choice

Jim Gwinner, who represents the Consumer Health Products Administration, argued a different point during the Fenton meeting. He called it an unnecessary financial burden for patients.

"I know this issue of drug abuse and methamphetamine abuse is a very serious issue," Gwinner said. "We recognize the growing problem. But we shouldn't be going to the extreme of taking a safe and legal product off the shelves for consumers."

Gwinner and Grellner routinely provide opposite arguments about the pseudoephedrine issue at government venues across the state.

Access to pseudoephedrine medications and the inconvenience that some say would be a result of a prescription-only law and the increase in meth labs are the two sides of the debate on which in which Grellner and Gwinner repeatedly lock horns. It's a dilemma the Fenton aldermen also wrestled with. Some aldermen say they sympathize with Grellner's battles against meth labs, but also want to make sure they are not placing undue barriers on citizens who only want sinus relief.

Alderman Gary Fischer said bluntly at one point during the meeting: "I have a big nose." Fischer said he often is plagued with nasal passage blockage due to a cold or respiratory ailment, adding that pseudoephedrine is very effective at treating his symptoms. He said he would have to make a doctor's appointment to obtain a prescription if Fenton approves a plan to require prescription-only pseudoephedrine sales.

Alderman Dan Borgard suggested a prescription should be as easy to get as making a phone call to the family doctor, but Fischer said his doctor requires a visit first.

Grellner argues that a prescription-only law actually could save time and effort for patients because they could pick up as many as three boxes in one visit to the pharmacy with a prescription, instead of three trips for one box each under the current law.

"There is nobody dying from a stuffy nose," Grellner said. But he said it's not the case with meth addicts and those near them. Grellner said it is common for people to be burned when the plastic bottle in which meth is made explodes or catches fire, in a method called "shake and bake." Other hazards come from the highly toxic chemicals used in manufacture of meth, including anhydrous ammonia and others. 

"Ninety percent of the pseudoephedrine that is purchased is going to meth labs," Grellner said. "Why do my meth labs have to continue because Fenton still wants to sell pseudoephedrine?" 

Fenton Mayor Dennis Hancock says it's not as simple as that.

"It's hard to determine what's the right answer," Hancock said. "Meth is a scourge on our society, but I don't think it's because people can buy pseudoephedrine in Fenton. They are going to go wherever they can to find it."

Take our poll at the end of this article to tell us how you feel about Fenton's proposed presciption-only ordinance.

Do high sales of pseudoephedrine lead to more meth labs in Fenton?

Capt. Jeff Bader, commander of the , mapped out every meth lab seizure in St. Louis and Jefferson counties in 2011.

He discovered that although Fenton is a popular place to buy pseudoephedrine, meth labs are not a major problem.

"We don't see a whole lot of meth-related crime in Fenton," Bader said. "Forty percent of our time is actually consumed combatting heroin usage."

Bader said many of the burglaries and petty thefts in Fenton are due to people stealing items they can sell in order to buy heroin.

And that goes for pseudoephedrine, too. Bader said some pseudoephedrine purchasers are using the medication to trade for heroin, adding that a box of pseudoephedrine can be worth $50-$60 in trade.

Despite the thousands of boxes of pseudoephedrine sold in Fenton, the Fenton police department only had seven meth lab seizures in 2011, and none of those were at a home. Three were at local motels. The rest were seized by officers from various vehicles, so-called rolling labs, that had been stopped for other infractions.

Bader's report shows a high incidence of meth lab seizures clustered in the Oakville and Mehlville areas with another cluster near Lambert-St. Louis International Airport. The Jefferson County map shows meth lab seizures scattered throughout the county.

Bader said part of the city's concern about being the location of high pseudoephedrine sales is that it brings a bad element to town who might be involved with other crimes while they're here. He's also concerned that requiring a prescription would merely push the sale of the medications to another community, like neighboring Sunset Hills, for example.

For that reason, Bader, Hancock and some of the Fenton aldermen favor a St. Louis County-wide prescription-only law. Grellner said he has talked with St. Louis County officials and hopes he can convince them to approve such legislation.

New medication could curb meth production

Another issue in whether to pass a prescription-only ordinance in Fenton is the possibility that a new drug will make the matter a moot point. The new medication is called Releva. It's being manufactured by Highland Pharmaceuticals, a Maryland Heights company.

Releva is different from products like Sudafed because the pseudoephedrine it contains cannot be extracted or converted in order to make meth. It uses a formulation known as Tarex.

"We are able to thwart both processes," said Emilie Dolan, director of marketing and media relations for Highland Pharmaceuticals.

Typically, the pseudoephedrine is cooked with dangerous and highly flammable chemicals to yield the highly addictive stimulant. When pseudoephedrine is delivered in the Tarex format (a solid dose, oral capsule), this standard separation process is interrupted, resulting in a gummy-like substance, which subsequently will not crystallize, according to a company description of Releva.

In testing, the technology has returned exceptionally strong sinus relief results, making it a viable alternative to current efforts that focus on the illegal sale and distribution of pseudoephedrine, including physician prescription requirements, Dolan said.

Grellner is impressed with Highland's success with Releva.

"It's the most promising drug we've ever seen," he said. "We should be really, really proud of (Highland)."

But Releva has not been approved to be sold over the counter yet. The medication, which has been approved by the Federal Drug Administration, is awaiting approval of an exemption from the Combat Methamphetamine Epidemic Act 2005 of the Drug Enforcement Administration. A DEA exemption would allow Releva to be sold on store shelves and therefore would not be subject to a limited number of boxes, nor would consumers need a doctor's prescription to get it.

Dolan said she couldn't estimate when the exemption might be approved.

"The real appeal of Releva is that people will be able to walk into a pharmacy and buy the product off store shelves," Dolan said. "We want them to have unencumbered access."

With the prospect of Releva being available on store shelves, possibly in the coming months, some Fenton aldermen are reluctant to approve legislation that would inconvenience the public by requiring a doctor's prescription for existing pseudoephedrine medications.

Although a formal vote was not taken at last week's meeting, some aldermen suggested the law would be less necessary when a product such as Releva is available freely at local pharmacies.

The prescription-only pseudoephedrine ordinance is expected to be voted on at the May 24 meeting of the Fenton Board of Aldermen.

Let us know how you feel about the proposed prescription-only proposal in Fenton in our poll below.