canyonwalker: Breaking Bad stylized logo showing Walter White (breaking bad)
In Season 2 of Breaking Bad Walt decides it's time to scale up the drug making operation. There's a supply chain problem with going big, though. Jesse has been sourcing pseudephedrine pills, an over-the-counter cold medicine that can be crushed up and used as of the key precursors to making methamphetamine, by sending a network of buyers out to drugstores to buy boxes. He can manage that at small scale but not 5x or 10x the quantity because in 2008, when the show was filmed, there were already laws limiting the sale of pseudephedrine— because of exactly the criminal drug-making this show is about.

Pseudephedrine is a common medication that is sold under the brand name Sudafed and plenty of generics. Except it's not so common anymore. Long ago I could just pop into a CVS when I was feeling sick, but a few bottles of different pills, and get relief. A 2006 federal law required stores to limit purchases and check ID. I remember blogging years ago that I had to show more ID to buy cough syrup than I had to show to vote. And in that case, the thing I was buying didn't even contain pseudephedrine. The government's clamp-down was so tough that retailers acted out of fear and limited not just pseudephedrine but anything that seemed even vaguely similar to it.

Today I can still buy pseudephedrine, by going to the pharmacist who keeps it locked behind the counter. I still have to show ID, which is recorded, and I'm still limited in how much I can purchase at a time. But the stores don't always stock it. This is one of the other consequences of strict limits: it gets basically taxed out of existence. Make it hard to get, and people will give up trying to get it. When people stop trying to buy it, even for legit uses, stores stop stocking it regularly. Why carry something for which there's little demand?

Meanwhile the pharmacy and pharmaceutical industries shifted to foist a stupid placebo on us. They replaced pseudephedrine with phenylephrine— a drug that was proven not to work. Thanks, meth makers, you made it harder to for the rest of us to treat our colds and allergies. And thanks, War on Drugs, Big Pharma, and Weak-Kneed FDA. 👎


canyonwalker: Y U No Listen? (Y U No Listen?)
It's in the news this week that the drug phenylephrine, used as a key ingredient in a variety of cold medicines to reduce swelling of nasal passages, simply doesn't work. An FDA advisory panel made this unanimous finding on Tuesday after reviewing recent scientific studies showing that oral forms of the drug (i.e, pills and cough syrups) provide no more benefit to patients than a placebo. Example coverage: CNBC article, 12 Sep 2023.

My first thought when I saw the news was, "I could have told you that 10-plus years ago." That's how long ago I tried the medicine myself and quickly determined it doesn't work.

10-plus years ago is when pharmacies starting carding me to buy pseudoephedrine over the counter. Pseudoephedrine is the ingredient in classic formulations of brands like Sudafed. (Indeed the name Sudafed is derived directly from pseudoephedrine.) Apparently drug dealers of the illegal kind were cooking pseudoephedrine pills into meth. As governments required stores to clamp down on selling that legal drug, drug makers shifted their main brands to use a related but weaker active ingredient, phenylephrine.

I call phenylephrine weaker because that's how pharmacists described it to me when I challenged them about it.

Me: I can't find any pseudoephedrine on the shelves, is it behind the counter?

Pharmacist: Yes, but right now we're out. We don't get regular stock anymore. Try these pills with phenylephrine; they're better.

Me: I have tried phenylephrine. It doesn't work. It doesn't relieve my symptoms like pseudoephedrine does.

Pharmacist: Well, it's a weaker formulation. You just need to take more pills.

Me: How is it better if I have to take more pills?

Pharmacist: It's better because you have more control over your dosage.

Me: Taking 4-5 pills to get the same benefit I used to get from 1 does not seem "better" to me. Also, taking 4-5 pills is contrary to the safety directions on the package. How is that "better"?

Pharmacist: You can ask your doctor.

Now we learn that "weaker" was just bullshit for doesn't work.

canyonwalker: Planes, Trains, and Automobiles. Travel! (planes trains and automobiles)
The REAL ID program, which requires enhanced drivers licenses to do all sorts of not-driving things such as enter an airport, federal courthouse, or your Congressional representative's office, has been postponed another 2 years. Today the DHS pushed back the deadline for full enforcement from May 3, 2023 to May 7, 2025. Source: DHS press release, 5 Dec 2022.

The reason that I note it has been pushed back again is that the REAL ID program was enacted into law back in... 2005. With the latest extension it will have taken twenty years to implement— or more if it gets delayed again! As the idea of creating more secure identity documents was one of the recommendations coming out of the 9/11 commission, one has to wonder the fact it will have taken 24 years since 9/11 to get them implemented demonstrates they're just security theater and actually not consequential for public safety.

There are many reasons why this program has been delayed for so many years. Initially it was because a lot of states opposed the program that created federal security requirements on state-issued driving permits. States opposed it partly because Congress passed without hearings or debate. In the House, it was dropped from a must-pass appropriations bill because of member objections but then reinserted in conference committee. The full House then approved the appropriations bill with the unrelated Real ID rider, as did the Senate. Et voilà: How A Bill (Really) Becomes A Law.

While many states fought the law for several years, it did remain the law. The federal government extended deadlines a few times to give them more time to comply. When it looked like the final extension would end in 2019, the roughly half the states that were holding out aligned with the program so as not to create hardships for their citizens when traveling or attempting to interact with the federal government. But then another extension came, giving states until 2020... at which point the Coronavirus Pandemic arrived, so the federal government extended it a few more times, ultimately to May 2023. And now it's May 2025.

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