1. Legislative Efforts to Combat
Pseudoephedrine Misuse:
Kentucky’s Experience
 William C. Thornbury, M.D., F.A.A.F.P.
 Gerry Stover, Executive Director KAFP

2. ACTIVITY DISCLAIMER
The material presented at this activity is being made available by
Dr. William C. Thornbury, Jr and Medical Associates Clinic for educational purposes
only. This material is not intended to represent the only, nor necessarily best, method or
procedure appropriate for the legislative/medical situations discussed but, rather, is
intended to present an approach, view, statement or opinion of the faculty that may be
helpful to others who face similar situations.
Dr. Thornbury disclaims any and all liability for injury or other damages resulting to any
individual attending this program and for all claims that may arise out of the use of the
use or techniques demonstrated therein by such individuals, whether these claims shall be
asserted by a physician or any other person. Every effort has been made to ensure the
accuracy of the data presented at these activities; however, no claim or patent is made
that said information is fully accurate or reliable. Participants will need to investigate,
examine and verify each statement and/or particular claim made during this presentation.
Participants, and physicians, may care to check specific details using due diligence, in
standard sources, prior to application. These materials have been produced solely for
the entertainment and education of attendees. Any use of content, replication of data, or
key positions taken with this presentation is prohibited without written consent .

3. The Problem
 PSE Synthesis  Methamphetamine
2009 Rand Corp: $23.4B/yr (U.S.Gov’t)
Kentucky
2007 2008 2009 2010
(294) (416) (736) (1100)

4. Cost
 KSP $32M/2010 Law Enforcement
 1,100 Incidents, Up 40% from 2009
(OK St Police: $350K/Incident All Factors)
Net Cost KY: $385M/2010 or $8-92.00/pers/yr

5. 1. Missouri – 1285
2. Indiana – 620
3. Tennessee – 559
4. Illinois – 360
5. Arkansas – 309
6. Kentucky – 278
7. California – 273
8. Michigan – 172
9. North carolina – 155
Map includes Laboratories, Chemical/Equipment/Glassware 10. Mississippi – 152
seizures, and Dumpsites that have been received by the MSHP Ohio - 152
for entry into NSS as of 12/31/2007

6. 2009

7. Solution
 I. PSE by Rx in KY
 II. Support Colleagues in Surrounding States Rx
 III. Educate Federal Support PSE Import Ban
 IV. Encourage Pharm Manfn Change Delivery

8. PSE by Rx
 Oregon Data:
 98% Reduction from 20062009
 Meth Lab Incidents: 47210

10. PSE by Rx
 Mississippi Data:
65% Global Reduction July-Dec 2010
90% Reduction Labs: Harrison Co (22528)
90% Reduction Lab: Jackson Co (53/mo5/mo)
(July-December 2010, WLOX 12/28/10)

11. KAFP Resolution
 KAFP Exc Director, Gerry Stover
 KNOA President, Stanley Salyards
 KSP Major Joe Wilson

12. KMA Resolution
 Warren Co Drug Task Force/KSP
 Barren County KMAKMA
 KMA Legislative Committee

13. Legislative Effort
KY Board of Pharmacy
 KPhA
 KYAAP
 State Legislators
 Federal Legislators
 Press
 KAFP Journal Article

14. Legislative Antagonists
Retail Pharmaceutical Industry
METHCHECK (NPLEx): Electronic Monitoring
KY Sherriff’s Assoc

15. PSE by Rx  KY SB-45
 $350,000 Lobbying 2010 Legislative Yr
 “Robo-Calls” Legislative “Green Sheets”
 PR Campaign in Metro Areas

16. PSE by Rx  KY SB-45
 $350,000 Lobbying 2010 Legislative Yr
 “Robo-Calls” Legislative “Green Sheets”
 PR Campaign in Metro Areas
[Keep Doing What You’re Doing, It’s Working Fine.”]

17. PSE by Rx  KY SB-45
DEFEATED

18. Fall 2010
 CVS Fine: $75M (PSE to Criminals/25 States)

19. Fall 2010
 CVS Fine: $75M (PSE to Criminals/25 States)
Spring 2011
 AAFP 10-State in WI (Encouraged COD)
Summer 2011
 KY Mainstream Press Moves Storyline

20. Fall 2011---September
 KMA-HOD Committee Meeting
 Exempt Select Isomers from Rx Policy
 “Guests” Educate on PSE
 AAFP-COD Committee Hearing PSE by Rx
 Calls for Amendment
 Concerned Delegates

21. News > Local
Cain: What I say is not for sale
By James Mayse, Messenger-Inquirer
Published: Wednesday, February 16, 2011 12:08 AM CST
Daviess County Sheriff Keith Cain, who has been an advocate of electronic tracking system for pseudoephedrine purchases, said Tuesday
he is compensated for his time and expenses when he travels out of state to talk about electronic tracking.
Cain said he was compensated for his time and expenses three or four times last year when he traveled out of state to discuss electronic tracking.
On those occasions, he was paid for time and expenses by the pharmaceutical lobbying firm that opposes making pseudoephedrine a prescription.
On Tuesday, Cain traveled to Indianapolis to discuss electronic tracking before a Senate committee of the Indiana General Assembly.
Cain's compensation and expenses for the trip will be paid by the Consumer Healthcare Products Association -- a lobbying firm
that supports electronic tracking as an alternative to making pseudoephedrine a prescription drug. Cain said Tuesday
his compensation depends on what is involved but varies from $500 to $1,500 per day.

22. News > Local
Cain: What I say is not for sale
By James Mayse, Messenger-Inquirer
Published: Wednesday, February 16, 2011 12:08 AM CST
Daviess County Sheriff Keith Cain, who has been an advocate of electronic tracking system for pseudoephedrine
purchases, said Tuesday he is compensated for his time and expenses when he travels out of state to talk about electronic tracking.
Cain said he was compensated for his time and expenses three or four times last year when he traveled out of state to discuss electronic tracking.
On those occasions, he was paid for time and expenses by the pharmaceutical lobbying firm that opposes making pseudoephedrine a prescription.
On Tuesday, Cain traveled to Indianapolis to discuss electronic tracking before a Senate committee of the Indiana General Assembly.
Cain's compensation and expenses for the trip will be paid
by the Consumer Healthcare Products Association -- a lobbying firm
that supports electronic tracking as an alternative to making pseudoephedrine a prescription drug. Cain said Tuesday
his compensation depends on what is involved but varies from $500 to $1,500 per day.

23. News > Local
Cain: What I say is not for sale
By James Mayse, Messenger-Inquirer
Published: Wednesday, February 16, 2011 12:08 AM CST
Daviess County Sheriff Keith Cain, who has been an advocate of electronic tracking system for pseudoephedrine purchases, said Tuesday
he is compensated for his time and expenses when he travels out of state to talk about electronic tracking.
Cain said he was compensated for his time and expenses three or four times last year when he traveled out of state to discuss electronic tracking.
On those occasions, he was paid for time and expenses by the pharmaceutical lobbying firm that opposes making pseudoephedrine a prescription.
On Tuesday, Cain traveled to Indianapolis to discuss electronic tracking before a Senate committee of the Indiana General Assembly.
Cain's compensation and expenses for the trip will be paid by the Consumer Healthcare Products Association -- a lobbying firm
that supports electronic tracking as an alternative to making pseudoephedrine a prescription drug. Cain said Tuesday
his compensation depends on what is involved but varies from $500 to $1,500 per day.
Kentucky Registered Legislative Agents
October 27, 2011
Acquisto, James 502-xxx-xxxx Address XXX, Louisville KY 40223 Appriss

24. Myth vs Fact
1. OR: PSE is on the Increase.

26. Myth vs Fact
1. OR: PSE is on the Increase.
From: Rob Bovett <RBoet@co.lcon.or.us>
To: stanley stanley <jutstan@yahoo.com>
Sent: Wednesday, October 19, 2011 4:40 PM
Subject: Re: OR meth lab numbers
Stan,
Oregon is at 7 for this year. We had 13 last year.
Take care,
Rob

30. Myth vs Fact
2. PSE by Rx Would Increase Health Care Costs
 $12 OTC ------ > $110 Rx

31. Myth vs Fact
2. PSE by Rx Would Increase Health Care Costs
 $12 OTC ------ > $110 Rx
Move to Rx: Generic Competition
More Likely: Gel Caps OTC for Cheap

32. Myth vs Fact
3. Only 2% of PSE Purchases are Illicit.

33. Myth vs Fact
3. Only 2% of PSE Purchases are Illicit.
OK 2008 Baseline: 250K PSE tabs
 6 mos into “Shake-N-Bake” Method
 600K Tabs  750K Today (300%)
Increase in: Meth Labs, Addicts, Deaths.

35. Myth vs Fact
4. NPLEx (E-Tracking) Fixes the Problem at the Source

36. Myth vs Fact
4. NPLEx (E-Tracking) Fixes the Problem at the Source
 Cannot Stop “Smurfing”
 Cannot Stop Fake I.D.’s
 Law Enforcement Don’t Have Resources to
Combat the Problem at the Point-of-Sale.

38. Myth vs Fact
5. PSE by Rx Would Inconvenience Law-Abiding Citizens

39. Myth vs Fact
5. PSE by Rx Would Inconvenience Law-Abiding Citizens
 OR: No Consumer Mandate to Reverse Law
 OR: No Physician Mandate to Reverse Law
 OR: No Political Mandate to Reverse Law

40. Myth vs Fact
5. PSE by Rx Would Inconvenience Law-Abiding Citizens
PSE for Sx Relief……DN “Cure” any disease process.
Phenylephrine, Topical Decongestants, Antihistamines OTC

41. Myth vs Fact
6. PSE “Behind-the-Counter” hasn’t solved the problem;
it’s a Law-Enforcement Issue.

42. Myth vs Fact
6. PSE “Behind-the-Counter” hasn’t solved the problem;
it’s a Law-Enforcement Issue.
 Yes. (Smurfing, Fake I.D.’s, etc.)
 Meth Use, Meth Labs are different issues.
(Law Enforcement needs to shift resources.)
 Physicians: Are we guardians of public health?

43. Myth vs Fact
7. Insufficient Data: Need “Evidence-Based Policies”

47. Myth vs Fact
Mississippi Bureau of Narcotics:
7/1/09 - 8/5/10: 1,002 labs, rescued 226 children.
7/1/10 - 8/5/10: 351 labs, rescued 53 children.
A reduction of 65% in labs and 77% in children.
The Mississippi Bureau of Narcotics indicates that their methods of response and investigation have
not changed since the scheduling law began. They simply do not get as many meth lab complaints
since MS requires PSE by Rx.

48. Meth Lab Seizures
OR & OK OK OR KY
PSE Moved
OR Schedules PSE OK Adds Meth Lab
Behind –the-Counter
(OK E-Tracking) offender block list 1078
OK To E-tracking
Driver’s License Data
Combat Meth Act into E-Tracking
812 All states: 818
(to find fake DL)
Behind-the-Counter 743
741
600 589 KY E-Tracking
(Methcheck)
472
428
334
309 309
194 213
189
148
55
22 21 13 12
2004 2005 2006 2007 2008 2009 2010

49. Meth Lab Seizures
KY
1078
Kentucky
741
600 589
428
309 309
2004 2005 2006 2007 2008 2009 2010

50. Meth Lab Seizures
KY
2011 Data
1458 Labs 1078
Kentucky
741
600 589
428
309 309
2004 2005 2006 2007 2008 2009 2010

51.  Controlled Substance
“The basis for control and regulation is the danger of addiction,
abuse, physical and mental harm (including death), the trafficking
by illegal means, and the dangers from actions of those who have
used the substances.”

52. THANK YOU
 Kentucky Academy of Family Practitioners
 Gerry Stover, Executive Director