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The article mentions the ban in 2006 of over-the-counter sales of Sudafed (pseudoephedrine). One of my favorite satirical articles is "A simple and convenient synthesis of pseudoephedrine from N-methylamphetamine". (The joke being that Sudafed is now hard to purchase while meth is readily available.)

https://www.improbable.com/airchives/paperair/volume19/v19i3...




In the below podcast an author of a book about recent meth developments talks about the ban of Sudafed entirely in Mexico lead to a change in the market toward fentanyl.

Author and journalist Sam Quinones talks about his book, The Least of Us, with EconTalk host Russ Roberts. Quinones focuses on the devastation caused by methamphetamine and fentanyl, the latest evolution of innovation in the supply of mind-altering drugs in the United States. The latest versions of meth, he argues, are more emotionally damaging than before and have played a central role in the expansion of the homeless in tent encampments in American cities. The conversation includes an exploration of the rising number of overdose deaths in the United States and what role community and other institutions might play in reducing the death toll.

https://www.econtalk.org/sam-quinones-on-meth-fentanyl-and-t...


This book was abstracted into a great Atlantic article mentioned at the beginning of the original post.

https://www.theatlantic.com/magazine/archive/2021/11/the-new...


Good article. A similar thing happened here when the Australian Federal Police enacted an operation in Cambodia and similar areas to shut down the production of safrole, extracted from the root of the Sassafras tree (also the flavouring in root beer and sarsparilla). Ecstasy became much harder to get on the street and pushed users towards harder drugs like meth and heroin (resulting in a large number of addictions and increase in overall crime).


I heard that. Interesting discussion.


The ironic thing is the sheer drop in price is probably due in part to the P2P route taking over. It's a more involved process than Sudafed meth, but it's easier to scale, since you aren't bottlenecked by the pharmaceutical supply.

Once you establish the facility and pipeline, you can crank out industrial amounts of crank. The precursors are cheap and used in huge quantities by legitimate labs.


As dramatized in the television series Breaking Bad


If only they'd legalize, tax, and regulate the meth...

We could get our real cold symptom treatments back as true OTCs and stop wasting so much time chasing petty criminals.

It would also help identify drug addicts and get them help before problems become bad.


If they did that, the consumption would only go up, resulting in even more overdoses. That’s what happened in Portugal, after drug decriminalization — drug consumption there went up significantly (with exception of heroin, which went down, but it also went down in other European countries at the same time which did not decriminalize it). Full on legalization will increase consumption even higher.

Of course, one might argue that it’s fine, because it’s the drug users themselves who would suffer from this. But, considering the current push to get people vaccinated against their will, for their own good, I don’t expect this argument to work for drugs either… who am I kidding, of course people should have a right to use as much drugs as they want, but should have no right to get a job if they are not vaccinated, it’s 2021 after all.


> That’s what happened in Portugal, after drug decriminalization — drug consumption there went up significantly (with exception of heroin, which went down, but it also went down in other European countries at the same time which did not decriminalize it). Full on legalization will increase consumption even higher.

...Do you have sources on this? My awareness of Portugal's situation is basically the opposite of that, ascertained via [1][2][3] et al. I'm interested in dissenting information if it's available. I also wonder why it is that the assumption is "more drug use" == "bad" when the range of things that constitute 'drugs' is so wide - from alcohol to cannabis to lsd to cocaine, there's a ton of delta between the effects (sociological and personal) of use.

[1] https://transformdrugs.org/blog/drug-decriminalisation-in-po... [2] https://substanceabusepolicy.biomedcentral.com/articles/10.1... [3] https://www.cato.org/sites/cato.org/files/pubs/pdf/greenwald...


Your own first link discusses this:

> In the first five years after drug policy reform, use of illegal drugs rose slightly among the general population but fell again in the following five years.

I remember looking at the actual figures, and what happened was that use of heroin in Portugal went down significantly, and use of all other drugs went up significantly, giving slight rise in total drug use on net.

> Use among 15-24 year olds fell throughout the decade,

This implies that use among other groups than 15-24 year old had not fell throughout the decade.

> and among the general population was lower in 2012 than in 2001.

The reason they pick year 2012 is because it's convenient to their argument, and they give out the game later:

> However, consumption trends in Portugal have been keenly disputed and often misrepresented. While drug use during individual lifetimes among the general population appeared to increase in the decade following reform, use within the past 12 months fell between 2001 and 2012. Both the World Health Organization and the United Nations Office on Drugs and Crime consider use in the past 12 months (recent drug use) or within the past month (current drug use) as better indicators of trends among the general population.18

> Since 2012, past-year use appears to have risen, particularly among those over the age of 25.20 This is, however, based on relatively limited data from SICAD (the Portuguese drug dependence agency) and only one further dataset — in 2016.

The lesson here is that there has been a lot of very dishonest reporting about the results of drug decriminalization in Portugal. You are just another victim of it. Omission of critical facts, cherry-picking groups and dates, and flip-flopping between different ways to measure as needed, are all very common techniques in crafting narratives, misleading people into believing falsehoods, without actually stating them outright, so that they can't easily be caught with blatant lying -- the blatant falsehoods then are repeated by people who were tricked into believing false narratives, which facilitates spreading it, while allowing the authors to wash their hands.

Of course, you don't need to trust some random guy on the internet who's too lazy to dig up relevant statistics, you can keep believing the non-profit industrial complex. You might spend some time looking up these figures yourself, but why bother, after all these non-profits would never lie to you, would they?


Some of what you're referring to can be found here: https://en.wikipedia.org/wiki/Drug_policy_of_Portugal#Observ...

I'm not sure it's all that cut-and-dry. The story seems to be a general increase in the consumption statistics, but a decrease in criminal statistics. Maybe not a silver bullet for ending drug abuse, but a net benefit for Portugese society.

Alas, I don't live in Portugal... maybe someone who does can chime in?


> It has been proposed that this effect may have been related to the candor of interviewees, who may have been inclined to answer more truthfully due to a reduction in the stigma associated with drug use.


If you can't trust the data, just ask whether citizens are happy with the change. Considering that Portugal hasn't rolled back their decriminalisation, I'd say that either things have pretty much improved, or at least stayed the same.


>> Use among 15-24 year olds fell throughout the decade,

>This implies that use among other groups than 15-24 year old had not fell throughout the decade.

Within the context of logic, that is not an implication.


You know what I hear when a product is touted as being "in the top 10"? That it's definitely somewhere between #6 and #10. Because if it was 3rd, it'd be "top 3", and if it was 5th, it would be "in the top 5".

If a pull quote or headline shows a good statistic for one cohort, it's a fair bet that other cohorts didn't show such a positive result, or else the touting would have been something like "overall" rather than "15–24".


Within the context of logic, you cannot imply anything about other cohorts from this one statement alone. However, if general population use remained steady or rose, it would definitely imply that fall is attributable to said cohort.

Does the article have anything to say about general population?

> "While drug use during individual lifetimes among the general population appeared to increase in the decade following reform,"


No, but it is within context of narrative crafting practices. If it fell across all age groups, they would have said so, instead of restricting their claim to narrow group of youths. To misunderstand it is either sign of extreme naivety, or willful ignorance.


By your same logic, if it rose, they would have said so. They didn't.

Perhaps it was unchanged meaningfully / statistically significant enough to comment?


> By your same logic, if it rose, they would have said so. They didn't.

No, because they aren’t uninterested, unbiased observers just reporting the facts. The entire linked article is pushing very specific policy, and it is only expected that they will only raise arguments in favor of the policy they are proposing.

> Perhaps it was unchanged meaningfully / statistically significant enough to comment?

No. I looked at the data, and reported it accurately. Drug use went up overall, and if you disregard drop in heroin use (though only among young people, it also went up among those 35+), use increased significantly. Drop in heroin use among youth has offset the growth in use of other drugs.


> No. I looked at the data, and reported it accurately.

You were asked for sources. Instead, you pointed to the article someone else linked, and asserted that it’s biased reporting so the data that they didn’t show backs up what you say.

You still haven’t provided any sources for your ongoing assertions.


They don't provide solid sources because they don't exist. Their claims are untrue in the spirit in which they were posted: That the results of the policy were uniformly harmful.


Will you apologize to me for implying that I’m lying here about the ground data facts on drug use in Portugal, if I do provide the sources? Or are you just performatively asking me for sources, refusing to extend even a modicum of charity, just to disappear after I spend half an hour digging back up the government documents I remember seeing a few years ago, when I looked into this?


I have done this research already, which is why I can in good faith say that you are wrong and reality doesn't support what you say. I'll charitably offer that it is possible that I was wrong, and if you prove that I will absolutely apologise.


Well, to be fair. Your drug use can't put me in the ICU.


Not directly, but addicted people sometimes turn to violent crime to raise funds, and that violent crime certainly can put you in the ICU.


Meth is definitely one of the drugs that becomes a public nuisance, since people do become erratic and violent while using. Meth users are the only people that worry me when walking through our city since it can make people who are already unstable become unpredictably violent. I wonder if other drugs were legal would people still do meth?


Meth was legal until the 70s, society functioned. The current problem is another side effect of the war on drugs

https://www.history.com/topics/crime/history-of-meth


According to period newspapers, it very much was a problem almost immediately after public introduction in the late 40s and early 50s. Here's an example from Australia, which banned it by 1955:

https://trove.nla.gov.au/newspaper/article/71874426?searchTe...


Reading today's newspapers, you'd think Southern California just survived the apocalypse after the half inch of rain last weekend.


This is very much false, and completely contrary to the actual history. War on drugs only happened because of greatly increased social dysfunction due to drugs, not the other way around. It enjoyed wide social support at the time it was started, precisely because people saw how damaging the drugs are to their communities. The idea that drug-related social dysfunction is an effect of war on drugs is yet another of those "wet streets cause rain" ideas.


No. The war on drugs was an acknowledged political act to disenfranchise black people and the anti (Vietnam) war movement. Lopez, German (March 22, 2016). "Nixon official: real reason for the drug war was to criminalize black people and hippies". Vox. Archived from the original on May 30, 2017. Retrieved June 13, 2017.


Which is why when the War on Drugs started, the Congressional Black Caucus met with Nixon to urge him to stop it.

…no, they didnt, in fact they urged him to do the opposite: to ramp it up as fast as possible, precisely to stop the damage the drugs were causing to black communities.

https://www.npr.org/sections/codeswitch/2013/08/16/212620886...

The linked material came out on NPR in 2013, before it was decided that the history needs to be revised. I recommend taking a look at it before it is also revised, to remove all references to what had actually happened, to how black leaders were main force behind the War on Drugs.


Did you finish reading it? >The Rev. Herbert Daughtry, a longtime pastor in New York, once was addicted to heroin and served time. He's convinced that black leaders who embraced the drug war did serious harm to the community, but says a lot of African-Americans were desperate for ways to make their neighborhoods safe again. "If you're the victim, then you don't want to hear anything about treatment, just, 'Get this guy off the street.' "

Makes sense to me


Yes, I did. The quote you gave supports what I said: that the black leaders pushed for War on Drugs, precisely to counteract the destructive effects of drugs on their communities. Rev. Herbert Daughtry might believe today that they were wrong to do so, and he might well be correct. This is not what I’m arguing against. I’m arguing against a blatant falsehood, that War on Drugs was purely a mean to disenfranchise black Americans, and that social decay related to drug use was an effect, not a cause of the War on Drugs. These claims are very much false, and this is obvious to anyone who lived through these times, or who spends even minimal amount of effort to look at primary sources.


Ah I misunderstood your point, I agree with you


How do you explain this quote then, surely the war would cause a decrease no? Odd usage spiked decades _after_ they banned it

>Use of crystal meth in the United States exploded in the early 1990s. Between 1994 and 2004, methamphetamine use rose from just under two percent of the U.S. adult population to approximately five percent.


Society functions while people have access to guns too, yet there are still consequences to that choice. I am pro legalization of most drugs, but meth does give me pause. No one smoking a joint or tripped out on opioids has ever attacked me while screaming at ghosts in the street, I don't know enough about the role of meth in those kinds of instabilities but anecdotally meth, and alcohol too, sure seem to cause a whole lot of trouble in my city.


Other drugs already are legal. Alcohol is legal, and marijuana is effectively legal in Seattle, where people apparently do a lot of meth.


While true neither of those drugs would replace meth. Alcohol probably causes more social misconduct than meth anyway.


Possibly because it is legal.


Angry people can turn violent and put you in the ICU, too. To be fair, the list of things that can put you in the ICU is very very long, and many of us avoid it for the majority of our lives.

Like angry people, the vast majority of folks don't turn to violent crime, especially if other avenues exist. Society can provide this if necessary and we already have laws concerning violent crime that we can use.

I'll note that most of us pass addicted people every day when we leave the house. Most of them, you simply won't know they are addicted and if you are normal, you'll probably assume a person or two is addicted, yet they are not.


You can apply that logic to almost anything people use as a vice or get physically/psychologically addicted to


People trying to steal to get drugs could. People high on drugs certainly could. A lot of Breaking and Entering, for example, is to obtain money to feed a drug habit. For the person doing the stealing, all they care about is the cost of the drug, so plans to regulate and tax meth, well, don't necessarily improve that situation.


But we aren't talking about plans to regulate meth; it's already very heavily regulated. We're talking about plans to partly deregulate meth, which we can expect to significantly reduce the cost of the drug, from the US$50 or more per gram described in this article down to US$1 per gram or less like other synthetic drugs with similarly simple synthesis routes. The US$50 a gram isn't the cost of operating the reactors or measuring the purity of the result; it's the cost of hiring an army of foot soldiers to keep drug addicts or the police from stealing the stuff, because you can't trust the police, because it's illegal.

Yeah, people high on meth do crimes. But at least if the stuff is legal they won't do crimes to buy meth.


So the way it worked out with marijuana is the legal stuff is a lot more expensive than the street stuff. Maybe it would be different with meth, but I'm not sure why.

https://www.inverse.com/article/39899-recreational-weed-cali...

Basically the whole legal drug movement is targeted at non-addicts to let them pay a premium for a sanitary, legal, controlled experience. The political justifications for the movement are all about harm reduction. But the reality is that if you are an apothecary in SF, you don't really want junkies hanging out in your lobby, for the same reason that communities don't want junkies in their streets. Mental problems, theft, possible violence, behavioral issues -- it would chase away paying customers, and impose security and liability costs on them.

Those unwilling to pay for that more civilized experience go to the street. One important thing to remember is that legalization did not destroy the illegal market. They are different markets, although there is certainly overlap.

https://www.nytimes.com/2019/04/27/us/marijuana-california-l...


> Based on a number of California stores they investigated, the cost for an eighth will now range from around $50 to $65.

> told The New York Times in September that the black market price for an eighth of an ounce is around $20.

Just to share some Canadian numbers, in Ontario, CAD$3.57/gram at the low end through the government store. Of course you could purchase $10/gram or $15/gram if you wanted.

On the black market (clearnet) side, you're looking at around CAD$250 for 2 ounces, or CAD$4.45/g for some mix and match specials. I suspect you can sometimes find $99 ounces which is still $3.53/gram.

Can't really speak to quality of course. Not sure why California black market is going for $5.71/gram

The biggest difference between the black market and regulated market in Canada is the potency of edibles, or so I hear. Government wants to make sure nobody can get high if they mistakenly eat a box thinking its candy, which is kinda a problem if you want to get high.


I didn't know this about Canada -- it's interesting.

It's not clear to me how the black market should go for more if you can just go into a legal place and buy there. What am I missing? Perhaps you need a prescription or something, and people can't get that, so they pay a premium on the black market? Or maybe the legal market limits how much you can buy? Something has to support a higher black market price, since after all it is more legal risk for the participants, and possibly things like risk of buying something unknown.

Or maybe the black market operates in places where there is no legal vendor and so can just charge more? Or they offer home delivery?


Massive over-investment in grow facilities on the regulated side. Think dotcom on IPOs starting ~5 years ago promising massive profits and owning the market.

Government website in Ontario does free delivery. Same day in bigger areas for $8. https://ocs.ca/blogs/article/ocs-same-day-and-express-delive...

Retail shops usually charge more than government website. We're flooded with those too.

Licensed Producers are literally sitting on tons of unsold inventory that will likely never sell and never export, and now racing to the bottom on price to get some revenue.

There will be a shakeout.

Because of the above inventory problems, it's possible what you're buying from the legal market has been sitting on a shelf for a while, but under controlled atmosphere, that's not the end of the world. Some places also gamma irradiate their product, which some people have an issue with, but it does keep down microbiological risk and extend shelf life.

Each province has different pricing, so its possible some are just charging a lot more and the black market websites sell for the same price everywhere.


This is a very CA specific problem cause by the fact that legalization is done at the state level and not federal.

Illegal CA cannabis production supplied a huge fraction of total US demand.

Legalization worked in that it is now harder to smuggle illegal cannabis to surrounding states legalizing (and there might be a stronger push to actually find and catch smugglers now).

Also in a high tax state such as CA a lot of 'black market' prices might be skewed by individual growers selling to their immediate friends, etc. This would not translate to other drugs because they don't grow on uh weeds.


In Canada at least in two provinces I've been to recently the price of mj has approximately neared par with the black market, more or less. You can still find some thats more expensive but you can also find some that isn't. The catch is that you have to buy an oz at a time to get that price - if you buy smaller amounts you will probably pay more than the black market.


if you buy smaller amounts you will probably pay more than the black market.

You pay more in the black market if you buy smaller amounts too - if your dealer will sell smaller amounts, that is.


Yes. That requires another specific decision to commit a crime. Respiratory viral infection requires no additional decision on part of the viral vector.

I agree there shouldn't be a blanket decriminalization of drug use because it does alter judgement/motivation and make a theft or even violent crime more likely.


Drugs destroy your ability to make good decisions. They are essentially hot wiring the brain's reward circuits which directly feed back into the brain's decision making processes. Most obviously, it's almost never the case that addicts consciously choose to become addicted.


"Drugs destroy your ability to make good decisions. They are essentially hot wiring the brain's reward circuits which directly feed back into the brain's decision making processes."

This reeks or propaganda based on a little bit of truth. Sure, being addicted to something warps your brain. It doesn't have to be drugs to do this, though. Gambling addiction is a menace for a subset of population too.

Sure, actually being on drugs will affect the way you think for a short time until it wears off. Some drugs might change your perspective on life (LSD and MDMA are common here).

But seriously: It also isn't as bad as you say.

Caffeine and nicotine aren't going to destroy your ability to make good decisions. Drinking moderately won't do that. You probably have worked with folks that were daily pot smokers your whole life without knowing. Some of them were alcoholics (admittedly, it'll warp some things, but a functional alcoholic tends to make good decisions to a point). A smaller number did heavier drugs occasionally: LSD a few times a year, cocaine 2-4 times a year.

And they've pretty much all retained the ability to make good decisions, even if they've made some you don't agree with.


Pretty sure that Erdos said that Dexedrine/variants of amphetamine made him want to do math.

Is wanting to do math a not good decision? Potentially, I guess.


If you are Erdos, it is a good decision.


Does anyone 100% consciously choose anything? If you make a decision after drinking a strong cup of coffee, how much of that decision came from the caffeine, and how much came from your “consciousness”?

I’m not necessarily disagreeing with you—addiction is a disease of forces and circumstances, for sure—but the level of “free will” present in any choice (or sequence of choices) is a certainly not amenable to a binary classification.


Yes, the degree "free will"/willpower factors into a decision is much more of a spectrum than a binary. I'm just pointing out that drug addiction shifts your decisions away from the free will end of the spectrum.


"Drug addiction" is not a singular problem with a singular solution. Every drug has unique effects, even between different people (two people take the same drug and don't have the same result). It does not serve public health to shoehorn everything into a square hole.


But the harm or benefit of a policy is not measured by how many specific decisions are performed, but rather by the overall effect of the policy on the community, no? So let's just talk about that rather than counting steps between A and B.


The overall harm or benefit to the community is certainly related to how many and likely those bad decisions are that result in a specific harm/benefit.



Well yeah. I'm all for locking up drunk drivers, offering rehab and then permanently revoking their drivers licenses if they do it again. That goes to the second decision to adversely affect others.


If true, then you should be able to make that case directly, no?


I personally am for this totally legalization but also giving it out for free. or better yet just have a blanket small minimum universal income so no one can decry that we're paying for someone's addiction.


Yeah, it's not about you... it's the other people you may infect and kill. Kids are mostly fine... if only they didn't have teachers or parents.


Teachers and parents can get vaccinated themselves, no? I thought the vaccine works, doesn’t it?


Yes, it works for much of the population.

I've personally had 3 full doses, and I can't be sure of my own protection. I'm on medicine that moderately suppresses my immune system, and it is likely that I am not protected.

And I'm one of the lucky ones: Some folks simply can't be vaccinated or simply won't get any protection.

And this isn't even getting into the fact that the folks not getting vaccinated means there are more chances for the virus to change in ways that make the vaccine worthless.

Me - and others - depend on everyone that can get vaccinated to, well, get the freaking vaccine. Not getting the vaccine is putting others at risk. And this is with vaccines working as designed.


The Alpha variant of COVID-19 was strongly suppressed by the vaccines that were approved in the US, and also the others globally.

Since around early Summer Delta has been the dominant variant, which is extremely more transmissible.

Even if vaccinated, Delta still retains effective transmutability, though (maybe?) to a reduced degree even for fully vaccinated individuals.

Since we still don't have sufficient tests to do blanket systematic tests of the entire population on a regular basis, it's extremely difficult to find asymptomatic cases. I've never been notified of an exposure, and have not had symptoms that I could attribute to COVID, thus haven't ever been tested during the entire pandemic.

For all I know, the vaccines could be effective and I might have had an asymptomatic case from someone who's not using WA notify (Washington state's notification app system) and would never know it.

I worry about the risk of spreading the disease to those who are not yet able to be vaccinated, which will soon thankfully include ages 5+ in the US; but that still doesn't allow for providing strong resistance and immune system training to the youngest children.


> Even if vaccinated, Delta still retains effective transmutability, though (maybe?) to a reduced degree even for fully vaccinated individuals.

If vaccine works to protect people who are vaccinated, but does not significantly reduce transmissibility, why force it on people who don't care about being protected? Do they not have a right to make their own choices when it comes to their own bodies? If not, why do we want to give people right to choose taking drugs, given their highly detrimental effects on their bodies and on their lives, in addition to high risk of overdose and death? This all seems completely incoherent to me.


Why, greater social goods and responsibility:

The vaccines still do seem to reduce infection among those who are exposed, and contribute to reducing (even if no longer eliminating) how contagious someone is when they are infected.

Combined with mask use while in public situations...

* Strangle out and eradicate the disease, or at least make very rare.

* Vastly decrease the load on our EMS and hospitals, which they could DIRELY use after almost 2 years of this BS and several waves of "beyond really bad" a year.

* Protect those who are not YET eligible for a vaccination, and who's parents hold views that prevent these innocents for receiving the most protection for disease possible.

* Reduction of spread, even if it doesn't eliminate the disease, will deprive it of chances to mutate which is better for everyone overall. Successful mutations will be like Delta vs Alpha, anything that we consider worse, relative to existing strains.

I would like the pandemic to END sometime, and we aren't getting there until as many as possible GET the vaccine and we finish the job of arming everyone to win the war.


last i read kids (~7 and under) didn't have "fully developed ACE2 receptors" which lead to the spike RBD not fully binding in young children. this allowed their immune system to fight the invader and gave them very strong protection against SARS-CoV-2.

mutations could bring about a spanish-flu style pandemic in the young so i agree it's not a good time to get comfortable yet.. but i'm not sure i agree with mRNA vaccines being forced on all (especially kids) without long term study data. especially when subunit and inactivated vaccines for the S1 protein now exist


> Your drug use can't put me in the ICU.

Take this to its logical conclusion, please. It's the big bang's fault!


I think https://hyper-traditionalist.tumblr.com/ would agree, advocating against the multidimensionality and expansion from the Big Bang (and yet, would also object to being described as being for or against any position, because a position would imply dimensions.)

Return to gravitational singularity, and all that.


Yes, there obviously can never be any effect from any decision anyone ever makes. Naturally.


Meth was legal until the 70s, society functioned. The current problem is another side effect of the war on drugs

https://www.history.com/topics/crime/history-of-meth


Until recently the dutch government ran opium factories: https://decorrespondent.nl/7514/nederland-runde-eeuwenlang-e...


> If they did that, the consumption would only go up, resulting in even more overdoses.

I believe the former. People like taking drugs after all.

But what makes you think the latter is likely?

(Anecdotally, from what I can tell American teenagers seems more likely to bing drink hard spirits than German teenagers who can legally enjoy a pint at the local pub.)


Only if they are over sixteen. Same for buying at the supermarket, gas station, or such. No sale without verification of legal ID. Of course there are ways around that, but it isn't that easy anymore.


Yes. I meant above 16 year olds. Though if you are with your parents, you can drink from age zero, if they let you.


> German teenagers who can legally enjoy a pint at the local pub.

Was that an intentional cultural mixup? My brain just stopped working after reading it, because of how little sense it made.


In Germany, you are legally allowed to buy beer and wine at age 16. The result is that most teenagers tend to stick for lower-percentage alcohol and don't go all-in for the hard stuff.


Yes, but not in pints, and not at pubs. That's England, not Germany.


Translation convention.

Pub is just the best English translation for 'Kneipe', and whether you drink a UK pint or half a litre of beer doesn't make too much of a difference.


In Canada you can still buy that over the counter. You get id-ed and they keep a record of your purchases, but since it's now generic pills it is now much cheaper than it was before


I grew up in Germany in a household that never used nasal decongestants, probably out of some fear that they might be dangerous.

When in Canada a doctor told me to buy some pseudoephedrine pills to treat a clotted ear and I found the experience so nice, that when back in Germany I walked into a pharmacy to get some.

The looks...


Japan is similarly puritanical about stimulants. Might have something to do with the way those drugs were used in those countries during the war…


It is the same in the US, but the FDA calls it "behind the counter". OTC means you grab it off a shelf yourself, BTC means the pharmacy checks your ID, and gives it to you, but still no prescription required.

https://www.fda.gov/drugs/information-drug-class/legal-requi...


OTC just means "Over the counter" or "without a prescription". A good way to test this is to see if your health insurance in the US will pay for it - most won't pay for OTC drugs.

Behind the counter just means there is less chance of folks stealing it and more control over who buys it and the amounts they buy.

There is generally a good amount of things you can get at the pharmacy that are like this: Most of the time, they are simply ordered if someone wants them because there isn't enough demand to keep it on the shelf. Most require no ID either: Sweet almond oil (for ears) is the example I can think of.

Related: In some states, they require a prescription for it because their laws are stricter than the federal guidelines.


OTC normally means that it doesn't require a prescription.


It's the same in the US; you can buy it without a prescription, but you have to have your ID logged.


There's also an age minimum. My freshman year of college I had the sniffles and a bad cough. I went to the pharmacy to get some Sudafed but couldn't purchase since I was still 17. Went to the school's health center where the doctor happily prescribed me opioids (the infamous purple drank).


And there's a limit on how much you can buy at a time, you can only get 15 24-hour pills every 15 days, which means you need a regular pharmacy trip


FDA pressured loperamide manufacturers to stop selling large quantity bottles because people thought eating a whole bottle was a good idea.

Problem: taking massive amounts of loperamide to get an opiate effect is a myth

Of course, the manufacturers were all happy to fall in line anyway and dramatically raise per-tablet prices (and packaging!)

Except one manufacturer.

Several years ago, I bought a 200-ct bottle for US$9 shipped to Canada. Now it's US$36.


It’s not a myth so much as it’s not particularly effective: large doses of it (dangerously so, I might add, people should not do this) are quite effective in getting rid of opioid withdrawals — and not just the peripheral effects.

In extremely large doses it has a distinctly weird feeling. I wouldn’t call it getting high, so I’d suppose that is indeed a myth, but gosh it feels hard on your heart at those doses.

Typically it’s addicts trying to avoid withdrawals (and who felt they did not have access to other opioid replacement therapies for various reasons) that tried that. Some died.


Problem: taking massive amounts of loperamide to get an opiate effect is a myth.

A decade or so ago I was reading a drug forum where an addict-chemist reported that acylating loperamide extracted from OTC pills allowed it to pass the blood brain barrier and deliver a true opiate high. His only reported test subject was himself, so I don't know if it was a genuine effect or not. And I haven't kept up with drug forums in recent years to see if this idea/technique spread. If so, it could explain the pill quantity restrictions; pseudoephedrine went through many years of changes in packaging/formulation as manufacturers tried to keep their products OTC while placating governments that didn't want those pills used as illicit drug precursors.


Tell me who needs 200-ct bottles of imodium. People who observe proper hygiene have food poisoning maybe once in 10 years (and whether a motility agent is a good idea in such cases is another question).


I have chronic gastrointestinal issues and the best "treatment" for them has been taking one every morning (on the recommendation of my GI doctor). This change has made it a lot more expensive and inconvenient to deal with.


In a just world, you'd get a 3 month supply covered like your normal prescription. It is an injustice that it isn't.


People that ignore expiry dates. And at least in our household's case, a clinically ignored case of endometriosis.


a clinically ignored case of endometriosis

That's exactly what I mean (and the sibling posting is more of the same). If you need more than six doses in a row then you should see a physician for a thorough workup because loperamide is just for the symptoms. The package will say as much. It's really hard to find fault with the FDA coming down on the extended-family size packaging.


I meant the clinician's ignorance about endometriosis.

The package will say to take 2 tabs stat and 1 after each loose bowel movement. Not hard to go through a dozen+ each menstrual cycle.


I'm sorry you had to put up with a hippocratic oaf. This should never have happened.


A few pharmacies weren't set up to take either a foreign ID or a US passport when the program started.

I ended up just buying it on Postmates, delivered, no ID check.


I'm guessing your courier got ID checked.


Is shake and bake easy? Seems pretty trivial


We'll be there soon. You still need a prescription in Oregon until Jan 1, 2022.


That really surprised me once. I was traveling in the states and wanted to buy pseudoephedrine, and the guy asked me for my id, asked me to sign a log book, and then proceeded to unlock a giant safe behind him.


New Zealand banned it some years ago and I'm still pissed off. The supposed replacement is clinically useless, and I resent suffering through massive head pain from clogged sinuses every winter, while professional gangs still make money hand over fist from meth.

I was in Vegas some years back and got some under the laxer US rules, and have enjoyed a few years of having it available, but alas my supply has run dry.


Can you order it from an online Australian pharmacy?

Or know someone here who can ship some over to you?

They ID you in Oz, but it's fairly easy to get. Pharmacists know the PE stuff is junk!

I've also found Ritalin works as a decongestant too! (for which I have an ADHD prescription)


I didn’t get IDed either of the times I’ve bought a box.

First time was in 2019: I went to Walmart for something for my ears on flights, after some back and forth the pharmacist recommended me pseudoephedrine.

Second time was in Sobeys last month (can fly again, yaaay) and I asked for it directly. The pharmacist had some trouble finding it, but sold it to me with no further issue.


Chances are that you bought the useless Sudafed PE. The (original) Sudafed is pseudoephedrine. Sudafed PE is phenylephrine. The molecules are similar, but the latter cannot be easily converted to methamphetamine so it is not regulated like the former. Sudafed is an effective nasal decongestant, while Sudafed PE is equivalent to a placebo. [1]

[1] https://pubmed.ncbi.nlm.nih.gov/19230461/


Keep an eye out if you purchased Sudafed PE or Sudafed original. PE is a new product that has old fashion Acetaminophen and is sold just like any other painkiller since that's all it is. It doesn't work well at all compared to the pseudoephedrine found in the behind the counter product.


This isn't true.

Sudafed PE is phenylephrine. It is not a pain killer, and it does not have the same safety profile as acetaminophen (Paracetamol for some of you). Not saying either is actually unsafe, but the drug interactions will most definitely differ and you might find yourself suffering.

I totally agree that it doesn't work very well.


A bit of a change was that it became pharmacy-only in many (most?all?) provinces. But pharmacies are everywhere, so not a huge deal.

Sad thing is many products were reformulated with phenylephrine, an uncontrolled similarly structured molecule that's completely junk as a decongestant.


Can still buy it over the counter in the UK too.




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