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Feature Regulation of decongestants

Cold turkey

BMJ 2007; 334 doi: (Published 07 June 2007) Cite this as: BMJ 2007;334:1190
  1. Rebecca Coombes, journalist
  1. London
  1. rcoombes{at}

    Highly popular cold remedies could be banned from sale because of their link to a dangerous drug epidemic that has yet to surface in the UK. Rebecca Coombes asks whether the authorities are over-reacting

    UK drug regulators are favouring making products containing the nasal decongestants pseudoephedrine and ephedrine available on prescription only to try to limit their use in the illicit manufacture of the class A drug methylamphetamine, also known as methamphetamine or crystal meth.

    A consultation by the Medicines and Healthcare Products Regulatory Agency could result in the UK having the toughest restrictions on pseudoephedrine in the world as early as this Christmas.1 Critics, including general practitioner representatives and an eminent pharmacologist, have been swift to liken the move to taking a sledgehammer to crack a nut. They say the drug regulators have been taken in by media hype and over-cautiousness among the police.

    Although potentially very harmful, methylamphetamine is much less widely used in the UK than in countries such as the United States, Australia, and the Czech Republic, where it is a big problem. In 2004, nearly 12 million people in the US had tried methylamphetamine. Recent estimates suggest that in Australia more people are dependent on methylamphetamine than on heroin.2 But none of these countries has taken such a hard line on pseudoephedrine. Instead, pack size has been reduced, sales limited to one pack, and names of customers recorded.

    The proposal to remove pseudoephedrine from retail sale has also split the medical fraternity—the BMA is in the prescription-only camp, but the Royal College of General Practitioners fears this puts up needless obstacles for patients otherwise happy to self treat colds and coughs and will increase general practitioners' workload.

    Industry bodies, such as the Proprietary Association of Great Britain, are unsurprisingly angry that …

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