Once Upon A Time There Was An Explosion

I have a fable that is obviously too late for Aesop’s collection of same.  It is unlikely to make its way into any later anthology. I might as well tell you about a tiny town whose sole virtue that it was on an interstate road that took a lot of people from various parts of California into Las Vegas, that famous refuge for people who are too sober and trying to get rid of excess money, sometimes while getting either married or divorced. Actually Littletown (we will call it that to avoid embarrassment to all two or three law abiding citizens). Had just one more virtue. Their county hired me as a consultant.  I did last in that job for a while, even though it covered three different small clinics, each of which needed me just a day or two a week. Since every morning when I woke up, I had to have my husband remind me not only what day of the week it was, but what city and clinic I was supposed to be at. The clinic buildings looked different from one another on the outside, a fact which didn’t help me very much because I ended up working on the inside and usually ate lunch at my desk. The patients in all three clinics were different from those that I had seen prior to that time in my career, for I had not done more than sporadic work with addicts, and there were a fair amount of people on crystal meth.  I practiced “from the book” and did the best I could (I always do) and helped some people somewhat, to get treatment and put their lives together.  But it was in Littletown, where the stores on Main Street were empty and the only local culture was the yogurt shelf at the (chain) supermarket, that I really learned about crystal meth for the first time.

One morning, in the most busy of the clinics, right near downtown Littletown (some patients walked) there was a very big “Bang.”  I talked to my (male and chronically tired looking) administrator, asked him where we were on the Richter scale, and told him my husband was back at our safely away from downtown Littletown motel seemed to be fine. He told me it was not an earthquake. “It’s just another crystal meth lab that blew up.  The police will check it out, get anyone who needs it, to the emergency room, and arrest some folks.  You better get used to the explosions of crystal meth labs.  You are going to hear lots of “bangs.”  This happens a lot, They just move their stuff and open up somewhere else in town. ”

He went on nonplussed.  Me, I did not like this.  I wasn’t crazy about the “If  it’s Tuesday, this is Littletown” kind of job anyway.  But the explosion was the first day I started thinking that I would be around for even a shorter time than I thought.

Even my then administrator knew that the first thing they had to do was to go to a drugstore and get some “Pseudoephed,” a lovely over the counter allergy medicine that often has as a side effect keeping people awake and making their heart race.

Making crystal meth is so easy an idiot could do it.  Like much information that gets people into trouble, directions for this surprisingly simple chemical synthesis are on the internet. I don’t subscribe to this website and I certainly don’t recommend homemade drugs, but I believe this to be a relatively simple synthesis, although it should be performed by someone who actually knows something about chemical methods.  I think this would stop people from blowing up.This site avoids getting to a direct recipe, but anyone who managed to get through a laboratory chemistry course in college could figure this.

Heck I accidentally made teargas long ago and far away in an undergraduate quantitative analytical chemistry lab, and cleared it of students.  Now I am a mavin-expert of some sort in at least pharmaceutically related chemistry. But I know how to do things.  I leave this to criminals, and allegedly, some well-trained people at larger labs, like in Mexico.

No I am not going to cite statistics.  One life ruined is too many.  I have seen plenty of lives ruined.

Pseudoephedrine (Sudafed  and others) is great for treating upper airway congestion.  It is what they call a “sympathomimetic” drug, which means that it mimics the actions of the sympathetic nervous system.  This means not just drying up nasal secretions, but sometimes causing things like rapid heartbeat, panic attacks; hypertension, sweating, anxiety all sorts of things.Once when I was a junior surgeon type, I tried a very low dose (on a weekend) when I though I could be coming down with a cold and wanted to save my patients from same.  I became a nervous basket case that Saturday, probably would have fit the criteria for every known anxiety disorder.  I went out and walked myself to exhaustion, did not speak with anyone, and swore I would never take any drug in that family ever again. So now pseudoephedrine is reviled,  Not because it makes some people as sick as it did me, but because of how easily it came become crystal meth.  Everyone from the United Nations to Walgreen’s seems to have had to come out with a position. Almost everyone has recommendations that are LOTS more stringent than existing law, which as far as I know basically says come up with some ID and register yourself with a pharmacist and you can get some of this.

Obviously this kind of thing cuts down on what drug companies are really about; profits and sales.  So of course, they have come up with alternative preparations, the most popular of which seems to be phenylephedrine. The studies are summarized.  Some folks think this is a good thing for upper respiratory symptoms; some do not.  Most frequent side effect is hypertension.  There are enough equivocal things going on that it his hard to tell if it is as effective and the Pseudephrine it usually replaces in allergy meds.

Different strokes for different folks.  When I was once working in a clinic that had lots of mold and congested me all the time, I went to a pharmacy across the street and bought a little pseudephrine.  I found that I had no clinically significant increase in pulse or blood pressure when I took it according to the instructions on the package. And as psychopharmacologists go, I am convinced I do a much better job when the oxygen makes it to my brain.  I was still exhausted, more than I would have expected to be, at the end of a day’s work, and I consider that the poor air quality.  But life goes on.

Like any fable, there is a moral.  Not just one, but a bunch.

1. Drug companies appear to be concerned about protecting their liability.

2. Drug companies appear to be concerned about maximizing their sales.

3. Drug companies do not appear to be excessively concerned about efficacy.  (There may, in this case be some realistic reasons, as the ability of allergy type symptoms to respond to placebos has been well known for a long time.)

4. You can get used to anything over time, even frequent explosions of local buildings in the course of doing illegal things inside them.

5.  When someone wants to make crystal meth badly, and is not deterred by lack of knowledge in chemical laboratory procedures, that same someone seems comfortable risking blowing up.

6.  Crystal meth is horrible for the people who take it, but it is equally risky for those who make it.

7.  If someone wants a biochemically risky experience, dealing with potential side effects from FDA approved prescription drugs can be bad enough, and maybe that is a nice reason for those who want highs or whatever to not try illicit ones.  Believe me, if anyone actually read a package insert, or asked a pharmacist “what is the worst that can go wrong,” any prescription can give you more thrills and chills than a roller coaster ride, so you really do not need this stuff.