Meth-Head to My Madness

Sunday night my throat hurt so badly that I kept having dreams about having a sore throat.

I'd be peering into mirrors to try and get a glimpse of the red patches, prying my jaws further and further apart til they were at a breaking point. I'd be in meetings, unable to listen to what people were saying because the only thing I knew was that my throat hurt.

I woke up repeatedly, each time to the grim realization that the sore throat itself was most assuredly not a figment of my REM-agination.

Fast forward to a couple days later — today, to be precise. The sore throat has subsided, but try as I might I absolutely cannot breathe. I blew a fair amount of cash on Tylenol Cold yesterday, but to no avail. I even doubled up on the decongestant by taking an extra dose of generic phenylephrine HCl.

Still no luck.

So last night I broke down and used some of that nasal spray, which is a big no-no (that stuff is addictive in that if you use it a day or two, you need it to breathe... even when the cold is gone).

But I needed a fix. And I needed it bad.

The spray wore off fairly early this morning, and misery struck once again. But I insisted on holding out until lunch-time, when I'd steal away from here in search of that heavenly decongestant that was so easy to obtain once upon a time.

I'm taking about pseudoephedrine.

Pseudoephedrine, for those of you who don't know, is a major ingredient in methamphetamine production. "Meth" is a pretty serious problem, particularly in rural areas where another major ingredient — anhydrous ammonia — is regularly stolen from farmers who use it in fertilizer (the remainder of the ingredients are easy enough to obtain... hence the nomenclature "poor man's coke").

After a year of usage, you'd scarcely recognize a meth user: in addition to dramatic weight loss and thinning hair, tooth decay is a near inevitability. As is graying, yellowish skin and a handful of other problems, including emotional, behavioral and psychological damage.

It's pretty serious stuff, and I'm all about making it more difficult for folks to manufacture meth. It ruins lives in the most literal sense of the word: parents neglect their children (or worse); meth labs engulf homes in flames; users lose their jobs; etc.

So a year or two ago, pharmaceutical companies replaced pseudoephedrine with phenylephrine in most over-the-counter cold, flu and allergy medications. Some varieties still contain pseudoephedrine, but you have to get it directly from the pharmacist.

So this newest illness is perhaps my second cold since OTC meds swapped nasal decongestants and pharmacists took pseudoephedrine behind the counter. And all I kept thinking yesterday while I chowed on Tylenol Cold was this:

This really isn't working.

And I remembered the time I was sick before that, also thinking the same thing. Didn't medications used to be more effective?

That's when I started wondering if perhaps phenylephrine wasn't as effective as its counterpart. Or perhaps it's all a matter of psychosomatics... in any event, I started aching for that wonder drug of a bygone era.

But first I did a little research to see if other folks had noticed the same problem. What I found was this: while phenylephrine and pseudoephedrine do the same thing, the former has a comparatively low level of bioavailability.

That means that by the time phenylephrine makes its way through your liver, there's not as much of it left to be absorbed. For it to be anywhere near as effective as pseudoephedrine in relieving nasal congestion, you'd need a lot more of it. Certainly more than they put in OTC meds.

And though I'm not 100% certain, I seem to recall from organic chemistry that bioavailability can vary by degrees from person to person.

In which case: has anyone else had problems with the efficacy of "reformulated" OTC meds? Or am I the only one who finds them to be ineffective?

***I went to the pharmacy on my lunch break and ruminated over all of the sundry ingredients before I eventually decided on a product, and took my "slip" up to the pharmacy.

I cannot even begin to tell you how embarrassed the tech made me feel. The accusing looks as she grabbed the slip from my hand. The squinting eyes as she took my driver's license and proceeded to enter personal information into a computer (so "they" know how often you purchase the drug).

I mean, I actually felt like I was doing something wrong.

But you know what? That was 90 minutes ago, and already I can breathe through my right nostril and whistle with my left (attractive, I know).

Who cares if my heart is racing... almost as quickly as my mind.