Are they still allowed at the pharmacist's discretion in the US? I tried a couple independent pharmacies and they had no idea what I was talking about. I called Rite Aid and spoke to the pharmacist at Rite Aid and he said they don't do it because they don't have the book for it. I'm sure people on here are more educated in this area than the people I spoke to.

Exempt Narcotics? Exempt from WHAT?

Exempt from a federal controlled schedule. Like low-dose codeine cough syrup, etc.
Some states schedule in C-V, some allow dispensing without prescription subject to the pharmacist approval plus registration with an ID. I guess that is the "book" CVS was telling him about.
It's all over the map regarding which stores will dispense and which ones won't. Many times, the pharmacist just doesn't want to screw with it which sounds like the CVS position.

I'm not sure what the current status of this is. They are, or were, low-dose narcotics scheduled as C-V under federal law. You would have to sign a register at the pharmacy to purchase. Tylenol #1 would be one example, maybe a cough syrup with a very low dose of codeine, or some similar preparation for diarrhea. However, most state laws prohibit the sale or posession of these things without a prescription even if federal law makes, or used to make, a provision to allow for it.

OTC sales of these type of low-dose preparations is still legal in some countries such as Canada, England, or Australia.

I can't imagine ANY pharm in MY area distributing anything with Codeine (even microscopic doseage) without 10 copies of a prescription from 4 different doctors. Then MAYBE.

Not in the USSA anyway - you must be thinking of Canada.

This site http://www.eplanetshopping.com/livelife/ ships from Canada, takes only Amex or a mailed MO and is very reliable I'm told.

Has all the low dose products including codeine cough syrup and the generics are quite reasonably priced considering that you are getting door-to-door delivery, IMO. They've been around forever. Click Products

I stocked up on same at SaveMart in Vancouver, Canada last time that we were there.

---------

My wife has bouts of bronchitis and because of a foolish and dangerous rapper trend, her PCP in the US now only writes "prescriptions" for OTC cough medicine. The pharmacist looks at the "prescription" and says Robitussin DM is in aisle 15.

Frankly, with all the more palatable offerings in any liquor store (from Moet Chandon to Peppermint Schnapps to Chardonnay), I can't fathom the allure of "drinking" cough medicine.


patient2all

In SC you can get the codeine cough syrup with 10 mg. codeine per tsp. You show your ID (must be over 21) and sign the book. Most pharmacies don't want the hassle of keeping up with the books but every town here has at least 2 or 3 mom and pop pharmacies that still sell the cough syrup and the Tylenol 1's just like in Canada. Not sure how many states participate though.

Patient:

USSA???????? Was that a freudian slip or intentional.... Way too close to USSR....

A CVS in the Cleveland, OH area will still sell Cough Syrup with Codeine after signing, but you better be coughing like an SOB, look respectable, and ready to die if you ask for it. I have seen only a few succeed and most fail to get it. Personally Cough Syrup just makes me feel worse.

Resorts,

I don't want to turn the thread political, but it was intentional. I don't like the direction our country is going. I fear for our future.

I love our country, but am suspect of the government. Both Democrats and Republicans.

BTW, I wear American flag t-shirts whenever they are clean.

patient2all

Back in the USSA.
New York girls really knock me out
They leave the west behind.

No, doesn't work.

I agree that we should always worry and vote and protest, etc. Blood of patriots and all that good stuff.

Thanks for all the responses guys. The pharmacists I talked to just sounded like they didn't want to bother with it. One told me that no one does that anymore.

GOOD !!! I thought it was just a mistake Mein Fuhrer!!

There are states where it is legal to buy certain schedule V drugs (in certain amounts per month) by signing a register. In these states where it is legal and the pharmacist doesn't want to be bothered by the process - Just tell him to give you 500 boxes of sudafed 120mg, and don't worry about reporting it to the gov.

I could see the cops just around the corner waiting to pick you up for receiving Meth ingredients. All of the Sudafed is not on the shelves, you have to sign for them and there is a limit. I would never try to buy even one box, because I do not care to be on "The List".

It must depend on the state. Nobody in my family has ever had problems buying one box of sudafed.

RE: Buying Sudafed or generic ?

Prior to 2005 (if memory serves) I could walk into Wal*mart and buy 2 packs of 96 count, 30mg OTC generics and no questions ask.

Now, all pseudoephedrine is behind the counter and I must show my drivers licence and sign something.
Price has gone up, of course.

The limit per person is 9 grams per month, but there are ways of getting around this, I'm told.

I seldom use the stuff anymore, so it is not a problem, but the very idea that some government agency is monitering me and treating me like a criminal angers me to no end.
Just another brick in the wall of our lose of freedoms and we take it like sheep.

Mean while, the supply of home made methamphetamine has not been reduced, as most of it comes from Mexico.

A ship carrying 100's of tons of ephedrine was nabbed near the Mexican coast, recently.

My views on government control of what one puts in ones body in the privacy of ones home are well known.
They are the same as Thomas Jeffersons and he had an interesting garden and fear the government might meddle is his medical experiments.

Want to save tax payer dollars ?
Eliminate the DEA and war on drugs/people.
20 or 30 billion saved, crime reduced, prisons emptied.
Will some abuse drugs and die ?
Yes, just as some will do 180mph on a Hayabusa and die.
When this happens, it's called thinning the herd.
Too many morons on this planet anyway and we cannot save them all.

Put efforts into saving the innocent, who are sick through no fault of their own.

Sorry if this is off topic, as ephedrine is an effective mild stimulant, sinus headache reliever and not a narcotic.
Sold in big bottles at truck stops, 10 years ago.

The food police will be around soon to check what you eat ?
Show your drivers license to buy a Whopper ?
What's the limit per month ?

I can't lay down without taking Sudafed. My sinuses will slam shut without it. I've tried the OTC version Sudafed PE, but it' just not as good. It won't get me thru the night. I usually buy 2 boxes of 48 tablets, which is the limit around here I think.

Thank God for Sudafed and Afrin. I don't know if my breathing problem was caused by the accident I had where I smashed in the side of my face and broke my jaw and fractured my skull, but I don't remember having this problem before the accident. Guess I should go and get it checked out, but I'm afraid they might find something. I'm SOOOOOO sick of going to doctors. Been living with it for some 37 yrs., so why stop now.

Popo, I am sorry for your sinus pain. I had chronic sinus infections for a year or two at one point and it hurts, I know.

Sudafed (the orig one inc. generics) is used to make crystal meth. My understanding is that a bill/regulation was passed specifically for this drug and its tracking requirements. I have never heard of buying 'exempt narcotics' w/out prescriptions, requiring only a signature.

But maybe I lived in the wrong states.

Thank you, but there's no sinus pain involved. I just get all stopped up when I lay down. I can't stand it when I can't breath thru my nose. I feel like I'm smothering. Crazy I know, but it kinda freaks me out.

Sometimes I fall asleep before I take the Sudafed and it's not very long that I start gasping and choking from being all stopped up. I hate that feeling. I'm afraid I'm hooked on the Afrin. Been using it for many yrs., quite a few times a day. I find myself having to use it more and more. I know I should see a doctor and get off of the stuff, but the thought of maybe having my nose packed, scares me to death. I know it's a mind thing, but I really freak out when I can't breath thru my nose.

Your definition of an exempt narcotic is not exactly correct. Actually, exempt refers to being exempt from various governmental Rules regarding the sale of certain narcotic drugs. At this time, the only exempt narcotics are codeine-containing preparations indicated for treatment of cough, although preparations containing paregoric (camphorated tincture of opium) for the treatment of simple diarrhea were also available until the early '90's. However, these drugs are not exempt from federal scheduling. In fact, all exempt narcotics available in the United States are classified in Schedule V. Keep in mind that the fact that a drug is scheduled does not automatically make it a legend (Rx Only) drug.

The term exempt narcotics actually pre-dates the implementation of the Controlled Substance Act ("CSA") of 1970, and any amendments to it. Some people may be under the misconception that the CSA made it more difficult to obtain narcotic drugs, but, with the exception of exempt narcotics, history really does not bear this out. Prior to the CSA, narcotic pain killers, like morphine and oxycodone were known as Class A Narcotics, and were subject to significant regulations. Hydrocodone in combination with non-narcotic drugs was a Class B narcotic. But there were some drugs that were "exempt" from most of the requirements regarding narcotic prescriptions for varying reasons, and many could be purchased without a prescription. In reality, the CSA of 1970, and subsequent regulations, including reclassifications, affected other types of drugs -- principally stimulants and depressants (which previously really were not subject to much regulation) -- much more significantly than it did narcotic pain killers. While both SHORT-acting barbituarates and all amphetamines in pill/capsule form were initially classified in C-III per the CSA of 1970, all were reclassified into C-II (unless they were combination-drugs) by the end of 1973. Methaqualone, placed into C-I in the early 1980's, was not even a controlled substance at the time the CSA of 1970 was passed, as were many other drugs that were later classified. (Although not initially scheduled, methaqualone was placed in C-II early in the 1970's.)

In some ways, despite all of the DEA and other governmental actions regarding prescription of narcotic pain-killers, and doctors who prescribe them, a valid argument could be made that it is still easier in many parts of the country for people in chronic pain to obtain relief through medication. Keep in mind that there was no such drug as OxyContin prior to the mid 1990's. And even though the DEA didn't really start hunting down doctors until pain management with narcotics became more available, licensing agencies in different states had the right to -- and did -- take action against doctors when they wanted to. Prescription of pain killers, and their use was actually quite stigmatized in the United States not too longer after the end of the 1800's. Prior to Temperance acts that were put into place in the early 1900's, morphine and heroin (in elixir form only) were O-T-C drugs. When I was a kid, I remember a friend who believes (or used to believe) that basically all drugs should be legalized and available without prescription. At the time, his argument was that if aspirin had just been developed that it would have been a prescription drug. Of course, both history that post-dates his statement, as well as prior history proves him incorrect. Many NSAID drugs, like naproxen sodium and ibuprofen, as well as various antihistamines, antacids, anti-allergy medications, and others that required a prescription when I was a kid are, in fact now approved for O-T-C use. And as for the idea that aspirin would have been a prescription drug if developed later, it should be noted that one of the reasons it became a commonplace drug was because it was considered relatively benign, and took the place of many of the narcotics that were available without prescription before Temperance laws were enacted.

I can see that I'm rambling, so let me try to get to what is available today. At this time, federal law permits the over-the-counter sale of up to four ounces of various codeine-containing preparations within a 48-hour period (unless the preparation has been specifically designated as a prescription-only drug), provided proper record-keeping be kept by the pharmacist, the purchaser be at least 18 (21 in some states/areas), and be known to the pharmacist (or have identification). Examples of these drugs include Robitussin AC (and generic versions of it), and Cheracol (with codeine).

Even though federal law permits these sales, many states, like New York, have regulations that either completely prevent their sales, or impose various restrictions that are more stringent. Some states, like Florida, permit only two ounces to be dispensed without prescription in any 48 hour period. Others permit the sale of four ounce bottles, but greatly restrict the amount that an individual can purchase. For example, Washington state permits the sale of no more than two bottles per year, and New Jersey permits only four. The problem is that even in states where permitted, because of the rights of pharmacists to exercise discretion, the vast majority of pharmacists won't dispense it (especially if the pharmacist doesn't know you, although many pharmacists have a blanket policy against it no matter how well you know them). Part of this could be related to the increased number of pharmacies in the country, and the fact that laws regarding exempt narcotics -- particularly on a state level -- are very difficult to enforce.

Some pharmacists in states where sales are permitted will even go to the extent of directly lying to people and say that they're not. Actually, sale of exempt narcotics is now so obscure that there may even be a few pharmacists who aren't even aware of the law(s). But, if you are dealing with a knowledgeable pharmacist who has been around a while, and you are in a state that permits sales of exempt narcotics, instead of asking whether the drug is available, you can simply just ask the pharmacist for a bottle of the drug. The pharmacist may still say no, but depending upon the amount of business you, your family and your family's friends provide to the pharmacy conceivably you might have some leverage.

To the best of my recollection, here is what happened to me once in a mom and pop pharmacy in southeastern New Jersey (where -- unless state law has recently changed) -- exempt narcotics are O-T-C:

I walk into the store, and ask the pharmacist for a four ounce bottle of Robitussin AC, or a generic equivalent.

The pharmacist tells me that this drug is only available by prescription.

I reply that under New Jersey law, up to four ounces can be sold without a prescription.

The pharmacist says something like, "We don't carry it in four ounce bottles. That's a really old law. I mean, if we carried it, we'd have a line of people out the door every day waiting to buy it."

I respond that I have found pharmacies in New Jersey in the past that have sold it to me (a true response).

The pharmacist replies, "Well, I guess you if you go to enough places you could probably find a guy who will sell it to you."

I didn't feel like continuing the conversation any further, so I left.

Of course, the guy was wrong about the line of people because I don't think I would have told anybody where I purchased the bottle if I felt there was any hint that it could lead to anything like he stated. And, at pharmacies that sell it, I've never seen a line for it, let alone a line out the door.

But what you should note importantly about this conversation, IMO, are not only that the pharmacist initially lied, but also the fact that he stated that he didn't carry the drug in four ounce bottles (the four ounce bottles are pre-labled by the drug companies that make them, and look like any other over-the counter cough syrup). Indeed, he may not have had any four ounce bottles designed for over-the counter sale in stock. The problem is that he undoubtedly had a pint size bottle in stock and, unless state law dictates otherwise (and New Jersey's doesn't), a pharmacist can legally sell you four ounces of the drug simply by taking an empty four ounce bottle, pouring four ounces of the drug in it, and placing directions on the bottle. So a pharmacist generally doesn't have to have O-T-C size bottles that are labeled by the manufacturer in stock in order to dispense it (and yes, I have purchased bottles prepared by pharmacists in just the manner I've described); yet, it is the most common excuse I have heard from pharmacists who refuse to sell it.

If you desire accurate information about this, it is really important that you look at the law in your state, if possible, that you talk credibly to pharmacists, and if you go to one, two, five, or even ten who either outright lie to you or simply refuse sale, do not believe that the eleventh necessarily will do the same (although you many also wish to re-check the law). Also, it is almost ALWAYS better to go to pharmacies in person and ask, rather than to call.

I don't know the laws of many states, nor if laws have changed in some states, but here are some states that permit O-T-C sales of exempt narcotics, or have done so in the past:

Maine
Vermont
Massachusetts (except for opium preparations)
New Jersey
Maryland
District of Columbia
Virginia
South Carolina
Georgia
Florida
Ohio
Michigan
Wisconsin
New Mexico (but must keep log book separate from the book used for pseudoephedrine sales)
Washington
Kansas
Oklahoma
Hawaii

Those are just some that I'm aware of, and there may be many more. Aside from New York, which does not permit sales as noted above, the state of Pennsylvania does not permit the sale of any preparation containing codeine without a prescription (it used to permit sales of the opium preparations that are no longer available for treatment of diarrhea).

I apologize for this very lengthy post.

Ive lived in WA for the past 11yrs and we are not exempt. Everything has to have a script even for cold medicne cuz of the many meth labs here, they screwed everything for people (no offense to users intended) and now there is not one pain management Dr here that will take anybody especially if youre low income. IMO My city thinks people on medicaid or no insurance are low-lives. It suck too cuz many are not they just associate that with low-come = drug addicts, many clinics that dont do diddly for the people that seriously need it. I mean sheesh at least if the dr's would take someone on as pain management then do a stinking TEST every month!!! Sorry just aggravated with the system. I have many serious documented issues for 10yrs now and am not getting the care I need after my reg dr left. Please no bashing on me

Rose

Well I live in Illinois and it is not on the list. There are so many Meth labs going around basically from Missouri. They have people come to all kinds of stated to buy sudafed fro all kinds of stores, even if they can only do 2 boxes at a time. They also have to show their drivers license and sign the book. They don't get very far. I read about it everyday in the local newspaper about poeple getting caught and they find a lot of boxes of sudafed in the trunks or wherever.
Sorry to be off topic, but I just don't understand it. Have you seen what people look like when they are on Meth? Crazy.

I would never bash on you. I am of the understanding that in Washington State it is difficult to obtain adequate pain management. This is one of the reasons I recommend that anyone in chronic pain who has the money should fly down to South Florida (it's the off-season in Florida right now, so flights shouldn't be that expensive). Broward County, Palm Beach County and Dade County are currently inundated with pain clinics/doctors. It's gotten to the point that the sheer number of pain management facilities has become so high (it seems that a new center opens roughly every three weeks), that the number of pain management doctors/clinics are not only now extremely noticeable in this part of Florida, but also in other parts of the country, particularly in Kentucky, Tennessee, and Arkansas (and some adjacent states). Although the competition is good from a financial perspective (competition lowers prices), I consider that the long-term effect will be bad. Florida legislators are now rushing to try to implement laws which are designed to stop the centers. There have been national news reports broadcast about it. Eventually, the state with the most pain management doctors and clinics may end up having among the fewest, which would be really sad. Most places won't see patients from out-of-state, although a few gladly welcome them). But it's actually quite easy and fast to get a Florida ID (it can be obtained the same day applied for) even if you don't actually live there, so people can still go to pain management centers even if the center only accepts patients with a Florida ID. Because of the fact that many heavily advertise in some "alternative" newspapers that are easy to obtain for free, I don't think that if listed many of them, I'd be placing them in an uncomfortable position. After all, it would effectively be additional advertising for them at no extra cost. I have been thinking of starting a thread where I would list many pain centers, and their varying requirements and pricing.


Any people interested in this information should actually make their interest clear to me, though, as I wouldn't want to write about all these places if almost nobody would genuinely consider heading to Florida to obtain pain medication. I generally would never mention the names of other pain management doctors/clinics that I'm familiar with in other parts of the country in order to protect the doctors, but since many of the Florida doctors/clinics place pages full of blatantly large advertisements, I guess they don't think they feel the need to be protected.

Per your post regarding Washington state, below is a link that shows that pharmacists in Washington are indeed permitted to dispense exempt narcotics. I was apparently wrong when I stated that Washington State law permits the purchase of no more than two bottles per year. The actual limitation is no more than two bottles every sixty days.

The link describes various aspects of Washington State Pharmacy Law, including the Rules for over-the-counter sales of exempt narcotics. You would need to copy the link in entirety, and paste it as one line in your browser to get to the site. You do have to go fairly far down the page once you get to it in order to see the laws/information regarding sale of Schedule V drugs without prescription.

I'm really sorry that you're not getting adequate relief right now.

http://74.125.47.132/search?q=cache:pmi8DOgr2b0J:www.pharmacy.wsu.edu/courses/PharP582/582Chapt5.ppt+washington+state+pharmacy+law+exempt+narcotic&cd=11&hl=en&ct=clnk&gl=us

There are stringent laws in place concerning the sale of pseudoephedrine. I have copied them below. What can be quite confusing is that the OTC product known as Sudafed used to have pseudoephedrine as the only active ingredient, and now has a variety of products sold under that name. The one you see sitting on the shelves and do not have do anything special to purchase no longer contains the ingredient it was named after, instead it is phenylephrine.

The following info was found word for word in about 6 different places, so is most likely the most up to date on the subject.


The House passed the Combat Methamphetamine Epidemic Act of 2005 ("CMEA") as an amendment to the renewal of the Patriot Act. Signed into law by president George W. Bush on March 6, 2006, the act amended Title 21 of the United States Code (21 USC 830) concerning the sale of pseudoephedrine-containing products. The Federal statute included the following requirements for merchants ("regulated seller") who sell these products (pseudoephedrine is defined as a "scheduled listed chemical product under 21 U.S.C. § 802(45(A)):

* A retrievable record of all purchases identifying the name and address of each party to be kept for two years.
* Required verification of proof of identity of all purchasers
* Required protection and disclosure methods in the collection of personal information
* Reports to the Attorney General of any suspicious payments or disappearances of the regulated products
* Required training of employees with regard to the requirements of the CMEA; Retailer must self-certify as to training and compliance
* Non-liquid dose form of regulated product may only be sold in unit dose blister packs
* Regulated products are to be stored behind the counter or in a locked cabinet in such a way as to restrict public access
* Daily sales of regulated products not to exceed 3.6 grams without regard to the number of transactions
* 30 day (not monthly) sales limit not to exceed 7.5 grams if sold by mail-order or "mobile retail vendor"
* 30 day purchase limit not to exceed 9 grams of pseudoephedrine base in regulated products (misdemeanor possession offense under 21 U.S.C. § 844a for the individual who buys it)

Thirty-eight individual states also have varying laws on the matter: Alabama, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawai'i (as of May 1, 2009) Illinois, Indiana, Iowa, Kansas, Kentucky, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nevada, New Hampshire, New Jersey, New York, North Carolina, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, West Virginia, Wisconsin and Washington laws require pharmacies to sell pseudoephedrine behind-the-counter and to collect personal information from the purchaser. Oregon requires a prescription to purchase products containing pseudoephedrine.

Thanks everyone for you imput. And yes they do keep ALL of these meds behind the counter. You cannot buy from the shelf. I have CHF and COPD so when I get sick my dr prescribes sudafed to open up my lungs BUT it makes me so jittery that I have a hard time taking them.

As for pain management it didnt use to be like this UNTIL a clinic what giving pt's whatever they wanted. Methadone, percs, hydro's and other narcs.....meaning if they per say wanted Methadone and percs and hydro's taken with what he prescribed someone OD'd on the combinations so FDA shut them down and since then its gone down hill. It really sucks cuz if you even ask about pain management they wont see you....in their minds......red flag...= drug seaker!!

Not everyone is a drug seeker. Oh well nothing we can do to change things. Also I cant afford to fly to FL I am a single mother with a very disabled child 22 but more like 4 or 5. Im happy for those of you who can make the flight and get your pain managed.

Rose

I would like to add (now that we are discussing pseudoephedrine) that anyone taking it should get a home BP moniter and keep check on ones blood pressure.

It is an under rated physical (and mental)stimulant and raises BP, if this is a problem for some.

Works great as a short term sinus pain reliever but in hindsight, better to get to the root cause and leave it alone if one has existing high blood pressure.

Peace

I agree, I also have high BP on top of all those ailmants that I have and dont understand why my new dr would put me on sudafed given the nature of my issues. With heart disease I am not supposed to take these things. So bottom line I dont take them and let nature takes its toll What the heck is wrong with these dr's giving pt's meds that could potentially cause harm for people that have these conditions. All I can say is this makes me "baffeled" I am also not allowed to take ibuprofin cuz of ibs and other this but she says take it. My urologist says I CANT take them cuz I have been very close to being on dialisis. Now that ive been taking these my kidneys have been shutting down again. My pcp doc says oh take Ibuprofin for acute pain. Its in my charts NO ANSAIDS OR MORE THAN 1,000 MG OF TYL. Oh boy hope I dont get in trouble if this is off topic LOL

ROSE

Lets not forget that if marijuana was legalized it could be taxed - billions in new revenue.....

I know what you mean, PoPo. I have to use Afrin twice a day myself (although no sudafed). I wonder if you have a deviated septum? I don't know if that would cause the symptoms you have but it would be worth getting it checked out. Once you know what the problem is, you can then decide it you want to have it treated.