Pharmaceutical sales of pseudoephedrine: the impact of electronic tracking systems on methamphetamine crime incidents

IssuesProject Stop, a real‐time monitoring program for pseudoephedrine‐containing medicines, was initiated in 2005 by the Pharmacy Guild of Australia in collaboration with police in the state of Queensland. The program implemented an online database to record pseudoephedrine purchases (and attempted purchases) to prevent large‐scale diversion to methamphetamine production.ApproachThis narrative review aims to understand the overall impact of Project Stop, what evidence exists for this kind of intervention in Australia, and what lessons can be learned from its introduction. Systematic database searches were conducted in Embase, PubMed, Web of Science and Google Scholar, with 20 relevant sources selected for inclusion.Key FindingsProject Stop successfully prevented some pseudoephedrine from being diverted from pharmacies to methamphetamine production. The intervention has been most effective in jurisdictions that made the program mandatory. Project Stop was also associated with a temporary decline in clandestine laboratory seizures in Queensland, changes in methamphetamine production methods and reduced voluntary treatment admissions for methamphetamine use. Implementation was not associated with an appreciable effect on secondary indicators, such as methamphetamine production and harmful use.ImplicationsFuture applications of a Project Stop model must ensure ongoing impact evaluation, assessment of its effect on individual's drug‐related behaviour and combine it with policies that address drug use as a health issue.ConclusionProject Stop has been narrowly successful in terms of reducing pseudoephedrine diversion and demonstrates the potential for third‐party policing practices directed at the consumer level, in collaboration with healthcare practitioners, rather than only regulating precursor wholesalers.

Section: Resultsmentioning

confidence: 99%

The impact of pseudoephedrine regulation at Australian pharmacies through Project Stop: A narrative review

Brookfield,

Gartner

2023

“…Typically, these cases involved pharmacists selling pseudoephedrine, sometimes at inflated prices, despite ProjectSTOP notifications arising. While mandatory schemes improve uptake among pharmacies , even so, ProjectSTOP was not found to impact on the production possession, distribution or importation of methamphetamine up until 2011 . Further research on the efficacy of ProjectSTOP is needed to assess whether outcomes have improved over time and the potential role of these cases in deterring misconduct by other HPs.…”

Section: Discussionmentioning

confidence: 99%

What factors contributed to the misconduct of health practitioners? An analysis of Australian cases involving the diversion and supply of pharmaceutical drugs for non‐medical use between 2010 and 2016

Hulme

Hughes

Nielsen

2019

Introduction and Aims. Increasing quantities of pharmaceutical drugs are used non-medically around the world, including in Australia, resulting in rising harms. This study examines the role of health practitioners (HP) in diversion and the circumstances surrounding their misconduct in Australia. Design and Methods. Tribunal decisions were obtained from the Australasian Legal Information Institute for 117 complaints against HPs for inappropriately prescribing/supplying or misappropriating drugs, representing a comprehensive search of cases from 2010 to 2016. Bivariate and multivariate logistic regressions were used to examine patterns of misconduct by demographics, drug type, scale and contributors. Results. Cases involving inappropriate prescribing/supply (73%) had greater odds of involving doctors (adjusted odds ratio [AOR] 48.18, 95% confidence interval [CI] 3.63-640.11) and pharmacists (AOR 85.59, 95% CI 5.08-1443.05) and HPs over 50 years (AOR 16.54, 95% CI 2.80-97.60) and lower odds of being attributed to individual circumstances (AOR 0.06, 95% CI 0.01-0.57). Cases involving misappropriation (31%) had greater odds of involving nurses (AOR 19.86, 95% CI 2.50-157.93), HPs under 40 years (AOR 5.08, 95% CI 1.24-20.90) and being attributed to individual circumstances (AOR 7.96, 95% CI 1. 52-41.75). Subgroup analyses indicated that doctors were more likely to inappropriately prescribe pharmaceutical opioids, sedatives and Schedule 8 drugs, and their misconduct was attributed to lacking the skills and temperament to manage complex patient groups, while pharmacists were more often involved in pseudoephedrine supply for financial reasons. Discussion and Conclusions. Strategies to reduce diversion should be multifaceted and may include better supporting HPs to manage complex patient groups and removing barriers to substance use treatment for HPs. [Hulme S, Hughes CE, Nielsen S. What factors contributed to the misconduct of health practitioners? An analysis of Australian cases involving the diversion and supply of pharmaceutical drugs for non-medical use between 2010 and 2016. Drug Alcohol Rev 2019;38:366-376]

“…for a review [2]), such as limits on the sales and supply of precursors required for methamphetamine production [21,22]. While these regulations have previously demonstrated effectiveness in reducing indicators of methamphetamine supply [21–23], many cooks are now able to synthesise precursors from processed products [10], and international efforts to disrupt illicit drug supply, trafficking and manufacture have met with limited success [2]. These regulations also may be less effective in preventing methamphetamine manufacture by cooks producing methamphetamine exclusively for individual consumption.…”

Section: Discussionmentioning

confidence: 99%

Patterns of methamphetamine production among an international sample of methamphetamine ‘cooks’

Puljević

Zahnow

Benfer

et al. 2020

Self Cite

Introduction and Aims The illicit manufacture of methamphetamine in clandestine laboratories is associated with significant risks to the community and environment. Currently little is known about clandestine laboratories or the individual ‘cooks’ who operate them; current research directly engaging with cooks is limited to three qualitative studies with small samples (n < 24) of cooks based in the USA. This descriptive brief report starts to address this knowledge gap by exploring characteristics of an international sample of self‐identified methamphetamine cooks. Design and Methods Using data from the 2017 and 2018 Global Drug Surveys, we identified 125 individuals from 24 countries who reported past manufacture of methamphetamine. We explored respondents' socio‐demographic characteristics and patterns of methamphetamine production using descriptive statistics. Results The majority of methamphetamine cooks were male (82%) and Caucasian (70%) and, contrary to previous studies, 43% were employed and 51% had at least a high school certificate. Cooks most commonly sourced precursors from pharmacies (50%), followed by friends (24%). Almost half of the cooks (47%) produced methamphetamine exclusively for self‐consumption. Discussion and Conclusions The heterogeneous nature of the sample and varying precursor sources reflect the limitations of existing regulations aimed at limiting methamphetamine production. These findings point to the need for innovative and multi‐faceted efforts aimed at reducing and preventing the harms associated with methamphetamine manufacture.