The illegal street drug Crystal Meth has become a growing problem in Ontario and your pharmacy can play an important role in protecting the public.

The Nature of the Drug

Crystal meth, or methamphetamine, is also known by the street names ice, crystal, chalk, and speed. The drug is illegal, potentially fatal and highly addictive. Crystal meth poses significant health risk to users, while both the use and production of this drug also impacts on public safety and the environment.

The drug can be made relatively cheaply with a key ingredient, pseudoephedrine, available in most cold medications sold over-the-counter in pharmacies, groceries and variety stores. Many of the additional ingredients required for producing crystal meth are readily available at pharmacies and retail stores.

According to Health Canada, methamphetamine can produce a powerful psychological dependence. Its use is associated with episodes of violent behaviour, paranoia, anxiety, confusion, and insomnia. Long-term use has also been associated with psychotic behaviour including paranoia, auditory hallucinations, mood disturbances, and delusions.

The paranoia may result in homicidal or suicidal thoughts. Psychotic symptoms may persist for months after the drug is discontinued. Methamphetamine can also cause a variety of medical complications including weight loss and cardiovascular problems. The risk of short-term or possible neurological damage is also a concern.

Methamphetamine is now reportedly being used by diverse groups of people and it appeals to people who wish to stay awake for extended periods of time and maintain their performance ability, for example, long-distance drivers and students.
Directions on how to make crystal meth are readily available on the Internet and this has lead to a significant increase in “home labs” and individuals attempting to produce the drug.

The chemicals used in production are highly flammable, combustible, toxic and present significant safety risks to both people and the environment.

Monitor to Prevent Diversion

Your pharmacy should monitor and determine if there are unusual sales or theft patterns with pseudoephedrine products so that you can take appropriate action to fulfill your responsibility in preventing diversion and ensure ongoing safe drug distribution.

Government Actions

Health Canada has amended The Controlled Drugs and Substances Act, increasing the penalties for possession, trafficking, and production of crystal meth.

In 2003 Health Canada placed restrictions on wholesalers, manufacturers, and distributors in an effort to divert large quantities of pseudoephedrine from reaching the illicit market.

As a result, makers of crystal meth, including individual users, are now turning to the ingredients found in products with smaller quantities available from sources such as pharmacies.

The College is consulting with both the federal and provincial governments on this issue and will provide pharmacies with information as initiatives develop.

• Voluntarily join and support the Meth Watch Program at www.methwatch.ca. This program was originally designed in the U.S. (where crystal meth abuse is more rampant) to reduce methamphetamine production without disrupting the availability of legal products. Free information is available at www.methwatch.ca including educational resources for all pharmacy staff. Information on the Meth Watch Program was also published in the March/April 2005 issue
• Visit Health Canada for information on crystal meth at its website www.drugwise.gc.ca
• Get familiar with the precursor legislation by reviewing the article in the July/August 2003 issue and the Practice Q & A’s in the September/October 2003 issue
• Ensure all of your pharmacy’s staff are aware of signs of abnormal purchases or purchase patterns for pseudoephedrine and other materials required for making crystal meth including rubbing alcohol, batteries, and acetone. Tips to identify these behaviours are available on the Meth Watch website
• Consider whether you need to move products containing pseudoephedrine-only (single entity) behind-the-counter so that you can control sales of unusually high quantities whenever problems occur
• Consider whether you need to move all pseudoephedrine products in your front store to a shelf closer to the dispensary counter so that these products remain highly visible for staff to observe
• Consider increasing staff awareness and the use of anti-theft measures such as tags, as pseudoephedrine is also a target for potential shoplifting
• Consider limiting the number of pseudoephedrine products that can be sold at one time, and post signage to this effect where cold medication is located to deter purchases for illicit use
• Ensure your pharmacists and front store staff are aware of groups of people who enter the pharmacy together to buy a large quantity of pseudoephedrine products
• Review your pharmacy’s sales to identify unusual increases in pseudoephedrine purchases, or check sales against inventory to determine if your pharmacy is experiencing theft of these products
• Advise local police if any unusual sales patterns of pseudoephedrine or other crystal meth ingredients occur at your pharmacy