Proposed Ban on Pseudoephedrine- radio interview

What does the AMA, the Australian Medical Association, think about this? The president is Dr Mukesh Haikerwal, and he joins us this morning.

Good morning Dr Haikerwal.

DR HAIKERWAL: Hi, good morning. How are you?

ROSS SOLLY: I'm well. What do you think of a possible ban on products containing pseudoephedrine?

DR HAIKERWAL: Well, I think what we need to do is see what it is that is trying to be achieved here. Pseudoephedrine is in many concoctions to help the symptoms of colds and flus that afflict us throughout the year, and obviously much more through winter.

If we were to ban pseudoephedrine, the world would still keep spinning and we'd certainly have other ways of trying to remediate some of those awful symptoms you get during those cold-and-flu type days.

I think that we don't want the tail to be wagging the dog. I mean, if the vast majority of Australians use this and use it wisely under the guidance of their pharmacists and certainly with a doctor if necessary, you can basically stay away from work for a short period of time and get back to work soon - soldier on, as they say - and basically minimise the impact on the workforce.

If you take this off the market, it means that people suffer a bit longer, maybe use other sorts of remedies. But you know, will you actually then prevent these awful life-threatening, life-changing drugs like ice coming onto the market? Will this stop the supply?

If the answer is yes, then I think it's a done deal. If the answer is no, then you've got to ask why is it that you take away symptom relief from the vast majority of the public to supposedly knock on the head something that's pretty nasty.

ROSS SOLLY: So what's the best way to do this? Do we have a trial period maybe?

DR HAIKERWAL: Well, I think that obviously the Government is looking at asking this expert committee to look at the evidence. I think that's important. I think that we need to see if there are other ways to skin the cat.

But ultimately if there's a need for a ban, I think if we have the evidence to hand and it supports it, that should be the way to go.

ROSS SOLLY: Is there much evidence to support the idea that people are using cold-and-flu tablets to get the pseudoephedrine to use for drugs like Ice?

DR HAIKERWAL: Well, this is certainly the wisdom that's out there. I have talked with the Pharmacy Guild about this and they've got a program to try and minimise the supply of these things through pharmacists, and that's a good way to go.

I think people are obviously aware that if they're buying large amounts of this stuff that it will be noted, and so that's a problem. But you know, the people that are making the illicit drugs don't actually go to the supermarket or the pharmacist with a trolley and shop in the normal way.

So really, it's a way of making sure that we minimise the impact of ice and other such drugs. We need to make sure that when people are addicted that they get treatment for it and the help through - with the same compassion that anybody else with any other affliction has.

But the supply has to be stopped. It has to be stamped on as hard as we can. But you know we don't want the symptom relief of the rest of the Australian public being put in jeopardy.

ROSS SOLLY: Yes, that's right. I mean, I've spoken to two people this morning who are currently having or battling colds. I don't know whether they're using cold-and-flu tablets, but it's a pretty common approach, isn't it?

DR HAIKERWAL: It's a common approach. Most people maybe just take a day or two off work rather than a week or so off work. It means that they are able to perform at work because they are free of symptoms. It's probably a bit severe to take pseudoephedrine completely off the market unless it actually does show clearly that it will stop the Ice epidemic. And somehow, I have my doubts.

ROSS SOLLY: You have your doubts?

DR HAIKERWAL: Well, certainly, I mean, the supply of this will be from sources other than a pharmacy and in this way.

ROSS SOLLY: So the Pharmacy Guild is right, then, Dr Haikerwal, when it says that if you take cold-and-flu tablets off the shelves, if you ban it, it will result in people having more days off sick?

DR HAIKERWAL: Well, certainly, I mean, if they feel it brings symptom relief. If you relieve your symptoms, you can get back to work. And people in Australia work so hard, they're desperate to get back to work, and that's what they do. If they feel crook two or three days longer, they'll stay off work two or three days longer.

ROSS SOLLY: Gee, it's an interesting quandary for the Government, then, because obviously healthcare costs are going to - and costs for employers - are going to be driven up by this.

DR HAIKERWAL: Well, that's right. But Ice is a dreadful problem. It's going to cause significant problems for our community if we don't deal with it, and certainly we need to be providing the care for those that are afflicted by an addiction to it. But nonetheless, it's a nasty piece of work and certainly the manufacturers aren't doing this in nice factories. So we need to make sure we clear it up.

ROSS SOLLY: Dr Haikerwal, a question from a listener, John. He wants to know: could they make pseudoephedrine a prescription drug, or cold-and-flu tablets prescription drugs?

DR HAIKERWAL: That would be a way of dealing with it, what they call up-scheduling it, so it's either from the pharmacy only and citing the person, or whether it's … with a doctor's prescription. That would reduce some of that supply, definitely.

ROSS SOLLY: Yes. Are you involved in the discussion? I would imagine you have been counselled on this.

DR HAIKERWAL: Yes, I most certainly have been in touch with the Guild about that and we're certainly are working together on progressing some of this.

ROSS SOLLY: Yes, and you have a representative on this committee that Christopher Pyne has set up?

DR HAIKERWAL: I'll have to take advice. I don't know whether I specifically.

ROSS SOLLY: Yes. Well, one would hope so. You are the AMA, after all, and it's a major national working group.

DR HAIKERWAL: I promise I'll check on it straight away.

ROSS SOLLY: Okay. Dr Haikerwal, it is interesting to find out how we - because it is, I mean, are you hearing more reports of more and more patients who are dealing with Ice and other methamphetamine problems?

DR HAIKERWAL: Yes, there is certainly much more of this about. Certainly my colleagues in emergency departments see a lot of the collateral damage of that. They have to deal with the effects of this on a daily basis, as do my colleagues in the rest of the hospital system. Some practices that deal with people with drug addictions obviously have a lot more exposure.

So it's certainly a huge problem. And the recent report from the Australian Institute of Health and Welfare has shown that Australia's use of drugs like ecstasy and Ice is so great that the message hasn't sunk home. These are poisons, they're not party pills.

ROSS SOLLY: Yes, it's shocking when you see some of the figures.

Dr Haikerwal, thank you for taking the time to talk to us this morning.

DR HAIKERWAL: Thank you. Good morning.

ROSS SOLLY: Dr Mukesh Haikerwal is the president of the AMA.

It might look on the surface like using a sledgehammer to crack a walnut, but as Dr Haikerwal has just said, it's - and he deals with it on the frontline, when you're dealing with people who are battling addictions to things like ice, I suppose everything's got to be on the table, doesn't it? You've got to consider all alternatives.

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