Pseudoephedrine is an orally active medicine that causes blood vessels in the nasal epithelium to contract, limiting inflammation and mucus secretion and thus relieving the symptoms of nasal congestion arising from viral infection (‘colds and flu’) or allergic reactions (‘hay fever’) in the upper respiratory tract.
A number of ‘over-the-counter’ (OTC) preparations containing pseudoephedrine alone or in combination with other medicines such as analgesics or antihistamines are available in New Zealand for the treatment of colds, influenza and allergies. Parenthetically, since decongestants undoubtedly improve wellbeing and functioning during colds and influenza, given the current context of the H1N1 pandemic there may be concern that any restriction on such agents might adversely affect the population. It is important to emphasise that these medications do not affect or treat the viral infection, and indeed their use allows individuals to resume employment or social contacts while they are still infectious.
Pseudoephedrine is the precursor of choice in New Zealand for the illicit manufacture of the Class A controlled drug methamphetamine. Pseudoephedrine for this purpose is obtained by diversion (theft or ‘pill shopping’) of OTC pseudoephedrine preparations, or by illegal bulk imports of pseudoephedrine-containing medicines (predominantly ‘ContacNT’ capsules manufactured legitimately in China).
In June 2009 the Prime Minister requested the Chief Science Advisor to consider the evidence relating to legal access to pseudoephedrine and advise whether a tightening of such access might be acceptable from a medical perspective without having any adverse effects on the population, in the presumption that reduced access might reduce the social harm relating to methamphetamine use.