Brian Rudman: Anti-P law doesn't stand up to scrutiny

For Beehive-watchers searching for signs the blokes are truly back in town, look no further than the exceptions to the near total ban on pseudoephedrine-based medications the Prime Minister plans to introduce in his war on P.

Despite Mr Key's soothing assurance that it will become a "prescription-only medication", implying that cold sufferers will be able to get a prescription from their GP then drag themselves off to the local chemist, that won't be true.

The only way to obtain pseudoephedrine legally once the law is changed is if you turn up at a hospital emergency room with an erection that won't subside. I jest not.

It seems Mr Key's trusty new chief scientific adviser, Professor Peter Gluckman, has discovered that this truly versatile drug not only miraculously clears congested Nasal passages and, when used to excess, drives people crazy, it also has a certain talent for relaxing engorged penile blood vessels.

Mr Key didn't go into this sort of detail when he declared war last Friday.

Maybe he feared he'd blush.

Indeed his reference to making it "a prescription-only medication" lulled me into thinking I'd still be able to obtain my pseudoephedrine-laced Nasal decongestant, even if at greater cost and inconvenience than at present.

But the small print of Professor Gluckman's recommendations says otherwise. The drug will be reclassified as a Class B2 controlled drug under the Misuse of Drugs Act, "restricting supplies to hospital pharmacies only".

Mr Key didn't elaborate either when he said there would be exceptions because "there's still a small group of of people who may in some circumstances benefit from using PSE [pseudoephedrine]-based products instead." Once again, the implication was he was referring to cold sufferers. But not so.

The only people he and Professor Gluckman want to give a helping hand to are idiots who have over-dosed themselves on Viagra.

The professor told the PM he had considered a total ban on PSE. "This option would provide the tightest control on pseudoephedrine in that there would remain no legal basis for possession of the substance in New Zealand."

But, all heart, he unearthed research that "there are (rare) medical situations in which the vasoconstrictor activity of pseudoephedrine is useful (for example, the treatment of priapism associated with overdosage of medication for erectile dysfunction) and this level of control may create clinical difficulties."

So knock on Dr John's door with your sinuses inflamed and your head pounding and all you'll get is a sorry, no can do, the fight against P takes precedence over your runny nose. But turn up at the hospital emergency room with the same symptoms below the belt and it will be "how much would you like, sir?"

One could well ask, if innocent cold sufferers have to sacrifice the most effective relief as their contribution to the war on P, then why not the self-inflicted sufferers of priapism? My personal chief scientific adviser at http://emedicine.medscape.com suggests a bag of frozen peas applied to the affected area works wonders in such cases. So, it is said, does a swift whack with a wooden stick.

My scientific adviser also tells me "the exact efficacy of this medication [pseudoephedrine] orally is unknown".

Yet even Professor Gluckman admits that while "objective evidence" of the relative merits of PSE-containing Nasal decongestants versus PSE-free products is poor, there is "anecdotal evidence" that the PSE-containing products "provide greater consumer convenience and possibly effectiveness".

Professor John Shaw, head of Auckland University's School of Pharmacy, has no such doubts. Writing in the Weekend Herald, he says that as a pharmacist for more than 30 years and an occasional cold sufferer, "I can state categorically that there is no better Nasal decongestant than pseudoephedrine, no matter what the expert reports say."

Banning a product that brings great relief to many New Zealanders to protect a few thrill-seekers who use it illegally, sets an interesting precedent. What will Mr Key's response be when the family of a drive-by shooting victim asks him to ban guns? Compared with pseudoephedrine, guns are much more dangerous. In 2002, the Public Health Association calculated that "on average, [there are] 80 deaths and 65 hospital admissions each year as a result of intentional or unintentional use of firearms in New Zealand".

In his review of firearm controls for the Police a decade ago, Justice Thomas Thorp noted there "are some 4000 firearms offences each year" and that "it is ... the most serious offences in which firearms are most likely to be used, and the consequences of firearm offending may be particularly grave".

He estimated there were between 700,000 and one million firearms in New Zealand and that while it was impossible to know how many were kept for illegal purposes, "there is clear evidence of a substantial pool of illegal guns which is periodically refreshed by purchases, theft and burglary, and (to a lesser extent) by illegal imports. It has been variously estimated at between 10,000 and 25,000, and could be higher ..."

And then there's tobacco. Why not declare war on a truly dangerous drug? About 50 per cent of smokers will shorten their lives because of this legal drug. A law to ban tobacco sales would save an estimated 4000 New Zealanders' lives, and the New Zealand economy, $22 billion annually.