Recognizing Methamphetamine Abuse at the Pharmacy Counter

Five percent of the U.S. population is believed have used methamphetamine at some point in their lives, according to the Pharmacist’s Letter (June 2013). This means there’s a good chance a pharmacist working today may come across patients who use the drug.


Read below for some tips on seeing the signs of meth use/abuse in your pharmacy patients.


As you no doubt know, the Combat Methamphetamine Epidemic Act of 2005 (CMEA), enacted into law in 2006, requires that OTC sales of PPA, PSE and ephedrine (ingredients used in the making of meth) are limited to 3.6g per day and 9 g per 30-day period per person. This goes for retail pharmacies as well as mail-order pharmacies. Also, non-liquid forms of these medicines must be sold in two-unit blister packs and retail pharmacies must place them in a locked cabinet and/or behind the pharmacy’s counter to deter quick access by customers.


In addition, the seller of these drugs must keep an electronic or written log of sales, identifying the purchaser, the product and the quantity sold. The person buying the drug also must show an acceptable photo ID and provide his or her name and address. The seller of the drug must verify that the name in the logbook is the same as the name on the form of ID. These logs must be maintained for two years from date of purchase.


Buyers of these drugs also must be at least 18 years of age.


Each state also has its own laws regarding the sale of these drugs, but federal law often is more restrictive. You can access the restrictions for each state here.


It’s extremely important that pharmacists are familiar with the signs of meth abuse. Physical signs include:

  • Skin sores
  • Dental issues
  • Agitation
  • Paranoia
  • Hyper or violent behavior

Users also may be inclined to purchase the following items (to help them in their meth creation):

  • Glass flasks/funnels
  • Coffee pots and filters
  • Iodine
  • Matches
  • Anhydrous ammonia (often found in cold packs and fertilizers)
  • Nail polish remover
  • Rubbing alcohol
  • Plastic soda bottle and gas cans
  • Mason jars
  • Brake cleaner fluid
  • Coolers
  • Rubber tubing
  • Drain cleaners
  • Salt
  • Camera batteries
  • Hydriodic acid (found in disinfectants)
  • Rubber gloves
  • Bunsen burners
  • Duct tape
  • Propane/butane

If you believe a customer/patient is abusing/using methamphetamine, you should follow your company’s policy and report any suspicious activity to appropriate medical and law enforcement/safety authorities. Don’t confront the individual: meth users’ behavior can be very erratic and you could put yourself, your colleagues and other pharmacy customers in danger.

If you’re a pharmacist of pharm technician looking for new opportunities, don’t be shy: contact the recruiters at Rx relief®. Whether you’re looking for temporary positions (more flexibility) or more permanent work, we can help. We look forward to hearing from you.