Should pseudoephedrine (trade name Sudafed) be among your preps? In this podcast, Salty and I explore the upsides and downsides of this potent drug. (The usual caveat: We’re not physicians and don’t give medical advice. This is for your information only.)
What is pseudoephedrine?
Pseudoephedrine gets its fame from looking like someone even more famous. The real stars of the show are epinephrine and norepinephrine. When you encounter stress, you need to do some things to help you cope: Raise your blood pressure, constrict blood vessels, speed up your heart, open your airways. Epinephrine and norepinephrine are the hormone and neurotransmitter that tell your tissues to do all of these things.
Pseudoephedrine goes by the Sudafed brand, or a host of generic versions.
Pseudoephedrine looks like these molecules, so your body mistakes it for these molecules and has a lot of the same responses it would normally have to stress.
Pseudoephedrine is a powerful decongestant
Stress responses constrict blood vessels in the nose and sinuses and reduce mucus production. This destroys nasal congestion. Pseudoephedrine is a great decongestant. It lets you breathe when you were clogged and reduces sinus pressure when those air spaces in your skull were full of bottled up fluids. Sweet relief!
It’s been nicknamed ‘diver candy’ because it’s so popular with scuba divers. When you dive to the bottom of a pool, you feel the increased pressure in your ears and sinuses unless you help the air move in and out of them as you change depth. That effect just keeps getting stronger as you go deeper. Doing it with blocked sinuses will totally ruin your day (week, maybe month) by overpressuring delicate membranes. Pseudoephedrine will help keep your sinuses from getting inflamed by all the pressure changes.
Sinuses are spaces in your skull that can get congested just as your nose does. It’s not fun. *
It can be of some help in opening airways in asthmatics as well.
I’ve known people to use pseudoephedrine as a mild stimulant when they wanted to stay up and study longer.
So what’s the problem with pseudoephedrine?
Every drug that actually does anything has its downsides. The good news? Pseudoephedrine mimics stress responses to decongest nasal passages and sinuses. The bad news? Pseudoephedrine also mimics stress responses in raising blood pressure and heart rate. It raises alertness and reduces sleep – whether you want it to or not. Those are things everyone should think about before taking it.
The social problem with pseudoephedrine
More troublesome with this particular drug are the issues involved with buying it. For many years, it was just another over the counter drug. That changed about the same time the millennium did, around 2000. I remember going to a local (pretty sketchy) giant flea market and seeing whole tubs of Sudafed. I was puzzled; was it just the residues of a store going bust? Who could want that much pseudoephedrine?
Methamphetamine producers could. Pseudoephedrine and ammonia are its prime constituents, and ammonia is all over rural areas in big tanks; it’s a fertilizer. As a result, rural areas like ours were awash in meth makers. Since we have to let the farmers have the ammonia, law enforcement has made the pseudoephedrine hard to get to throttle the meth production.
Most places, one has to show an ID to even buy Sudafed. Although it’s perfectly legal to sell over the counter, every buyer’s name gets put in a database so they can track how much you’re buying even if you spread it over multiple stores. Some places require prescriptions for it, and other stores just quit selling it because of the hassle.
So what are other options for pseudoephedrine’s jobs?
Stores will happily sell you pseudoephedrine’s first cousin, a chemical variant called phenylephrine (or Sudafed-PE). It’s freely available because you can’t cook meth out of it. The bad news is, it doesn’t work nearly as well as actual pseudoephedrine. It does decongest most people somewhat, but the effects wear off long before it’s safe to take another dose. It’s about as satisfying a substitute as a vegan hot dog. (There are lots of very good vegetarian meat substitutes out there. But the hot dogs are totally sad.)
Oxymetazoline nasal sprays do an Excellent job of decongesting. There’s a big stinger in their tail though. If you take them for very long, your body adapts to the drug and reduces its own decongesting actions to compensate. Then when you quit the drug, you have to suffer through a period of awful ‘rebound congestion’ before your own system gets back on the job. No Fun! Salty and I do use the sprays to sleep when we’re really clogged up, but we have a firm ‘three nights and out’ policy.
Reducing the development of allergies in the first place, such as by using loratidine (Claritin, Alavert) or diphenhydramine (Benadryl). Diphenhydramine totally puts a lot of people to sleep though, so it’s a lousy choice unless it’s time to sleep.
A good non-drug option
Our favorite approach is using nasal strips. They’re like bandages with a springy bit of plastic in the middle. You put them over your nose and the physically hold open nasal passages, with zero chance of drug problems. Bonus: They often reduce snoring and more importantly, sleep apnea. The only real downside I know of is they don’t have a great shelf life; for preppers they’re a ‘rotate’ item, not a ‘store and forget’ item.
Nasal strips (BreatheRight or similar) improve breathing and reduce snoring without drugs.
*Thanks for the image to CFCF [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)], from Wikimedia Commons
