So let me get this straight. I walked into my local pharmacy last week with a splitting headache and congestion that made me feel like my face was about to explode. I grabbed a box of Sudafed, headed to the counter, and was told I needed to show my ID, sign a log, and—oh, by the way—I could only buy one box because I’d hit my daily limit.

My daily limit. For cold medicine.

But here’s the kicker: that same pharmacy has Narcan sitting right there on the shelf. No ID needed. No questions asked. Anyone, including teenagers, can walk in and buy it. The same goes for Plan B, the morning-after pill. A 15-year-old could purchase either one without showing identification or answering to anyone.

Now, don’t get me wrong—I’m not saying Narcan and emergency contraception shouldn’t be easily accessible. In fact, I think it’s great that New York has made these medications available without barriers. Both serve critical public health needs. Narcan saves lives during opioid overdoses, and emergency contraception gives people control over their reproductive choices after unprotected sex or contraceptive failure.

But the contrast is stark. And it really makes you wonder about the society we’re living in.
The Cold Medicine Crackdown

Let’s discuss why purchasing Sudafed feels like a quasi-criminal act. Back in 2005, Congress passed the Combat Methamphetamine Epidemic Act, which was rolled into the Patriot Act and became law in 2006. The reasoning was straightforward: pseudoephedrine, the active ingredient in effective decongestants, can be used to manufacture methamphetamine. By restricting access to pseudoephedrine, lawmakers hoped to curb meth production.

The restrictions are pretty tight:

• You can buy a maximum of 3.6 grams per day
• Monthly limit is 9 grams (roughly 2-3 boxes, depending on the product)
• You must show photo ID
• Your purchase is logged in a tracking system
• Products must be kept behind the counter

Now here’s the ironic part: these restrictions have been wildly ineffective at stopping meth production. Large-scale meth operations have shifted mainly to Mexican “superlabs” that use different manufacturing methods, or they import the finished product. Meanwhile, everyday people with sinus infections and allergies are treated like potential criminals.
When the Rules Hurt Regular People

Imagine you’re a single parent. Your three kids come down with a nasty cold—because of course they all get sick at the same time. You go to the pharmacy and realize you can buy exactly one box of the medicine that actually works. Come back tomorrow if you need more. Hope the kids can tough it out overnight.

Or you may have chronic sinus issues and need regular access to decongestants. Tough luck—you’re hitting that monthly limit whether you like it or not. Your only real option? Ask your doctor for a prescription, which may require an additional appointment and copay, adding another hoop to jump through for something that used to be available on regular store shelves.

And if you try to stock up during the cold season, so you’re prepared? The system flags you. You might even get a visit from law enforcement if your purchasing pattern looks suspicious enough.
Meanwhile, No Questions Asked

Compare this to walking into the same pharmacy and picking up Narcan or Plan B. No ID is required. No tracking system. No monthly limits. A teenager could buy either one without anyone batting an eye—and legally, that’s exactly how it should work in New York.

Narcan access makes perfect sense from a public health standpoint. Opioid overdoses kill people, and naloxone reverses those overdoses. Making it freely available means bystanders, friends, and family members can save lives. There’s no potential for abuse—naloxone only works if opioids are present in someone’s system, and it has no recreational value. New York has been a leader in making it accessible, and overdose deaths have been prevented as a result.

Emergency contraception follows similar logic. Time is critical—it’s most effective within 72 hours of unprotected sex. Requiring prescriptions or ID checks would create barriers that could result in unintended pregnancies. There’s no potential for abuse, and the medical risks are minimal. Making it available to minors recognizes that teenagers are capable of making healthcare decisions and might face barriers to accessing other forms of contraception or prenatal care.

Both of these policies reflect a mature, evidence-based approach to public health: remove barriers to medications that serve genuine medical needs and have little to no potential for misuse.
So What’s the Problem?

The disconnect is this: we’ve created a system where the medications with no abuse potential and clear public health benefits are freely available. At the same time, a decongestant that’s been around for decades requires surveillance-level tracking. The logic seems inverted.

Part of this comes down to political theater. Being “tough on meth” was a popular stance in the mid-2000s, and no politician wants to be the one who loosened restrictions on precursor chemicals—even if those restrictions aren’t actually working. It’s the appearance of doing something, even when that something inconveniences millions of people with legitimate medical needs while barely denting illegal drug production.

There’s also a weird paternalism at play. The pseudoephedrine restrictions assume that regular citizens can’t be trusted with cold medicine—that given the chance, we might all turn into amateur chemists cooking meth in our basements. But we’re apparently trusted enough to handle emergency contraception and overdose-reversal medication responsibly.
Has Anyone Tried to Fix This?

Reform efforts have been minimal. Tennessee made headlines in 2024 by increasing their limits slightly—they’d had the most restrictive rules in the nation, and the new law raised the monthly limit from 5.76 grams to 7.2 grams. That’s it. That’s the progress.

At the federal level? Nothing. The Combat Methamphetamine Epidemic Act hasn’t seen significant amendments since 2006. There’s just no political will to touch it. The pharmaceutical industry has lobbied for increased access, pointing out that the restrictions burden law-abiding citizens without meaningfully impacting meth production, but they’ve gotten nowhere.
Living in the Paradox

Here we are, living in a society where a congested adult has to show ID and sign a government tracking log to buy a single box of Sudafed, while a teenager can walk out with Narcan and Plan B, without any questions asked.

Am I crazy for thinking this is backwards? Or is it just me?

Perhaps the answer lies in the fact that both systems reflect different values and distinct moments in time. The Narcan and emergency contraception policies show what evidence-based, compassionate public health policy looks like. The pseudoephedrine restrictions show what happens when lawmakers prioritize political optics and the appearance of being “tough on drugs” over practical effectiveness.

I’m not arguing that we should restrict access to Narcan or Plan B—quite the opposite. Those policies get it right. But maybe, just maybe, we could apply that same evidence-based thinking to cold medicine. Trust people with their own healthcare decisions. Focus enforcement efforts on actual drug trafficking operations, not parents trying to get through the cold season.

Until then, I guess I’ll plan my Sudafed purchases like I’m conducting covert operations, while teenagers pick up overdose-reversal medication more easily than I can buy nasal decongestant.

If that’s not a commentary on the contradictions we’re living with, I don’t know what is.