1618: Cold Medicine

Explain xkcd: It's 'cause you're dumb.
Jump to: navigation, search
Cold Medicine
Seriously considering buying some illegal drugs to try to turn them back into cold medicine.
Title text: Seriously considering buying some illegal drugs to try to turn them back into cold medicine.


In this comic Cueball is probably representing Randall who seems to have been suffering from a long lasting cold that he just can't get rid of. Two weeks before this comic Randall posted another comic about how a cold works: 1612: Colds. This is also supported by the way the title text is phrased to make it sound like something Randall writes, disconnected with the action in the comic (see below).

In the comic Cueball is evidently suffering from a cold and he is searching the shelves labeled cold and Flu at a pharmacy for any kind of cold medicine (hence the title), to alleviate his symptoms. Note that this is all he can hope for, as there are still no cure that really helps getting rid of the cold any faster. All medication can do is help relieving the symptoms until the body's own immune system takes care of the relatively harmless cold virus.

After looking at several different options Cueball is clearly unsatisfied with what he finds. Either he doesn't feel that any of the unmonitored drugs available on the serve-yourself-shelf is useful, or he is actually too sick to properly ascertain which medicine he needs. In the end he approaches the counter and asks the pharmacist (Ponytail) to give him one of every kind of cold medicine which requires an ID to purchase. Two years later Randall finds a solution for Cueball's problem with a new cold medicine with only active ingredients, including among other all the active ingredients from all the cold medicines on the market, see 1896: Active Ingredients Only.

Warning: Taking lots of different medicines together in real life could harm, or even kill you, because certain combinations of medications interact in ways that make them dangerous or even lethal.

Ponytail tries to warn Cueball of another danger, that by simply purchasing so much cold medicine he would end up on a law enforcement watchlist, presumably one of the government agencies (DEA, FBI, CIA etc.) But she never gets to finish her sentence because the sick Cueball is beyond caring and tells her this.

In the USA, cold medicines containing pseudoephedrine are kept behind the counter and IDs purchasing them are monitored, because pseudoephedrine can be used to make the scheduled drug methamphetamine or meth (a more hydrophobic - and thus potent - version of amphetamine). However, it is also an extremely effective decongestant (a pharmaceutical drug that is used to relieve nasal congestion/plugged nose), much more so than the common substitutes such as phenylephrine and oxymetazoline which have no clinically proven decongestant effect.

This could be one reason why Cueball just requests all kinds of cold medicines of amongst other this type; he does not appear to care what exactly he is purchasing, believing that his one criterion will provide him medicine powerful enough for his illness. It may also be that he is just too sick to care or realize that this will arouse suspicion of him being a drug dealer, or to recognize the need to select only one medication of these type.

The title text seems to be Randall's own comment on how badly he is affected by his cold. He thus, humorously, suggests that he is now ready to purchase illegal drugs (this would then be meth) in order to turn it back into a cold medicine (i.e. pseudoephedrine). This would not be safe to do, but may be a reference to this spoof paper: A Simple and Convenient Synthesis of Pseudoephedrine From N-Methylamphetamine, a take on the long-going joke about the recent difficulty in obtaining pseudoephedrine, i.e. it is now easier to get your hands on the illegal drug made from it.

It is a humorous exaggeration of how far Randall is willing to go to get the best cold medicine, and the potency of the drugs needed to treat his apparently debilitating illness. There are many illegal drugs that when first synthesized were planned to be used as a medical drug, but then later abused by drug addicts, but given the subject of the comic, the title text obviously refers to meth.

Randall continued in the medical world with the next comic: 1619: Watson Medical Algorithm.


[Cueball is standing in a drug store, with a drug in his hand he has taken from the shelf he is standing next to. The shelf is labeled.]
Cueball: *Sniffle*
Label: Cold & Flu
[Cueball is standing alone, examining some medicine he is holding up, while having some other medicine in the other hand.]
Cueball: *Cough*
Cueball: *Sniff*
[Cueball continues examining more medicine. Looking down on one in his hand, having another in the other hand and there are also three packages at his feet.]
Cueball: Ughhh...
[Cueball is at the labeled counter in the drug store with computer etc. Ponytail is behind the counter.]
Counter label: Sale
Cueball: Just gimme one of every kind of cold medicine you need ID to buy.
Ponytail: You'll go on the watchlist for—
Cueball: Don't care.

comment.png add a comment! ⋅ comment.png add a topic (use sparingly)! ⋅ Icons-mini-action refresh blue.gif refresh comments!


I would question the assertion re: oxymetazoline having no decongestant effect. Oxymetazoline is the active component of Afrin and similar nasal sprays. Like pseudoephedrine, it is an adrenergic receptor agonist vasoconstrictor that is quite effective at shrinking swollen intranasal tissue (turbinates e.g.). Such swelling creates the sensation of a blocked nasal airway aka "stuffy nose" or "congestion". It works so well that people can become dependent on the sprays because stopping them causes "rebound congestion" aka rhinitis medicamentosa. Oxymetazoline may lack the bronchodilation/smooth muscle effects of pseudoephedrine (I'm not sure), but that's a separate issue. 22:37, 27 January 2016 (UTC)

How hard would it actually be to turn street drugs back into cold medicine? Benjaminikuta (talk) 05:41, 18 December 2015 (UTC)

- I'm unsure on the actual scientific accuracy of this, given it is a fake paper, but http://heterodoxy.cc/meowdocs/pseudo/pseudosynth.pdf 05:49, 18 December 2015 (UTC)

This is in reference to recent studies that have proven that Phenylephrine is no worse than a placebo. https://en.wikipedia.org/wiki/Phenylephrine http://www.annallergy.org/article/S1081-1206(10)60240-2/abstract 06:53, 18 December 2015 (UTC)

- I keep hearing about this Placebo. It seems like a very potent medicine that is good for everything. Where can you buy it? (talk) (please sign your comments with ~~~~)

Just get anything that is labeled 'homeopathic'. -- 10:55, 18 December 2015 (UTC)
In more than 100 countries it is manufactured under the brand name Tic Tac and available even in supermarkets. -- Hkmaly (talk) 13:41, 18 December 2015 (UTC)
The web site http://www.penisreductionpills.com/ openly admits to selling only placebos, perhaps you could try there? 21:04, 21 December 2015 (UTC)

-I don't know about the paper specifically, but by the principle of microscopic reversibility (https://en.wikipedia.org/wiki/Microscopic_reversibility), not only can you turn the products back into the reagents, you can do so using the exact same mechanisms. Chemical reactions are always going both ways, and they will tend towards the equilibrium from the higher concentration ~pure meth. That does not say anything about practicality, I am not versed in meth-synthesis, but maybe it involves a process with a product harder to acquire than pseudoerphine (maybe because it is useless and simply disposed of) which would be required as a reagent in this case. I don't know. 00:29, 19 December 2015 (UTC)

I don't think it's suggesting turning meth back to medicine. I think it's a reference to heroin and at least a handful(?) of other now-illegal drugs originally introduced purely as medicinal products. Xseo (talk) 12:13, 18 December 2015 (UTC)

- i respectfully disagree, i reckon its exactly suggesting that ... Need cold medicine so bad i would buy illegal drugs made from cold medicine and seek to reverse the process. Obviously not the most practical way of getting cold medicine ... but thats the joke.Plm-qaz snr (talk) 13:08, 18 December 2015 (UTC)
I concur with Plm-qaz snr --Kynde (talk) 18:56, 20 December 2015 (UTC)

Codeine was originally a cough suppressant. It was and is the most effective and reliable cough medicine available and very safe in the usual quantities. You can't get it, though -- for an ordinary cough -- because some people like to use a lot of it for fun and sometimes get addicted to large quantities of it. You could synthesize it or an analogue of it from heroin or oxycodone about as safely as any kitchen chemistry because they share the same opium base.

The principal cold medicines are cough suppressants (codeine is best -- other things work but much worse), decongestant (pseudoephedrine works great, phenylephrine is no more effective than a placebo), mild anti-inflammatories like ibuprofen, and antihistamines for anti-sneezing (there are many good ones based on Seldane like Claritin). Most people like to combine those at nighttime with a good mild tranquil sleep promoter -- I recommend whisky or rum. Note that pseudoephedrine is banned in some states of the USA such as Oregon. 13:58, 18 December 2015 (UTC)

There are OTC cough suppressants, perhaps most notably dextromethorphan; cough drops and tea are also sometimes used for this. You also forgot a category, expectorants (the most common OTC one being guaifenesin), which don't prevent coughing directly but are nonetheless good to take if you are coughing a lot because of stuff being in your lungs that shouldn't be. (If you're coughing because of throat irritation, then an expectorant won't help with that, go for the cough drops and tea and maybe dextromethorphan.)

But yes, apart from various vapor therapies that superficially clean out mild nasal decongestion (menthol -- often found in cough drops -- is the most common, but e.g. hot pepper products can also work), the only over-the-counter decongestant that's any good at all against a head cold is pseudoephedrine, which you have to show ID to buy these days. If Randall had a really bad head cold and was trying to treat it with the stuff you _don't_ have to show ID to buy, he'd have been miserable. It's easy to imagine a person in that situation reaching the end of his rope and concluding that he needs the real stuff, regardless of what watch lists it might put him on. (Though in practice, I doubt very seriously whether buying any normal quantity of the stuff could get you on a watch list. They're watching for people buying the kinds of quantities you'd need if you were trying to run a meth lab, which even if you use several buyers and go to every drug store in town is still not really in the same volume category as what someone with a cold would normally be expected to buy.) --Jonadab, 2015 Dec 22, 11:58pm EST

I take the title text differently - that since buying pseudoephedrine-containing drugs legally in a larger than minimal quantity (e.g. to stockpile them at home to have them at hand when you need them) already makes you a criminal suspect with 100% certainty (because you have to show your ID), it may be safer to buy illegal drugs on the black market, where you have at least some chance of not being caught. As for turning meth back to PE - it is possible for sure, since all chemical processes are reversible in one way or another, but I am not versed enough in organic chemistry to say if it is easier or harder than the other way round. -- 12:33, 18 December 2015 (UTC)

Burning is chemical process. Creating wood from ash is generally considered unpractical. -- Hkmaly (talk) 13:41, 18 December 2015 (UTC)
Yes, it is impractical. However, due to one of the fundamental principles of quantum mechanics being the fact that information can't be destroyed, only obfuscated, scatter, maybe even left out of reach, but never destroyed, all the information needed to turn the ash back into wood is still in the universe. All that is left to do is retrieve all that information and figure out a way by which everything can become uncombusted, and you have it turned back into wood. Sure, it would be easier to use the ash as fertilizer to help grow another tree, but it isn't impossible.Mulan15262 (talk) 14:50, 18 December 2015 (UTC)

You'd have to reacquire and reassemble not just the ash, but the smoke and gases too. Miamiclay (talk) 05:47, 19 December 2015 (UTC)

Today I learned that you can make methamphetamine from Pseudoephedrine! 18:34, 18 December 2015 (UTC)

From the start of the pseudoephedrine/meth fiasco, the only thing I on my mind was "what a waste of perfectly good Sudafed!" Schiffy (Speak to me|What I've done) 02:09, 19 December 2015 (UTC)

Is it worth mentioning that he posted a comic relating to colds two weeks prior? (1612: Colds) Perhaps Randall is in a rather extended bout and at the point where buying meth to synthesise pseudo just seems like the logical thing to do. 03:13, 19 December 2015 (UTC)

Very much. I had already incorporated into the explanation that Cueball = Randall here, at least in the title text. So I will add your observation as another reason to believe this. Was wondering why no one else could see that it was Randall who had a cold. And now it seems like it is a rather long one. --Kynde (talk) 18:56, 20 December 2015 (UTC)

This is actually semi serious. When I have a cold, literally the only thing that works is pseudoephedrine. And Sudafed, which is the registered label for pseudoephedrine, now sells Sudafed without the pseudoephedrine. In a cold induced daze I have actually managed to buy the not pseudoephedrine Sudafed, and only realized my mistake several days later when the cold symptoms aren't going away. "Give me the stuff I need an id to buy" is a pretty reasonable response, although of course asking for one of everything is a bit over the top and includes things that aren't pseudoephedrine. (talk) (please sign your comments with ~~~~)

This (as the comment above) also make a lot of sense for this comic. Will try to include it in the explanation- --Kynde (talk) 18:56, 20 December 2015 (UTC)

The explanation currently says "...who as anyone else is very likely to have a cold at this time of year (released in December)". I am about to edit this to be more region specific, because many parts of the world are hot in December (including Australia where I live) which means colds are uncommon at this time of year. Martin (talk) 21:54, 20 December 2015 (UTC)

In the United Kingdom at least one cough suppressant available OTC contains a small amount of morphine. (talk) (please sign your comments with ~~~~)

You can also buy morphine OTC for an upset tummy, in the form "Kaolin and Morphine". Martin (talk) 22:59, 21 December 2015 (UTC)

Apologies if I've missed this exact take on the hovertext, in amongst the above, but my reading of it is that right now, where illegal drugs are unobtainable, legal drugs are converted into them (for fun and/or profit). But the problems of getting the legal drugs are even greater (either because of the confusion, the pharmacy refusing to sell large amounts or just the threat of the watch-list) and so the illegal ones are more obtainable, in the hope of being back-converted into the desired 'legal' ones.

Also, there's also this issue about multiple packet designs just being the same thing, that happened recently. There's possibly a link, but I'm not sure. Personally, I swear by placebos! 00:04, 22 December 2015 (UTC)