From what I gather, the main line of reasoning for wanting all drugs OTC is the idea of a smaller government, less regulation, and the idea that a person needs to take personal responsibility for drugs. You want to get high on Vicodin? Have at it! But no complaining if you ruin your liver, or die, or what have you. Think you have disease A and want to save money by forgoing a doctor and getting the medicine yourself? Well, good luck, and let’s hope you’re right! If you’re wrong, it’s your own fault if you get worse and die, right?
But they seem to gloss over the issue I raised in that thread…bacteria (and to a lesser extent, viruses) evolving to become more resistant to the medications we use to treat them. This doesn’t just affect the person taking the drugs…they can help to breed a super-strain of bacteria, and spread it to the population.
We already have the problem of people not taking their antibiotics properly…they don’t take all their pills, stop taking them when the feel better rather than finish out the bottle, etc…this is bad enough on it’s own, but then combine it with taking the wrong medication, taking it when it will do no good (for a cold or flu), and the problems compound.
So…to those who advocate drugs be OTC, do you really want ALL drugs OTC, or do you think that simply loosening restrictions would be better? For instance, allow more drugs for subjective illness/disease (like painkillers, muscle relaxants) or ones that are less likely to be misused or cause health problems to the public (birth control, ED pills, etc…) to be sold OTC, while things like anti-virals, antibiotics, etc… be kept prescription only?
What you said is what I think.
We already sell many, many, many forms of acetaminophen OTC, which can kill you with ten pills, and we sell them in bottles of hundreds. The problem is not keeping people from damaging or hurting themselves, it is to stop the stupid war on drugs. I agree that 89% of the time, an individual will prescribe themselves or their family the wrong antibiotic. That’s why Docs don’t have family or selves for patients, for one thing.
Otherwise, turn it loose!
With OTC narcotics, like booze, those who want to kill themselves already mostly already are. I agree there would be a small spike in deaths, etc, but the reason junkies die is usually because the supply becomes too pure, and not that they don’t know their limits. With prescription clean drugs, not a problem.
It may seem these are deeply related, but they are incidental
a) Yes, I really do want all drugs unregulated from a dispensing standpoint.
b) In that thread, I must shamefully admit I was running a gotcha that if we have decided that the government controls dispensing, then the government controls dispensing (a followup comment) and the objections of pharmacists don’t amount to shit. Can’t sell LSD, must sell Plan-B—that’s life under the thumb, deal with it.
On-topic:
I believe people are broadly responsible, and we should not overwhelmingly stand in the way of responsible people because some are irresponsible. DUI is a crime, not drinking alcohol. There are massive costs associated with free drug use. But there are massive costs to the war on drugs, as well. I simply believe we have made the wrong choice from a cost/benefit standpoint.
Right. Meanwhile, how many hundreds of thousands of people in jail for drug use will be out in society? If they don’t have to pay the black market rent, could they be at least marginally productive instead of a massive drain on the justice system? How many people are denied college aid because of a little pot? How many people die because drugs aren’t released fast enough? How much more expensive is a narcotic or stimulant habit because you can’t just go to the pharmacy to pick up a generic brand? (And how much crime is caused by this additional price? And how many die because of unregulated products?)
There will be costs and benefits to either position. Obviously we’d like to reap all the benefits of both positions without paying any of the costs but this is not possible and we have to make hard choices.
and also, how about making the requirement instead of a doctor’s prescription of the antiviral or antibiotic, that there be some evidence the person needs it (a test of some kind they could pay for in lieu of prescription)?
Meantime if we want to stop immunity in bacteria we first need to make illegal the practice of giving healthy animals antibiotic in their feed… that’s the primary driver of the evolving immunity as I understand things, not over prescription…
Just thinking out loud here, but in some countries I’ve been to (Thailand and Vietnam just to name two), a wide range of antibiotics are available OTC, and they’re insanely inexpensive too. The house I’m currently living in (big family, ten or twelve people depending on what day it is) has a cache of them. But I people here aren’t popping them like tic-tacs, so there doesn’t seem to be the abuse problem that there is in the USA. A few people I’ve asked say they’ll take meds when told to either by a doctor or a pharmacist. So even though they have antibiotics in the house or easily available OTC, they still seek out professional advice before taking them.
But it’s way cool that I can get my Omeperazole for 5 cents a dose here
Eta: to speak more directly to the op, I guess I support it by virtue of not lobbying against the status quo. That is, most meds are OTC here and there doesn’t seem to be a huge problem.
I want all drugs OTC for the reason you state - it’s disgusting that the government should be allowed to regulate what one takes.
I also recognise that allowing antibiotics to be given out would lead to superbugs, a horrendous evil - and therefore despite it being morally and ethically wrong to restrict antibiotics, we have to do it.
Having said that, that is the only category of drugs about which I feel this way (although maybe antivirals may count as well, I dunno). Doing an evil needs huge justification.
In particular, I am all for opioids being given out like sweeties. Doesn’t have to affect anyone else. I know it’s not nice to live with an opiate addict, but no one forces you to.
I don’t think prescriptions are there to stop addicts. They’re likely to be able to find the drugs prescription or no. They prescriptions are primarily to stop people who are taking opioids for originally legitimate purposes from continuing to take them longer then they should and becoming addicted. This is the largest source of new people becoming addicted to pain-killers, and having a doctor and pharmacist enforced cut-off keeps it from being a bigger problem then it would otherwise.
Painkillers are also difficult to self-regulate, as people build tolerances fairly quickly. So that’s another good reason for doctors and pharmacists to have a firm control on how much individuals are taking.
Folks do remember that there are more types of drugs than antibiotics, antivirals and narcotics, right. Are some people really saying that they think it would be just peachy if they could wake up in the morning and say “You know, I think I’m depressed. I’ll pop down to Walgreens for some MAOIs. Or should I get tricyclics? SSRIs? Ah fuck it, I’ll get the combi-pak!”
Or maybe you check your BP at the machine in the mall and find out it’s a little high. “Off to Rite-Aid for some ACE inhibitors!” As someone who blacked out due to low BP during the adjustment period on a new medication (lovely concussion that was, lucky I wasn’t driving as I would have been 5 minutes later) I think the idea of unrestricted access to all drug classes is not only stupid, it’s dangerous.
Some things are too fucking dangerous to let the average Joe select for themselves, especially as it may impact others.
So you’d be totally OK with the idea that some idiot can self-diagnose, self-medicate, black out while in control of a vehicle and kill bystanders 'cause that’s the price ya gotta pay for freedom. If, so, I have no words.
I’d love to see basic antibiotics available OTC. Why should I wait 2 days with pus using out to get something for the infection? It can’t be a question of bacteria vs. virus because its an established fact that doctors will prescribe antibiotics for colds. Anti-biotic resistance? That’s a problem even without the OTC issue.
But yet you hold the position that would lead to a lot more people dying than the current policy. Usually drugs are not OTC for a reason. It’s especially easy to figure out why opiates are prescription only. I’ve known several people that have died from a prescription opiate overdose and I can only imagine it would be a lot more if it were easier to obtain.
No. I hold a position that would lead to a lot more people dying of self-medicating. Less people would die from getting shanked in prison for their heroin addiction. Less people would die from gangs having the funds to act as an ad hoc standing army supported by black market rents. Less people would be in prison. Less funds would be spent on regulating, which could be spent otherwise.
Yes, if you are only willing to look at the costs of my decision, and only the benefits of yours, then my way is definitely madness. You’ll forgive me if I resist such an analytical method, though.
Seeing as the costs of your position can, and will, include the needless deaths of innocents, I think you might need to analyze it a little past the “war on drugs evil” part. Or maybe you think more road accidents, persons acting out while on psychoactive drugs, suicides including “hell let’s kill the family as well” and such are a good thing. I would hope not.
But how would you know which antibiotic you need? And while some doctors have been known to prescribe needles antibiotics to “shut their patient up,” most don’t, and I believe fewer and fewer are as of late, though I don’t know that for sure.
And storyguide3 brings up an interesting point…someone takes medication XYZ, and either takes too much, too little, or it’s entirely wrong for them, and as a result (crashes their car, wanders out into the street, has a psychotic episode) they end up injuring or killing someone…is that still an acceptable “side effect” of less regulation on drugs? Is the idea that less people overall might die because the War on Drugs will, at the very least, be minimized make it ok? Even if it’s one dead innocent bystander vs ten dead gang-bangers?
And FTR, I am in favor of a little less regulation myself, but not to the extent some people seem to be advocating in this thread. Mostly, I think it would be nice to have slightly stronger pain meds availble, if not OTC, then just by getting directly from the pharmacy counter without a presciption, like how pseudoephedrine is handled now…but not necessarily with the whole database aspect.
