When was the last time we had a serious debate about why prescription drugs are gate kept? In most countries, you can buy OTC drugs which in the U.S. require a prescription. Removing that barrier reduces costs and improve privacy.
One problem the US has is that prescription stuff is held to a higher standard, but in most other countries the standards for medical stuff and how patients get those things are unrelated. So you could OTC something without lowering the legal standards for quality or testing. The US needs to fix that, keep the standards, but OTC by default unless it can be argued why not.
(Learned this one tinkering on the Airbreak CPAP project.)
https://airbreak.dev/disassembly/
Standard disclaimers apply, I'm not responsible for people bricking their CPAPs or other life support equipment with this information, you live your own life the way you choose. Please don't screw around with a "live" machine hooked to a patient cough.
I was trying to see what the differences were between the lowest-end "start" CPAP and the highest end - while the firmware would flash over, the menu controls wouldn't work due to the changes made on the low end model - but the therapy start/stop did work (and it was delivering the correct therapy I programmed in via SD card with the clinician software).
Not all drugs are intended to treat conditions that laypeople are equipped to self-medicate for. Consider extreme examples to illustrate some of the reasons why: it would be completely crazy for people to attempt to use things like powerful chemotherapy or anesthesia drugs to self medicate. And between these and ibuprofen, there's a bunch of other drugs which could easily be harmful to the user (or the purchaser's dependents) if used under a layperson's unguided judgement.
I think this can be even more important in the US where people have a strong incentive to self-medicate without consulting a doctor.
Acetaminophen is a serious liver toxin that most of us know as Tylenol or paracetamol.
But overuse of them will cause antiviral resistance.
Same problem we've had with antibiotics.
I suspect the much more impactful driver of antibiotic resistance would be the antibiotics feed to live stock in mass.
Paragraph 2.1 of the main PDF on that page, on page 8:
> Increasing scientific evidence suggests that the clinical issues with antimicrobial resistance that we face in human medicine are primarily the result of antibiotic use in people, rather than the use of antibiotics in animals.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7651446/
> In France, antimicrobial consumption (AC) has been high for many decades in both hospitals and the community. Consumption within the community is 30% higher than the mean European rate and 2–3 times higher than the rates in countries with very low consumption and resistance levels, such as Scandinavian countries.
Given the similar mechanisms, they're likely to have the same issues with antivirals as they do with antibiotics.
Dishonesty is not cool.
What evidence would you accept? Is there evidence you'd like to highlight in the other direction?
>> Is there any evidence of this being a problem? Is antiviral resistance more prevalent in France...?
> Evidence, yes.
Either present evidence that France has increased rates of antiviral resistance, or stop gaslighting.
Dishonesty is not acceptable behavior, and is not excused by your mere desire to answer a different question about antibiotic resistance.
Drop this crap and just debate like an adult. You may have a point. But it’s difficult to see if you’re flipping out in the corner.
When people are evasive, or pretend to answer one question by talking about a different one, that is not debating like an adult. It is toxic and prevents genuine discussion.
Flippantly calling something dishonest when it may be miscommunication signals a tolerance for dishonesty. I would be upset if someone said I were dishonest, because I’m not. Someone who is commonly accused of dishonesty may be more ready to level that argument unsupported.
See what I did there? Do you see why that is not only counterproductive, but also immature?
If you really think someone is simply lying, downvote and move on. Self-congratulatory behaviour adds nothing to the discussion.
As far as the innuendo that I'm projecting or something, you are entitled to believe whatever you like. As for me and my interactions both in real life and online, I absolutely will not tolerate people who lie. Whether you do or not is up to you, I suppose.
I was in Spain a few months back and basically any drugs are only sold in pharmacies. And, at least one drug (Aleve brand name) which is broadly available OTC in the US generally requires a prescription in Spain and maybe France at least.
And you’re sure as heck not getting any antibiotic stronger than a first aid cream without a prescription in Germany.
In a conference few years ago, we had couple LEO speakers and DEA agent , as an example, simply stated that cough medicine being gated in US is the price we need to pay for the way things are now.
I am admittedly on the fence. As a younger person, my response was 'everything for everyone; no restrictions'. These days I hesitate more.
OTC cough medication is literally everywhere in the US... are you talking about something more specific?
edit: The net effect of those being that anything that actually works requires prescription.
[1] https://www.reuters.com/world/us/us-fda-seek-public-opinion-... [2] https://www.webmd.com/parenting/teens-cough-medicine-abuse
It basically serves as a way to sell people OTC decongestants, since the one that actually works (pseudoephedrine) is BTC.
How do people keep buying it and using it if it genuinely doesn't do anything for them?
2. people believe the box and/or ads
3. it comes in combination drugs and people don't actually know what each drug does. many people simply "buy cold medicine" when they have a cold, with no thought to the mechanism of the components.
If you're in a place where it is legal you haven't tried it before, next time you have a stuffy nose, give it a try. It doesn't do anything at all, and studies prove it!
The reason I asked is that I've tried the OTC decongestant sprays (which I believe have phenylephrine in them?) some years ago, and they've worked damn well. I don't really believe that the sprays don't work, if that's the claim. But I don't know enough to tell whether the phenylephrine in particular has any effect, and I didn't memorize the ingredient lists of the ones I've bought and tried.
They're likely multi-medication sprays. Even if they were purely phenylephrine as an active (lol) ingredient, saline nasal spray (water!) helps with some stuffy noses, especially allergy-driven ones.
"A spray with phenylephrine in it worked" and "the phenyleprhine worked" are very different things.
It is a legitimate vasoconstrictor, but not when taken orally. https://www.cnn.com/2023/09/12/health/phenylephrine-tablets-...
> The agency approved phenylephrine for over-the-counter use in the 1970s, but it became even more common after 2005, when legislation restricted access to OTC drugs that use a similar decongestant ingredient called pseudoephedrine.
> Phenylephrine works by temporarily reducing the swelling of blood vessels in the nasal passages. A respiratory infection or allergies prompt the body to send white blood cells to the nose, throat and sinuses, leading to swelling in the nasal membranes and the creation of mucus. Decongestants constrict the blood vessels in the sinuses and nose, reducing the swelling and helping fluids drain.
> In pill form, some scientists say, phenylephrine gets absorbed by the gut and is metabolized so well that only a tiny bit makes it to the bloodstream, where it is needed to reach the nose, according to the citizen petition that asks the FDA to pull the drug from store shelves. A citizen petition is a way for industry, consumer groups or individuals to petition the FDA to change regulations or take other administrative action.
That is nasal not oral. The mechanism of delivery matters, and those aren't directly comparable to the oral medicines which are currently under scrutiny.
> the agency said that its order would only be related to the oral drugs and not the spray form.
"They wouldn't sell it if it didn't work!"
People buy homeopathy for the same reasons. "It cured my cold! I took it for a couple of days and the cold went away!" Forgetting, of course, that colds resolve on their own in that same timeframe.
Functionally, no, it won't. The ingredient doesn't do anything; it's a scam.
I also have a prescription for this ointment to treat eczema. Last time I ran out I tried to call my dermatologist for a refill, but apparently he's retired now. So just to get this stupid skin cream I had to make an appointment with another doctor, wait a month, and pay money when I already knew exactly the medication I needed from the pharmacy.
It's cartel based regulations by the AMA. Everything about being a doctor is gate kept. Prescriptions, test results, even becoming a doctor is artificially made harder than it needs to be to keep prices high.
One doctor on HN told me why patients could only get test results through another appointment with the doctor. I thought it was because the docs wanted more money. He told me it was because patients can misinterpret results and go suicide. Yeah makes total sense treating patients like simpletons to keep the money funneling in. Suicide?. Give me a break.
It's criminal behavior disguised as concern.
Everyone can get it. Not everyone can get it prescribed. But I have previously-prescribed medication which I now just order in bulk overseas. Not because it’s cheaper (it is). But because the hassle of getting prescriptions filled every month is tedious.