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Comment by justinclift | Hacker News Reader

> Grocery store carts are more likely to have carts with wonky wheels than ... drugstores

Do countries other than the US have shopping carts in their "drug stores"?

For those outside of the US looking to answer, here is some context from the US. “Drug stores” in the US double as convenience stores. There is a pharmacy in the back along with over the counter medications, but they also sell cosmetics, basic prepackaged food, toys, alcohol, magazines, greeting cards, and other such things. It’s not like Americans are buying carts full of drugs. I also think drug stores generally have the small baskets, not the large carts one might find at a grocery store.

Really it's the opposite. It's called a pharmacy, but in practice it is a convenience store first, and a pharmacy second. Often times the pharmacy is closed, has restricted hours, is understaffed, etc.

Not really. Walgreens and CVS are basically this, and many of them have 24 hour pharmacies.

Where in the US do you live that you have easy access to a 24 hour pharmacy?

In my corner of the USA the only 24 hour pharmacy is in the children's hospital, about 15 miles away from my house.

I have three hospitals with ERs within 5 miles but no pharmacy.

Walgreens has quite a few around here. It’s something they advertise.

They were much more common before Covid, when places like Walmart were 24 hours.

Any major metropolitan area. Walgreens has dozens of 24 hour pharmacies in the Chicago metro area: https://www.walgreens.com/storelocator/find.jsp?24-hour-phar...

Today I learned another reason that despite appearances Baltimore is not a "major metropolitan area". I'm not being sarcastic, it really doesn't have the economy of one.

But I also wonder if it's just the very largest cities that have easy 24 hour pharmacy access.

> But I also wonder if it's just the very largest cities that have easy 24 hour pharmacy access.

I live near a city with population of about 50k. It has a 24 hour Walgreens.

Wow! I live in a city which is fifteen times larger, and there is no Walgreens open later than 10 PM (nor Rite Aid, nor Bartell); the pharmacies generally close by 8. I wonder why some places get better service than we do?

I live in suburban Detroit, and there's a few 24 hour CVS and Walgreen's near me.

There's both a Walgreens and a CVS near me, and both of their pharmacies close at 6pm. The nearest 24hour pharmacy is not quite two hours away.

> alcohol

Please tell me it's not the drinking kind?

It is a *drug* store.

Where I am (Ohio, USA), drug stores like CVS/Wallgreens sell beer, wine.

Hard liquor over a certain alcohol percent is only available at a state liquor agency.

And cigarettes in Nevada

Like they said, it doubles as a convenience store. In the states where convenience stores can sell alcohol (most of them), yes.

In Washington state, drug stores dedicate as much or more space to booze, including high proof liquors, as they do to medical goods.

Why not?

In many parts of world, it would be seen ironic. Like a gym selling junk food.

Like protein bars?

Yes, but at least at CVS they no longer sell cigarettes https://edition.cnn.com/2014/02/05/health/cvs-cigarettes/ind...

It’s changed now, I’m sure, but growing up in Indiana there were two places to buy hard liquor: liquor store, and the drug store. And the drug store was often cheaper.

I’ve always wondered what convoluted logic lead to passing such a law in 1889, or whenever they thought it was a good idea.

I would describe German drug stores in the same way (except that they don't contain a pharmacy and can't sell over the counter drugs). Smaller drug stores in big cities have a few small carts if any but often it's just baskets that you carry. Larger ones usually have carts. I don't think it's odd for them to have carts though, drug stores sell a lot of cleaning stuff which can be heavy and toilet paper which can fill up a cart pretty quick.

> I would describe German drug stores in the same way (except that they don't contain a pharmacy and can't sell over the counter drugs)

So, in the USA they are called "drug stores" because they sell... drugs. Prescription and over the counter. Are these really called drug stores, or using the German word for drugs, even though they don't sell them... because of their overlap with the non-drug business that the American ones have come to donate more square feet (and prob more revenue) to? Or for other reasons unrelated to USA practice?

Don't know how they are called in Germany but I guess it's similar as in the Netherlands: These "non drug" stores are called a "drogisterij" (and the English translation will be 'drugstore'), which is from a "chemist's shop" which in the past used to sell all kinds of stuff including medicine. These days the real drugstores are now solely called "apotheken" (pharmacies), I guess to distinguish them from each other.

There is some overlap with the two as the pharmacies also sell OTC drugs. edit: The pharmacy where I used to live as a kid was more of a drug store in the US sense with a pharmacy in the back, which also acts as the cashier, and the rest of the store was filled with all kinds of household products like beauty and cleaning.

They are called "Drogerie" or "Drogeriemarkt" which could be quite translated to drug store. Just like in the other comment about the Netherlands, a pharmacy is called "Apotheke" in Germany and only they are allowed to sell prescription drugs and most over-the-counter drugs. You can't get Aspirin or Ibuprofen in a Drogeriemarkt here. I think traditionally the line was more blurred between pharmacies and drug stores but regulations changed that and our drug stores became some kind of specialized (mainly non-food) supermarkets.

I'm actually not sure if the definition of over-the-counter drugs can be applied in the same way in Germany. We have prescription drugs and non-prescription drugs. Non-prescription drugs are still limited to be sold by pharmacies only by default, for example Ibuprofen (but only in small quantities). Some selected categories of less potent drugs or pharmaceutical products can be sold by any store (and even then only if they can prove they employ someone with sufficient expertise).

In Germany you have something close to „drug stores in the US“ but minus the pharmacy. For example: dm, Müller, Rossmann. The bigger ones (especially dm) actually always have shopping carts. It‘s very common for people to buy large things in these stores, like toilet paper, baby diapers etc. which can easily fill a shopping cart.

Yup, actually dm is short for "Drogeriemarkt", which could be translated as "drug market". And yes, due to legislation in Germany, they can only sell things like vitamin supplements, "real" drugs (even non-prescription ones) can only be sold in pharmacies.

My grandfather was a "Drogist" and his job was not to sell drugs, but anything pharmacy/chemistry related: "I got that oily dirt on my jacket" - "Say no more, I mix you the perfect soap for this". That feels quite the same as dm/Rossmann/.. from a customer point of view.

The modern word Droge/drug does not mean what it used to mean.

Seem like that's common in continental Europe.

In Spain in a "droguería" you would find something quite similar to a DM: cleaning supplies, some chemicals, personal hygiene and cosmetic products and the like. A "drogaria" in Portugal probably would a bit more similar like a hardware store, but also in the theme...

> Seem like that's common in continental Europe.

Yeah, it's a very historical thing dating back from times of Marco Polo, the Silk Road, and the likes.

In France we have "pharmacie", "droguerie", "épicerie", and "quincaillerie".

- "pharmacie" is the regulated medical thing, historically it was "apothicaire" (apothecary)

- "quincaillerie" is where you get hardware ("quincaille") like screws, tubes, metal parts, and whatnot, and by extension, tools. By extension "quincaille" coloquially refers to small, cheap stuff in a derogatory way (akin to "lemon" but for small things).

- "droguerie" is where you get various general usage, non-medical stuff, from hygiene to ; it is part of "épicerie", where it used to be "all manners of drugs sold under the merchand guild, from dye pigments to perfume, hygiene products and cosmetics, as well as medicine". In the XVIII century the "drugs" term largely meant "things of small value that you can put on the market" and "mixes for which only artists and craftsmen hold the secret".

With this definition you can see how it grew from "épicerie" (=> "spicery", a shop for spice) from the economy market of bringing such goods from specific countries like North Africa, Middle East, India, China and whatnot. Pigments, spice, and medicine were obtained from foreign sources and highly sought after. Of course this could involve a deal of mysticism and exotic mystery, a perfect recipe for snake-oil medicine and once medical goods began to be regulated it is left with "alternative" medicinal things.

- "épicerie" used to cover all of the above, but today it's your corner-shop that has a bit of everything and is open most of the time to 24/7 (bordering on the illegal, or outright skirting opening hour laws) and saves you in a pinch. These businesses are often held by people of above areas ascendance, not really surprising given the history of it.

There's also "parapharmacie" which sell things like lotions, shampoo, and other hygiene and beauty supplies. (Though not necessarily medicines, although some (most?) will also have that capacity.)

That would be more or less the same than in Spanish:

- "Farmacia" for the regulated drugs

- "Quincalla" is cheap hardware that you could find on a flea market or maybe a corner-shop. Old terms for places that would sell that kind of stuff would be "quincallería" or "chamarilería", but today you would probably go to a "bazar".

- And, as I anticipated, the "opens till late and has a bit of everything" store would be a "bazar", although sometimes is referred using the nationality or origin of the managers (usually from South Asia or China, at least on Spain)

Even old American writings talk of “the chemist” which is clearly an early pharmacist who has various chemicals he can mix to make medicines or house cleaning supplies.

Interesting, I never made the connection. In my language "drogéria" is a store like dm - place to get cosmetics, perfumes, cleaning supplies and other similar chemicals. No relation to pharmacies ("lekáreň" => "liek" = drug).

> "Drogeriemarkt", which could be translated as "drug market".

One has to distinguish between "[die] Drogerie" (more explizit term: "[das] Drogeriefachgeschäft") und "[der] Drogeriemarkt" (in particular in Austria and Switzerland this is strongly distinguished).

Drogerien are specialized shops with well-trained salespeople (Drogist: https://de.wikipedia.org/wiki/Drogist). Drogeriemärkte, on the other hand, are convenience stores that sell cleaning agents, cosmetics, nutritional supplements, ... Because in the latter, prizes are typically much cheaper, they replaced Drogerien in many cases.

For people from Europe not familiar with the big drug stores the parent is referring to: these drug stores are more like a Rossman with a pharmacy counter in the back.

Not familiar with Rossman but with german DM (drogerie markt) & Muller being well represented in my country (and I presumed other ones in Europe) for over a decade or more, I thought this concept had already been established in all of Europe.

In the US, a drug store is a DM with a pharmacy in the back. There are way fewer independent pharmacies in the US nowadays as 'drug stores' have taken over.

Things are getting more interfused all the time, like there is this store 'farmacia' where I live, looks like a pharmacy, sells pills, but you can't pick up prescriptions because it's not a real pharmacy. Then the national postal offices sell gadgets and trinkets, likely because sending actual mail is in decline, and package delivery is better served by private delivery services. Gas stations have even started selling bread because of a new law that prevents grocery stores and malls from working on most Sundays.

Around here gas stations sell bread and other basic grocery things because it gets people into the store.

Our local gas station stores are bigger than the first supermarkets, probably. Multiple aisles and fresh produce, etc.

We had a small chain in Seattle that was an oldschool holistic health store but also had a modern pharmacy attached. The one location nearest our home unfortunately did not have the pharmacy because the owner of the building also leased out to CVS across the street and the lease precluded a pharmacy from being in that location. I feel depressed going into CVS so in the end just moved my prescriptions to mail-order which is easiest (and probably most reliable) anyway.

Part of the reason independent pharmacies have declined is due to pharmacy benefit managers (PBMs). For example, Aetna owns CVS and they force you to go there.

I've certainly been to big Boots stores in the UK with small trolleys - the ones that are like a basket on wheels at waist height

Australian ones have a retail section with band-aids, non-prescription medicine, vitamins, nappies, sunscreen, skincare, hair care and "natural medicines" most of which are borderline frauds.

Maybe no trollies though.

Germany was mentioned, South Africa is another country that has drug stores, including the Pharmacy, e.g. Clicks.

I live in the US and haven’t ever seen a shopping cart in a drug store… maybe that’s why they stay so nice :)

They exist, but they're smaller than supermarket shopping carts.

In Chicago, shopping carts used to be commonly found in Osco Drugs, mostly because they were attached to Jewel Food stores. A few Dominick's groceries had Walgreens drugstores attached, but there weren't many of those.

Yea. Look up DM

Not sure why I'm being down voted for this but dm is definitely eu drug store with carts :D

"DM" is the store name? Do they have a website?

I was thinking you might have been meaning Denmark or something, as it wasn't clear. :)

Didn't down vote you though.

Yes, yes, dm.de

Thanks for the comment :)

Do people in other countries buy paracetamol and aspirin in 10L bottles so they wouldn't need to run their F4999 trucks to a drugstore every week?

Most countries have laws limiting the size of paracetamol & aspirin bottles to reduce overdoses & suicides.

The UK passed a law in 1998 about it and saw suicides from overdoses drop 21% and liver transplants from paracetamol poisoning drop 66%.

"Numbers of tablets per pack of paracetamol and salicylates decreased markedly in the year after the change in legislation on 16 September 1998. The annual number of deaths from paracetamol poisoning decreased by 21% (95% confidence interval 5% to 34%) and the number from salicylates decreased by 48% (11% to 70%). Liver transplant rates after paracetamol poisoning decreased by 66% (55% to 74%). The rate of non-fatal self poisoning with paracetamol in any form decreased by 11% (5% to 16%), mainly because of a 15% (8% to 21%) reduction in overdoses of paracetamol in non-compound form."

What are the limits? (Asked as a US guy who buys the 500 x 500mg bottles at BJ's.)

Interesting. How long does one of those bottles last for you?

---

In Australia, the regulating body for that stuff announced new limits back in 2023. They'll apply from Feb 2025 onwards:

https://www.tga.gov.au/news/media-releases/tga-makes-final-d...

* reduce the maximum size of packs available for general sale (e.g. supermarkets and convenience stores) from 20 to 16 tablets or capsules

* reduce the maximum size of packs available in pharmacies without the supervision of a pharmacist (i.e. ‘Pharmacy Only’ packs) from 100 to 50 tablets or capsules

* make other pack sizes of up to 100 tablets or capsules available only under the supervision of a pharmacist (‘Pharmacist Only’ medicines).

Those limits don't seem all that different from the existing pack sizes commonly on shelves though. So there's very likely some existing limits around pack sizes already.

Not sure about the UK, but in Europe typically pills are sold as blister packs. I don't think there's a limit per se, you can still buy a box of 50 at least.

> Countries where pack size restrictions had not been introduced were predominantly Eastern European [Slovakia, Lithuania, Croatia, Czech Republic, Poland (Lodz) and the Russia Federation (Moscow)].

https://doi.org/10.1111/bcpt.12959

You're allowed to purchase 2 packs of any drug containing paracetamol. Normally a pack contains either 12 or 24 tablets I think. Here's a link to a supermarket's policy: https://help.sainsburys.co.uk/help/products/phc-sale-analges...

Here in UK the limit is two packs per person, and packs are usually 8 or 16 tablets(annoyingly the law is about packs not tablets, so you can't buy 4 packs of 8 tablets even though it's the same as buying 2 packs of 16). Tbf if you do need more you can always buy more from pharmacy in almost unlimited amount, you just have to ask for it at the counter(and I guess the pharmacist might not sell it to you if it's "suspicious" whatever that means).

Painkillers are sold in packs of max 16 tablets in the UK (almost always 500mg for paracetamol, 200mg for ibuprofen). In addition they must be sold in blister packs not bottles, and all shops will only allow you to buy two packets per transaction (mix and match, you can’t have 2x paracetamol and 2x ibuprofen). I believe there are some exceptions for prescriptions.

Obviously you can still overdose by going to multiple stores and popping them all out of the blister packs but it puts enough of a barrier in that you have to be more determined (and more knowledgeable about what amount will actually kill you). Apparently it works.

> I believe there are some exceptions for prescriptions.

You can essentially forget the maximum pill numbers for paracetamol/ibuprofen when it comes to prescriptions in the UK. Doctors can prescribe hundreds of either pill to be given to a patient at once (eg if someone is prescribed to take 8 a day and they get their meds monthly, as is the case with one paracetamol recipient I know, the pharmacy gives him multiple 100x 500mg paracetamol boxes each month.)

(To be clear, "given to them at once" as in dispensing the pills, not giving to take all at once!)

> all shops will only allow you to buy two packets per transaction

They do that indeed, though I am not sure wthere it is the law of their own "do-gooder" policies. I don't think it is the law because it happened to me a few times to just pull a sad face and have the employee at the till just go "fine, but just this time".

This is slightly ridiculous, IMHO: You can buy more if you want, just split transactions. And of course no-one stops you from buying a trolley-full of vodka and bleach.

>This is slightly ridiculous, IMHO: You can buy more if you want, just split transactions. And of course no-one stops you from buying a trolley-full of vodka and bleach.

You can split transactions, but committing suicide takes effort, and a relatively significant rate of suicides are impulsive. For impulsive suicide, having a barrier or interruption can prevent the attempt. Something as small as a phone call interrupting you as you get the pills out could be sufficient to move past a particular impulse.

There is also a huge difference in suicide attempt method depending on gender. Women tend to gravitate towards pills, while men are more likely to use a gun.

The impulse has to be to eat the tablets or whatever's on hand. Going all the way to the shop to stock up on tablets does not strike me as impulsive.

So IMHO this restriction is an attempt at limiting the stock people have at home. Although I would argue this is none of the shop's business and, as far as I can gather, this is not a legal restriction.

It is a legal restriction and it has saved hundreds of lives.

https://www.ncbi.nlm.nih.gov/books/NBK374099/

The pack size is a legal restriction, not the number of packs you can buy in one transaction as long as the total number of tablets does not exceed 100 (i.e. legal restriction is in effect 6 packs in one transaction), from what I understand, while the 2-pack restriction is a "voluntary best practice".

Those 'voluntary' limitations, and there are others, are a bit of a pet peeve of mine because they strike me as hypocrisy/posturing/paternalism.

I think the main thing is the blister pack requirement, you can't just unscrew the lid and down a bottle.

Limiting to two... I don't know, it has occasionally annoyed me (when I think I want to 'stock up') but I suppose there's just no reason you actually need more than that at once (other than self-harm or with a prescription) so meh why not if it has a small chance at stopping a few suicide attempts.

> So IMHO this restriction is an attempt at limiting the stock people have at home

Correct. But this isn't a bad thing - it means people are less likely to have a large supply of dangerous pills at hand if they get a sudden urge to kill themselves or attempt a cry for help during a depressive episode.

> Although I would argue this is none of the shop's business

In practical terms it appears that this actually does reduce suicides and poisonings; it's a significant reduction in suffering in the world.

The cost is a very small and temporary limitation on personal convenience. It's surely worth it. See also seatbelt laws.

> and, as far as I can gather, this is not a legal restriction.

It is in some countries, but the legal obligation is on the vendor, not the individual. If you are confident that you do need a larger cache of tablets then you can do that yourself with only minimal extra inconvenience.

I think it's an elegant solution. Suicides are reduced, but the state doesn't overrule individual decision making on what their needs are.

What criteria do you use to evaluate that intervention? Which really means, how do you begin to estimate the actual amount of harm reduction that it provides?

Are there lots of cases where someone tried to overdose but was saved by it 'only' being 16 grams of paracetamol?

The grandparent of the post you're responding to provides stats showing that suicides/overdoses with OTC painkillers went down markedly after the change.

The number of deaths due to paracetamol poisoning fell by 22% in the year after the legislation. There was no significant increase in suicide deaths by other means. We see similar results with interventions like reducing the availability of highly toxic pesticides or installing barriers on bridges.

Most suicidality is impulsive and transient, so simple interventions to reduce access to means of suicide can have very significant results. There's very little you can do to prevent a sufficiently determined person from dying by suicide, but most people who die by suicide aren't strongly motivated to die - they're just briefly overwhelmed by life.

https://www.bmj.com/content/329/7474/1076

https://www.hsph.harvard.edu/means-matter/means-matter/saves...

I'm on an alt account here for obvious reasons.

I can only speak from my experience, but at one point I took all the paracetamol I had (suicidal and pretty drunk, the taste of cheap red wine and paracetamol is... unpleasant to say the least). I ended up fine after a friend forced me to go to the hospital the next day. If I had more tablets around, I would have taken them too. So it likely wouldn't stop someone who planned to kill themselves, however with me anyway not having like 100 tablets around did help due to it being impulsive enough.

It might have been quite a big difference due to how long after the fact I went to the hospital, I took quite a lot but it had done little enough damage that some medicine in my arm over the course of about a day and having to avoid alcohol and paracetamol for a while was enough to fix it.

I imagine a lot of cases are quite similar to mine and it probably did make quite a big difference with me as I only had 2 boxes around and one wasn't completely full.

What do you do with them? I'd guess the total lifetime consumption of any medicine for me and my family is less than 500 pills, a pack of 20 can last more than a year because it's not that often that any of it is needed, and when something happens, you take them for a couple of days and that's it. Do many people in USA pop painkillers or paracetamol or aspirin daily?

>Do many people in USA pop painkillers or paracetamol or aspirin daily?

Yes, it's very common, often around joint pain. Surely obesity and sedentary lifestyle play a role.

60 million Americans take Acetaminophen (paracetamol) on a weekly basis.

https://www.ncbi.nlm.nih.gov/books/NBK441917/

*ding ding ding*

Your nose is running? Pop some NyQuil. Hangover? NyQuil. Headache from the cold? NyQuil. Cold? NyQuil.

Just look at the list of symptoms it helps with at their site: https://vicks.com/en-us/shop-products/nyquil

https://tedium.co/2021/11/03/nyquil-cold-medicine-history/

https://www.npr.org/2022/09/22/1124252556/nyquil-chicken-cha...

https://www.huffpost.com/entry/fda-nyquil-chicken-warning_n_...

Don't want to judge but that's concerning. You can really mess up your internal organs with that much volume (even spread over a year with a family of four).

At Walmart I bought a bottle of 500 Aspirin and I've had it for over 10 years it may even be 15 years. I looked just now and see there are two pills left. I thought I was using too much at that rate.

Many countries have laws limiting the size of vehicles and weight for non-commercial licenses too :)

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