re: FDA Chief wants all meds to be over the counter unless addictive

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I'm not sure the policy makers care about the specifics all that much. You can make the argument that even medications like NSAIDs should be more closely monitored given their sundry effects on the body.

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Agree, and the dog that hasn't barked in the thread is we're a full five pages in and no one has called this out as a pharma cash grab yet.

Don't make me do your job, baws.

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Make sudafed available on the shelf again.

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That should happen.

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Where’s the proof if it hasn’t happened in countries that already sell them over the counter??? M

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Do you understand abx resistance at its most basic level?

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It depends on what you mean by a superbug - presumably has resistance to all known antibiotics. Thankfully we don't have those, but we have plenty with multi-drug antibiotic resistance. They mean harder to treat infections, longer to get better, more expensive, often only available by IV (so you have to be in hospital where you're at risk of nosocomial infections), more side effects of the big gun antibiotics. We'd be speeding up the clock on antibiotic resistance and it's under-invested in because these meds aren't big money-makers, but that would probably change in a world of OTC antibiotics.

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My error is thinking people would understand super bugs doesn’t mean your face melts when infected and you die the next day. On this board, I should have known better.

How? Will they not still be selling it?

I've been there. We talk in professional shorthand and forget that words like “superbug” land as sci-fi to a general audience. The interesting part of threads like this is realizing how much translation work there is between “clinical risk” and “how people picture it.” I have to stay humble or get trapped in dominance-display doom loops.

onmyliberalgrind is a big pharma leftist shill. He knows nothing about actual medical science.

Listen to the experts like RFK Jr. Don’t listen to these idiot so-called “doctors”.

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If you want your doctor's recommendation or insurance to pay for it, then you can still go to your doctor and get a prescription. No one is forcing you to not consult a doctor.

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I'm sorry, I miscommunicated. I never meant to imply that I would be one of the ones overdosing or under-dosing, because you're right, I will consult a doctor.

But lots and lots and lots of people won't. See below.

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This just makes it cheaper for people who know what medicine they need.

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This is frankly a specious proposal that appeals to people who are too shortsighted to think far enough down the road to consider at least three things:

1. Like most experts with 12+ years of training, you doctor makes it look easy. It isn't. I don't care if you stayed in a Holiday Inn last night. It may seem like, "Well, I already know I need the drug, what's the big deal?" The big deal is that you aren't considering that the new drug you just started taking over the counter that no one prescribed you interacts with the one you've been taking for 5 years, and you aren't considering it because you don't know that, and you don't know that because you aren't a fricking doctor.

Gemfibrozil and atorvastatin are drugs frequently prescribed to heart patients. They are cholesterol optimizing drugs...one lowers triglycerides and raises good cholesterol and the other lowers bad cholesterol.

If both are taken together, however, the Gemfibrozil increases the level atorvastatin in the blood 3-4 times the level it would be in the blood by itself. You can take them together, but you need to know to greatly reduce the dose of atorvastatin to compensate for that phenomenon, and you also need to know that taking them together greatly increases the chances of rhabdomyolysis, which can be fatal.

That's just an example. The point is that even with drugs that are just for cholesterol optimization, you can easily kill yourself because you don't know what you're doing—you're not a doctor or a pharmacist. Which brings me to #2...

2. Pharmaceuticals are a hell of a lot more dangerous than people think they are. They are already the third leading cause of death in America behind cancer and heart disease, and that's WITH physicians having to prescribe them. Imagine what that number is going to climb to when any dumbass who can fog a mirror can buy them at will, AND we send the implicit message that they are safe because they can be bought over the counter. Which brings me to #3...

3. It's not just "a few idiots" we're discussing. It's not the "lowest common denominator." Again, as the system stands right now, 3rd leading cause of death behind only cancer and heart disease. I owned medical clinics for a living and have seen lots and lots of patients come through and I have seen lawyers, accountants, IT techs, entrepreneurs, college professors, engineers, and all kinds of otherwise intelligent, professional people make really stupid decisions regarding medicine because of #1 and #2 above.

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The medical profession treats everyone like an idiot so they can continue to rip them o

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Populist conspiracy bullshite. They treat people like idiots because that's how the large minority—if not majority—of people act when it comes to medicine. You sound like I could count on you to be in that number.

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Anyone against this can no longer bitch about the cost of healthcare.

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O.k., then anyone for this should be willing give up their right to sue anyone for medical malpractice or any pharmaceutical company for any wrongful death.

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Actual numbers helps ground the conversation. Resistance seems to act more like an ecosystem signal than a simple policy outcome. OTC access is just one factor - prescribing culture, hospital practices, climate/agriculture, diagnostics, etc. all interact. So Colombia may not “prove” a single cause (in case people are worried that you're cherrypicking), but it does show what can happen when selective pressure accumulates

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The fundamental issues is that all antibiotics cannot treat all pathogens. Given that, the need for stewardship is much higher until we actually have more drugs that are effective. I mean, in Colombia, they have a 1% resistance rate for Carbapenems, out of nearly 500,000 isolated samples during a single year, which indicates the real cost of lax antibiotic stewardship, which is using what is considered a last-line medication so much that they even have that many samples to begin with as well as the fact they have any resistance at all.

There are plenty of issues with OTC antibiotic use which the public will never see nor understand. But a cursory peak at the data suggests that there is no real argument for increasing access to those medications in particular.

The real issue is that the effects of antibiotics are more direct in a 'cause and effect' sense. But what about drugs that cause AKI's? Or any of the sundry effects which can be cumulative? What about drugs that cumulatively would increase the risk of Torsades de Pointes or Stevens-Johnson or Serotonin Syndrome?

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Didn't they recently come out with a study that said it doesn't work?

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Certainly helps in the making of meth.