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If All Drugs Were OTC


Our current policy of requiring prescriptions for most drugs and prohibiting sale of some drugs has failed to curtail harm and in many ways has increased harm. The consequences, economic and otherwise, of making all drugs available over-the-counter would be enormous, not always predictable, and would play out over years, even decades.

My predictions:

  1. The physician's role would change from that of prescriber to that of advisor, much like the role of naturopaths.
  2. The physician shortage, especially the psychiatrist shortage, would end.
  3. The cost of medical care would plummet.
  4. I would like to think they would disappear, but the drug cartels would more likely find new ways to make money.
  5. Credibility of government and law enforcement would increase.
  6. Corruption of medical professionals would decrease dramatically.
  7. Prescribers could no longer use drugs as a carrot to keep patients "in therapy."
  8. Elimination of gratuitous trips to the prescriber's office for perfunctory refill authorization visits.
  9. Increased demand for drugs might lead to higher prices.
  10. Previously "illegal" drugs could be regulated with purity and dose standards and labeling. Heroin in particular would be much safer and could once again be used for treating pain or congestive heart failure.
  11. The incentive to design new drugs for the black market would disappear.
  12. The need to resort to violent methods for suicide would decrease.
  13. Terminally ill pts would not have to prove they are "not depressed" as they must now in OR and WA to obtain lethal doses of barbiturates.
  14. Those who did not trust Dr. Google would seek advice -- not just a prescription -- from a physician.
  15. Pharma would have less to gain by promoting their brands to physicians.
  16. The educational role of the pharmacist might increase.
  17. We could eliminate DEA.
  18. Prisons would empty.
  19. Buprenorphine would be available to any (adult) addict who wanted it.
  20. Medical malpractice premiums would plummet.
  21. Kids might find it harder to obtain drugs.
  22. Patients might be more open about their drug use when presenting for medical evaluation or treatment. This could limit potential increase in harm from use of contraindicated drugs or combinations of drugs.
  23. Physicians would have the role of cop by proxy forced upon them. They could focus on helping the patient.
  24. Just the fact that we could no longer assume that the law prevents drug use would have widespread consequences.
  25. Health insurance rates might decrease, but insurers might demand the equivalent of a prescription before they would reimburse for a drug.
  26. Physicians might feel less compelled to get money for the patient in the form of insurance reimbursement by time-wasting prior authorization.
  27. There is a risk, however, that the provider's role would morph even further into that of obtainer of reimbursement, or that role might transfer to the pharmacist, who has more to gain financially by selling the drug, given that the provider has even less to gain.
  28. Pharma already markets to consumers, but that could increase, at least for still patented drugs.
  29. Harm from disease transmission by dirty needle would likely decrease.
  30. Harm from inadvertent overdose due to absence of labeling would decrease.
  31. Harm from contamination due to unregulated purity would decrease.
  32. Harm resulting from users connections to the crime underworld would decrease.
  33. Harm resulting from conviction for drug possession would plummet.
  34. Drug lab accidents would decrease.

What other consequences would you predict?