Like so many thousands of others, I have been a victim of an over-the-counter (OTC) drug. They’re the drugs that are freely available from chemists without the need of a prescription.

My own nemesis came in the shape of Canesten, an anti-fungal cream developed to treat athlete’s foot and other mould-like infections. Within a day, my foot had ballooned to twice its size, and my whole body was covered in small blisters.

According to the UK’s drug reference “bible”, the ABPI Data Sheet Compendium, my reaction shouldn’t have happened. In fact, the worst I should have experienced was some mild local burning or irritation.

Nonetheless, my foot reached such a size that I was confined to bed and walking was virtually impossible.

It took about five days before my foot was back to normal, and for the blisters to disappear.

We OTC victims I feel a pressure group coming on will grow from

legions to multitudes as more prescription only drugs are let out on good behaviour to terrorize society.

This social shift away from prescription only drugs began in 1989

in Britain when the government’s Department of Health decided to

reduce the nation’s drugs bill. Too many drugs, they felt, were being subsidized by the National Health Service.

An economist might sympathize with the sentiments. A human being, however, would have to question it. Does a drug suddenly become “safe” simply because a government can no longer afford it? And isn’t this dumping of the worst sort? our notional human being might query.

As no such human being existed, the government went ahead with its drugs dumping policy. Already sitting on the shelves are the H2-receptor antagonists for dyspepsia and heartburn, topical acyclovir for herpes cold sores, imidazole antifungals, hydrocortisone cream, sodium cromoglycate eyedrops and some non-steroidal anti-inflammatories.

There are some terrors in that list, but any chemist will happily sell them to you without so much of a warning.

The next wave to win OTC status includes chloramphenicol eyedrops known to suppress bone marrow topical antibiotics and anti-emetics for migraine.

In the US, OTC drugs have almost taken on the status of sweets to be given to a deserving child. A recent report in the Journal of the American Medical Association (JAMA) reported that more than half of all three year olds in the US are currently taking an OTC drug. The “favourites” were cough and cold treatments, even though none have been proven to be effective. Worse, they can be dangerous, especially if the patient is taking a prescribed drug at the time.

Drugs is one industry where a free market is not advisable, as even Prof Hayek and his monetarist friends would doubtlessly agree. They are not some useful addition to the confectionary stand, nor should they be given or taken without serious thought and consultation.

If governments must dump drugs on the public, they should ensure there are the necessary policing safeguards in place. Only the chemist in charge should be allowed to dispense them, and before doing so should go through a simple checklist to see if the customer has any history of reactions, or is already on a prescribed drug. It might not be a bad idea to check that the customer’s diagnosis is right in the first place, come to think of it.

Doctors are also concerned. Those in the UK are calling on chemists

to join the yellow-card system, a voluntary network for reporting

drug reactions. They also want the drug to pass through new clinical trials (if they had, they might have noted my own reactions, which were not supposed to happen). These new trials could take into account the dosages as well as lifestyle influences such as smoking, diet and alcohol consumption.

Their worries are legitimate, although a phrase that has something to do with living in glass houses comes to mind. Fewer than 20 per cent of doctors in the UK even bother to fill out their yellow cards, and this is to report on more dangerous drugs. It may be hard, therefore, for the chemists to sympathize with the doctors and comply with their wishes.

Concerns about the OTCs have spread beyond Britain. American doctors are equally as worried , as is the consumer group Health Action International, based in Amsterdam. The group wants to see tighter controls on OTC advertising after research showed that 87 per cent didn’t mention any side effects in the marketing copy. This type of advertising only adds to the idea that OTC drugs are safe.

If these drugs are so accessible by the public, they must also be accountable. Any other dangerous product that can be bought with special supervision such as a child’s toy or a motorcar has to be recalled the moment some dangerous fault is detected.

Yet, as it stands, how can we discover which OTC drugs are dangerous if there is no proper reporting system in place? And who, anyway, will think of drawing the correlation between their reaction and the drug if they believe it to be safe?

Many are worried, but too little is being done. Unless some policing and reporting system is set up, and quickly, we could soon be witnessing a rash of serious complications which, to the sufferer, will always be mystery.

!ABryan Hubbard

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Written by What Doctors Don't Tell You

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