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Underworld Inc - Fake Pharma

THE LIBERTARIAN POINT OF VIEW - CONT'D

Black market

Many officers consider smuggled, counterfeit or diverted medications are "black market". As we have stated innumerable times there is no such thing as "black markets". There are only free markets and oppressed markets. People making use of free markets they do so for a variety of reasons, one of them to avoid interacting with legal representatives. Typically "illegal" immigrants have this problem hence they solve it by turning to the free market which does provides them with a solution. Again, as we stated many times, immigration restriction is invalid albeit legal. By restricting immigration the state creates the conditions whereby people need to access the free market in order to solve their problems. It is the state itself whose actions bring about the free market in a strange twist of faith. The more a state regulates the more the free market flourishes.

Self-prescription health hazards

Yet another excuse for preventing self-medication is the notion that a great deal of people die because of it. Self-prescription would not be possible should a free market would not exist, they reason. And to a degree, a very tiny degree, they are right. But let's place the whole situation into perspective.

Statistics to this regard are sketchy, but about 50% of all people self-medicate. This number would seem to be high, but when we look at the type of medications they are taking we can see that the potential danger is low. Medications are mostly for common illnesses such as colds, muscular pains, headaches and so on or are repeat prescriptions that were previously prescribed by physicians. Therefore the conclusion is obvious. Self-medication is a limited problem. But what about damage?

Several studies have shown that hospitalizations due to Over The Counter (OTC) medications is in the order of 1% of all hospitalizations due to adverse effect of medications. That's right. 1%. And the other 99%? Mostly due to professional prescription errors.

Let's take a look at these numbers: 1% versus 99%.

The obvious conclusion is that self-medication is most definitively not a problem. Now, we need to qualify this remark. When we talk about self-medication we mean people who wish to get better from an illness. We purposely exclude people who are drug addicts. This is so because drug addiction is treated as something separately by law enforcers although in many cases the laws do not make that discrimination.

We also make a difference because of the intention of the user. Self-medicating people are trying to get better from an illness; drug addicts are looking for a high. Two completely different purposes and two completely different types of medications. Let's not be disingenuous; it is quite difficult to get a "high" on aspirin!

But why would the hospitalization due to self-medication be so low? Simple. Because most people are not stupid. They fully realize that if they have a non-trivial health problem it is wise to get the advice of a person with knowledge. And this person will prescribe the appropriate medication. People don't typically go to a pharmacy to buy high pressure or blood thinners or anti-fungal medication on their own. In order to reach the conclusion that such medications are required, specialized knowledge needs to be accessed, knowledge that is beyond the reach of regular people (for now).

The conclusion is obvious; self-medication is not a critical issue that would justify the degree of propaganda, persecution and prosecution that it currently displays.

Strangely enough, this is exactly the point of view of non-developed countries. Self-medication is the norm, not the excuse for witch hunts. As it should be.

Larger issues

There is always somebody "out there" that brings out the issue of antibiotic resistance. The situation is this; the world is running out of effective antibiotics. Bacteria are increasingly becoming more resistant to antibiotics. This is so for several reasons. One of them is the widespread use of such antibiotics in the meat industry. The other one is due to the unnecessary use of antibiotics to treat viral infections (antibiotics have no effect on viruses, only on bacteria) and the tendency of people to self-medicate with antibiotics. In addition, the development of new antibiotics is a very expensive proposition, so expensive that pharma companies have mostly given up. Very few new antibiotics are being developed if any.

There. The end of the world is near. Quick. Get a sterile bunker. Now!

Or…

We can take a look at the whole scenario realistically speaking. Yes, we are running out of effective antibiotics. Yes, very few of them are being developed. Yes, it is a problem. But, the use of antibiotics in meat is not known by people because they trust "governments" to regulate. Should governments would not exist, this information would be widespread and the market would have punished users long time ago thus eliminating this threat. The unnecessary use of antibiotics by doctors has been mitigated enormously by the medical profession itself. It is bad business to have patients die on you because of antibiotic resistance. Again, the free market to the rescue. The last point we need to address is self-medication. This is a real problem since people will use antibiotics when not really necessary due to lack of knowledge. This happens mostly with poorer people. But the problem here is no self-medication but the lack of information. Why is this? Because access to this information is prohibitively expensive. Basically, if you are poor you can't afford to see a doctor. So self-medication is an income problem? Yes.

Yet, in an Austro-Libertarian system the wealth of all people increases dramatically. At the same time the prices of all gods and services (including professional medical advice) decreases dramatically. The conclusion is obvious. Should free markets would not be interfered with by states, people would have had sufficient money to go see a doctor, action that would prevent antibiotic medication in the first place!

We again reach the same conclusion. Growing antibiotic resistance is the direct result from government action.

Potentially dangerous

One of the elements that demonstrates the degree of "law enforcement" ignorance is the concept of "items that cannot be sold in the US because they are potentially dangerous" because of a "general public safety" concern.

Let's begin by stating that any medication is "potentially" dangerous and "potentially" a general public safety. Any one. Including aspirin. Or chamomile tea. Anything can potentially harm or kill you. Although it is true that not all medications present the same risk, it is also true that the concept of risk is highly subjective. This is easy to prove. There are many mediations licensed in developed countries (e.g. Germany) that are not licensed in other developed countries (e.g. US). In Germany a medication may carry an "acceptable" risk while in US it does not. The whole thing boils down to the definition of what is "acceptable". In this sense governments have stolen from our hands this decision. Considering that we are the owners of our own bodies, we are the only people in the world qualified to determine what is "dangerous" and what is "acceptable" for us. Not doctors, not pharmacists, not politicians, not bureaucrats and most certainly not "law enforcement". It is our decision.

However, having said that, we would be wise to listen to experts. There is nothing wrong with getting the best professional opinion one may get. But, and this is a big but, the final decision is ours not theirs. And this is the line that they cross every day.

Adulterated

In US there is a funny concept of unusable medications that the FDA uses. They call them "adulterated". Now, this terms conjures up the notion of evil doers sneaking into manufacturing facilities in the dead of night to add nasty chemicals to medications. This being the image conveniently portrait by FDA's PR and conveniently never denied, who wouldn't want to be "protected" from such a nightmare. Alas, nothing could be further from the truth.

In US (as well as in many other countries including EU, Japan, Canada, Brazil and so on) this PR holds true. The concept of "adulteration" simply means a mistake in the manufacturing (i.e. legitimate manufacturing) of medications. This mistake could be tablet size or colour, bigger or smaller box, a typo on the prospect, and so on. It could be anything however tiny and ridiculously small and, strangely enough, this is what really is most of the time. This is so because pharma companies do not want to be sued and they remove or destroy all sub-standard medications before they get into the market. The idea that somewhat regulators protect us against "adulterated" medication (as above described) is ludicrous. Pharma companies do so all by themselves.

Let's cook some meds

The next issue we need to address is home-made medication, or to be precise, home formulated medication. Most people are downright frightened by seeing two people filling capsules by hand or preparing injectables in a regular kitchen using a regular oven. This is so because most people are used to photos of mega-pharma-factories with people in overalls with masks on their faces. Yet…

We must remember than manual formulation of medications was standard practice in the past. We must equally remember that, with the exception of sterile products, all capsules, tablets and other pharmaceutical formulations are as nearly-sterile as you can get them, if you take basic precautions such as using gloves and a basic mask. That's it.

People believe that copying medications is difficult, it is not. Doing R&D and discovering new active molecules (i.e. medications) is hard and horrifically expensive. Doing formulation (i.e. preparing the recipe to manufacture pills / capsules etc) is difficult. But once the recipe is known, most manufacturing processes are not difficult because they are just mixing powders and making solutions and this is exactly what home-made medication is, replicating a known recipe.

This is not to say that home-made replicas are as good as factory made, but they are OK. The main differences are the dosage (which will fluctuate more) and the consistency from dosage to dosage. However, this is how original dosages were developed in the past and they got the job done. The risk is low unless the medication dose is critical.

And so we return again to the main issue. Risk. As we are the absolute owners of our bodies, we and only we can determine the amount of risk we are willing to take. If we consider that home-cooked meds are OK, then the state has no saying in it. Period. Now, having said that, would we take the risk of consuming home-cooked medications? Probably not… unless there would be a riskier condition. For example, would you take home-cooked medication if you had cancer and the medication you wanted is forbidden in the country you live? Many people would answer yes!

Again, it is a matter of risk and only you can answer the question.

But then, in a Libertarian system as there would be no countries you would be able to purchase anything you many want to from more… reputable and professional sources. In essence, a large part of the risk in taking home-cooked medication is the fact that they are home-cooked because they are illegal. In other words, state action creates the conditions for risks to be higher than what they need to be!

Not only that. Because the state is enforcing a mountain of ridiculous manufacturing conditions alongside with a mountain of paperwork, the price of medications is high. In a Libertarian system the free market itself would make medications accessible to everybody at a reasonable and ever-decreasing price.

 

Note: please see the Glossary if you are unfamiliar with certain words.

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