8 ms·

There's a bit more nuance here. There is certainly a political angle, but there is a non zero risk with taking something like this that should be discussed wit

There's a bit more nuance here. There is certainly a political angle, but there is a non zero risk with taking something like this that should be discussed with a doctor first, IMO. Bypassing a doctor does open up access, but there may be risks, especially if folks don't take the medicine correctly.

pyuser583 3y ago
We saw this with Theranos. They lobbied really hard to stop doctors from being gatekeepers to blood tests.
- jrockway 3y ago
  What's the problem? Theranos committed fraud and their founder is in prison. Meanwhile, you can order blood tests. Early in the COVID pandemic I thought I had it at the very start. I got myself an antibody test and found that I didn't. Good data, and I didn't need to go wait in a doctor's office with a bunch of COVID patients.
runako 3y ago
> but there may be risks, especially if folks don't take the medicine correctly. This describes every over-the-counter drug that has ever been sold. Keeping contraception prescription-only has always been about politics.
- candiddevmike 3y ago
  There are non hormonal options out there like IUDs (and condoms) that may be a better option though. Speaking as a parent, I would rather have my kids come talk to me /my wife about this stuff and work with us and a doctor to figure out what's best for them long term. I recognize not every kid has that kind of relationship with their parents and would benefit from purchasing it directly.
  - odyssey7 3y ago
    As much as this is coming from a good place with good intentions, some things are human rights[1] that parents shouldn’t be able to withhold. [1] https://theweek.com/articles/470330/birth-control-human-right https://theweek.com/articles/470330/birth-control-human-righ...
    - giantg2 3y ago
      That doesn't contradict what the parent is saying. Having access to non-hormonal options still fulfills the UN stance.
    - nsxwolf 3y ago
      This being a "human right" seems like a matter of opinion.
    - Levitz 3y ago
      Your article talks about an annual report, then links another article written 3 years before the one you link, said article doesn't link to the report. So I search for the report itself: https://www.unfpa.org/sites/default/files/pub-pdf/AR%202012%20EN-Final.pdf https://www.unfpa.org/sites/default/files/pub-pdf/AR%202012%... And the claim is nowhere near the one you are making. What the UNFPA (who can't even declare anything a human right, by the way) is saying is: >Family planning is anchored in respect for human rights, women’s empowerment, and social justice and quality. And >In October, UNFPA published its annual The State of World Population report, which made the case that family planning is a basic human right that unlocks unprecedented rewards for women in terms of health, economic power and gender equality. Putting medical barriers to access the pill is by no means whatsoever a violation of human rights.
  - runako 3y ago
    > There are non hormonal options out there like IUDs (and condoms) that may be a better option though. Whether one agrees or disagrees with this, the argument is not strong enough to warrant a prescription requirement. (Also and separately: human bodies are complex. If you talk to a few women you might discover that IUDs are not universally tolerated and condoms are not an acceptable substitute for a variety of reasons. There are good reasons many women choose to take oral contraceptives, even though they have a daily use requirement.) This isn't just about kids, it's also about the inconvenience and added cost (to pay for the doctor visits) placed on all women who use oral contraceptives. I'm not sure how it relates at all to this announcement.
- growse 3y ago
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  - nathancahill 3y ago
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  - hombre_fatal 3y ago
    To be fair you can’t even get dick pills in the states without a script (though these days you can get them expensively online via nonsense e-consultation). Meanwhile in Mexico you can buy generic Cialis and all sorts of drugs over the counter for $20/mo. Insulin and epi pens too.
- sugarpile 3y ago
  How do you think the two are equivalent? Hormone medications can have a profound impact on a person across the spectrum from mental to physical health. Secondly, taking BC wrong may lead to a false sense of security and subsequent unwanted pregnancies. I wouldn't be surprised if there was a, smallish, correlated increase in STDs, as well. Neither of those are a thing someone buying tylenol has to worry about. Disingenuous or poorly considered to think it can _only_ be about politics imo.
  - ribosometronome 3y ago
    >Secondly, taking BC wrong ... Neither of those are a thing someone buying tylenol has to worry about. Taking Tylenol wrong kills you.
  - giantg2 3y ago
    "I wouldn't be surprised if there was a, smallish, correlated increase in STDs, as well." I would highly doubt it. Contraception is already abundantly avaliable, including in online visits. I could see people switching from Rx to OTC. But I really don't think you could have a big enough increase in non-users to OTC to have any significant data.
  - stubybubs 3y ago
    "Acetaminophen toxicity is the second most common cause of liver transplantation worldwide and the most common cause of liver transplantation in the US. It is responsible for 56,000 emergency department visits, 2,600 hospitalizations, and 500 deaths per year in the United States." Emerg docs giving out NAC like candy for acetaminophen overdoses. It would never be approved if released today, but we've got a long history with it being OTC, so I don't see that changing.
  - ericmay 3y ago
    Let's get big government nanny state out of the way here. People can make their own decisions. It's not like you can't consult with a physician when taking contraceptives over the counter anyway. Everything you said here you can apply to other behaviors, ranging from alcohol/marijuana consumption, to eating fast food, to skydiving. OTC here is a result of politics specifically because access is being restricted or in the midst of being restricted. The reason this wasn't OTC was because there just wasn't a need to bother with it. Now there is. > I wouldn't be surprised if there was a, smallish, correlated increase in STDs, as well. This is really unsubstantiated and it would be nice if you didn't say things like this in the context of this conversation here unless you're going to provide a legitimate source. Even then if this were true I'm going to guess that an infinitesimal and unsubstantiated risk of higher STD rates is nothing compared to unwanted pregnancies from a public health standpoint.
- tyre 3y ago
  The FDA regulates both risks and efficacy. The efficacy of hormonal birth control plummets if not taken consistently, which for progestin-only pills (like this) includes the same time of day[0]. Talking to a doctor ensures that people really understand this. The downside of forgetting to take more advil in time is short-term pain. The downside of not understanding that your birth control isn't working is a child. As we've seen with patients stopping antibiotics early, even though they're prescription!, people make uninformed choices with medication. Depending on what it's for, there are more or less risks of making it OTC. All of that said, I agree that this has mostly been politics. [0]: https://www.plannedparenthood.org/blog/is-the-birth-control-pill-still-effective-if-you-take-it-two-hours-after-the-time-you-are-supposed-to-take-it https://www.plannedparenthood.org/blog/is-the-birth-control-...
  - a_wild_dandan 3y ago
    Conversely, the downside of forgetting when you can take Tylenol is maybe needing an organ transplant or dying. Which...is 100% efficacy on pain reduction, I suppose. So hey, the OTC medicine gods giveth and taketh.
  - kodah 3y ago
    > Talking to a doctor ensures that people really understand this. This seems antiquated at best. They could've approved some kind of app or process to streamline this. I'm sure it's not the only kind of medication this situation applies to.
  - cogman10 3y ago
    I'm not sure the point you're making here. The potential danger of forgetting to use a condom or misusing one (like a condom that's too old) is also a child. Condoms are currently sold in truck stop bathrooms. I really see no distinction between a condom and a birth control pill. Even with misuse, making the pill more widely available will almost certainly be a social good. It will prevent more unwanted children.
    - helipod12 3y ago
      Well you should, hormonal pills and latex are entirely different.
- neuronerdgirl 3y ago
  Good time to remind people that tylenol dosages as written on the bottle are just within the safety window to avoid toxicity[1]. Having done the math myself, you can't even take the extra strength stuff at the recommended timing without skipping a dose each day. Drugs, even OTC ones, have very real risks, and gatekeeping BC is laughable given the risks of not having it freely available. [1] https://www.health.harvard.edu/pain/acetaminophen-safety-be-cautious-but-not-afraid https://www.health.harvard.edu/pain/acetaminophen-safety-be-...
  - travisjungroth 3y ago
    Tylenol/paracetamol/acetaminophen also barely works. It increases the effectiveness of an aspirin and caffeine combo to relieve headaches (but not migraines). It’s generally ineffective against chronic pain, back pain, and severe pain. It’s a weak fever reducer. It’s one of the most popular medications in the world and its use isn’t especially supported by science. To the point of this thread, don’t mistake official policy for rational behavior.
    - pyuser583 3y ago
      Could you give me some sources on acetaminophen effectiveness? I’m really interested in this.
      - travisjungroth 3y ago
        This article links to a bunch of studies: https://theconversation.com/whats-the-point-of-paracetamol-66808 https://theconversation.com/whats-the-point-of-paracetamol-6... Here’s an NIH meta analysis: https://pubmed.ncbi.nlm.nih.gov/33786837/ https://pubmed.ncbi.nlm.nih.gov/33786837/ There are lots of studies out there, throw whatever symptom + acetaminophen effectiveness into Google for more. Just make sure that if a study is making a big deal about stat sig to check the actual treatment effect.
    - cogman10 3y ago
      > It’s a weak fever reducer. Anecdotal, but acetaminophen has been my goto for fever reduction. I've never had a problem with it (and it's taken me from 103->98 fairly frequently). And, unlike most NSAIDs, it's safe(ish) for younger kids. That said, I've never really noticed the pain killing effects.
apsec112 3y ago
The risks of pregnancy are much worse! Pregnancy is really tough and can lead to eleventy zillion health complications
- toomuchtodo 3y ago
  Also, ~40% of children born into poverty remain in poverty [1], and it costs $310k per child from 0-18 (excluding daycare and college costs) [2]. Broadly accessible reproductive healthcare is about as impactful as vaccines from a value delivered for the cost perspective. You want to avoid as many both unintended and unwanted pregnancies as possible (which ["unintended"] stands at about half of all US [3] and global [4] pregnancies annually). EDIT (hn throttling, can't reply): People who don't want children should be enabled and empowered to not have them. I am surprised that is a controversial opinion. [1] https://www.pbs.org/wgbh/frontline/article/how-poverty-can-follow-children-into-adulthood/ https://www.pbs.org/wgbh/frontline/article/how-poverty-can-f... [2] https://news.ycombinator.com/item?id=33991744 https://news.ycombinator.com/item?id=33991744 [3] https://www.guttmacher.org/sites/default/files/factsheet/fb-unintended-pregnancy-us.pdf https://www.guttmacher.org/sites/default/files/factsheet/fb-... [4] https://www.unfpa.org/press/nearly-half-all-pregnancies-are-unintended-global-crisis-says-new-unfpa-report https://www.unfpa.org/press/nearly-half-all-pregnancies-are-...
  - NoZebra120vClip 3y ago
    [flagged]
    - mrguyorama 3y ago
      Helping poor people who do not WANT kids not HAVE kids is not Eugenics but rather their basic human rights in a world that invented birth control.
      - ToValueFunfetti 3y ago
        When you're doing it explicitly because 40% of their offspring will be poor, I think you've at least entered a gray area. Aligning with the interests of eugenicists is hardly an argument against a policy though.
sixothree 3y ago
I think you would be amazed how many people don't "have a doctor" and simultaneously are the same people who would benefit from this.
- giantg2 3y ago
  I'm pretty sure you don't have to "have" a doctor for this. MinuteClinics and such can provide this. I would guess there are websites you can get Rx through too.
  - 0cf8612b2e1e 3y ago
    That’s still a needless barrier. If you are poor every dollar counts and being required to pay for a medical professional to rubber stamp a prescription does more harm than good.
    - giantg2 3y ago
      I'd like see the data that supports that. If true, we would do away with the prescription process altogether for most drugs.
      - 0cf8612b2e1e 3y ago
        That women find getting birth control a hassle? Ask anyone.
        giantg2 3y ago
        No, that the prescription process is providing more harm than good.
        travisjungroth 3y ago
        Having a doctor rubber stamp a prescription does more harm than good. If the argument is that getting a prescription is such a simple task it should cost almost nothing and be done instantly, then it likely doesn’t need to exist as a barrier at all.
donatj 3y ago
I think you overplay how much people actually listen to their doctor. I contend people listen to packaging and doctors about equally well.
dmoy 3y ago
> Bypassing a doctor does open up access, but there may be risks, especially if folks don't take the medicine correctly. In related news, it is shockingly easy to get messed up real bad by Tylenol. But you can get it in a 500-pill bottle from Costco.
- Scubabear68 3y ago
  My cousin is a toxicologist and he was talking about this in the 1980s - that the public had no idea how incredibly toxic Tylenol is and how easy it is to over dose on it and cause significant damage to your liver and other organs.
  - zinclozenge 3y ago
    The worst is that if you "OD" on tylenol, you won't die right away, but instead slowly and increasingly painfully over time, perfectly aware of what's going on.
  - dboreham 3y ago
    Depends on the country. In the UK people typically are aware of the dangers of acetaminophen, and you can't buy giant bottles.
- crote 3y ago
  That's pretty much a USA thing, though. In Europe you'll usually only come across blister packs, and they don't really go beyond 50 / box. It is a lot harder to accidentally OD when you have to individually remove every single pill from a blister pack, rather than just chugging a fistful straight out of the bottle.
  - dmoy 3y ago
    Sure, but the context here is why it took so long for the US to allow otc bc pills, the same country that allows 500 pill bottles of acetaminophen
- Levitz 3y ago
elijaht 3y ago
A lot of that ends up being bureaucratic wastes of time though. My partner was on birth control for years and had to jump through so many hoops - Had to go to yearly appointments to continue receiving it - Could not pick up more than a month at a time, which created logistical issues since they HAD to take it daily - Had to get the prescription renewed every three months or so, which often led to delays filling it It led to a ton of needlessly frustrating situations since the pill is so dependent on taking it daily.
- mustacheemperor 3y ago
  You are the first commenter to relate anything like even a secondhand real life experience with oral birth control. This thread (edit: at the time I am posting this) is full of men with little real knowledge of this drug insisting on why it’s reasonable it took 50 years for this to be available OTC. I don’t think the contents of their explanations are likely to be accurate, but I think they still explain why it took 50 years to be approved.
  - ModernMech 3y ago
    Your comment is at the top of the thread, so thank you for pointing this out before I waded further into the comment section. I'm sure you saved me some grief.
  - SantalBlush 3y ago
    This goes for other things on HN, too. If the topic doesn't involve programming, it's mostly just uninformed people talking shit.
    - cudgy 3y ago
      Because, naturally, humans can only be informed about a single topic: their career. Therefore, programmers are only capable of being knowledgeable about programming. And doctors are only capable of being knowledgable about medicine. And plumbers are only informed about plumbing topics. Really?
renewiltord 3y ago
Wait, what exactly has a zero risk? Drinking water has a non zero risk. Breathing air has a non zero risk. I once looked up at the sky. Pretty sure the risk wasn't zero.
sonigcgg 3y ago
What is your point? Eating fast food everyday has a non zero risk. Arguably a really high risk. Do you want a prescription for what you can eat as well?
TheCoelacanth 3y ago
That's true, but there are also very large risks with becoming pregnant. Historically, I believe it is by far the single largest cause of death for young women. Things have improved, but it is still quite risky. Everything in life involves risks, but I believe on net this reduces risk.
ramesh31 3y ago
>there is a non zero risk with taking something like this that should be discussed with a doctor first, IMO. Nonsense. I can walk into any store in the country and buy enough Tylenol to kill myself for $5 no questions asked. This is an unqualified good thing.
extragood 3y ago
I agree, and I see a lot of false equivalence comparing BC to the dangers of Tylenol/acetaminophen/paracetamol in this thread. Yes, both are drugs and can be misused with disastrous or even fatal consequences. The important distinction is that you can use oral contraceptives correctly and still have seriously negative, life-altering side effects. There are alternatives which may be preferable and ideally every woman should have access to a medical expert who can guide them to make the best choice. Access to an appropriate medical resource is in the other issue, in the absence of a completely safe and effective option. And that seems to outweigh the risks in the the US. I can only hope that, when given the option, women continue to consult medical professionals even though there is now an over-the-counter option available.
- kodah 3y ago
  Sure, and you can use NSAIDs correctly and experience the same. For instance, if you're taking methotrexate. At some point you need to have a new avenue for disseminating that type of information, especially when doctors visits are becoming more inconvenient and expensive.
- kaitai 3y ago
  I think that it's really shitty that one can take hormonal birth control with perfect responsibility and encounter negative side effects. I also think it's really shitty that the US has the highest infant and maternal mortality rates in the developed world. I've had to deal with both sides (taking hormonal birth control, with some side effects; having a "high risk" pregnancy and being confronted with forced surgery that would increase my mortality burden, against empirical medical evidence but for insurance reasons). My philosophy is consistent: given that the hand of cards is shitty, I want to choose how I play the cards. Ideally, as you say, folks should have full access to knowledgeable medical experts who can help guide them. Again, our mechanisms for delivery of care in the US don't allow that, and unfortunately our physician and nurse training doesn't facilitate that either. A lot of medical professionals insist that hormonal BC doesn't have side effects, many insurance companies don't cover experimentation to find the best method for a particular person, non-hormonal woman-controlled methods are underused in the US. Since medicine in the US is built around making money & defending against lawsuits, care gets lost.
jlarocco 3y ago
Walking across the street is a risk. Should I be required to discuss it with my doctor first? If you're concerned, you can talk to your doctor first. No need for everybody to live their lives by your whims.
deleted 3y ago
[deleted]
hunson_abadeer 3y ago
> there is a non zero risk with taking something like this that should be discussed with a doctor first, IMO. This costs money in the US. And it costs time and effort everywhere in the world, with doctors frequently using this as a hook to force you to visit them regularly and bill you or your insurance for that. And it's just disempowering bureaucratic bullshit when the risk is far less consequential than most other risks we take in life. Do you have a permission slip from your doctor for sitting in front of the computer all day? That's far worse to your health than oral contraceptives.
Obscurity4340 3y ago
There are a lot of OTC meds that are literally more dangerous or side effect heavy or have objectively worse risks, or are more damaging with long-term use than their superior prescription-only counterparts. Even within prescription medications, it is ironic that they often schedule more leniently based on the potential toxicity+lack of abuse potential (stick+ lack of carrot).

pyuser583 3y ago

We saw this with Theranos. They lobbied really hard to stop doctors from being gatekeepers to blood tests.

jrockway 3y ago
What's the problem? Theranos committed fraud and their founder is in prison. Meanwhile, you can order blood tests. Early in the COVID pandemic I thought I had it at the very start. I got myself an antibody test and found that I didn't. Good data, and I didn't need to go wait in a doctor's office with a bunch of COVID patients.

runako 3y ago

> but there may be risks, especially if folks don't take the medicine correctly. This describes every over-the-counter drug that has ever been sold. Keeping contraception prescription-only has always been about politics.

candiddevmike 3y ago
There are non hormonal options out there like IUDs (and condoms) that may be a better option though. Speaking as a parent, I would rather have my kids come talk to me /my wife about this stuff and work with us and a doctor to figure out what's best for them long term. I recognize not every kid has that kind of relationship with their parents and would benefit from purchasing it directly.
- odyssey7 3y ago
  As much as this is coming from a good place with good intentions, some things are human rights[1] that parents shouldn’t be able to withhold. [1] https://theweek.com/articles/470330/birth-control-human-right https://theweek.com/articles/470330/birth-control-human-righ...
  - giantg2 3y ago
    That doesn't contradict what the parent is saying. Having access to non-hormonal options still fulfills the UN stance.
  - nsxwolf 3y ago
    This being a "human right" seems like a matter of opinion.
  - Levitz 3y ago
    Your article talks about an annual report, then links another article written 3 years before the one you link, said article doesn't link to the report. So I search for the report itself: https://www.unfpa.org/sites/default/files/pub-pdf/AR%202012%20EN-Final.pdf https://www.unfpa.org/sites/default/files/pub-pdf/AR%202012%... And the claim is nowhere near the one you are making. What the UNFPA (who can't even declare anything a human right, by the way) is saying is: >Family planning is anchored in respect for human rights, women’s empowerment, and social justice and quality. And >In October, UNFPA published its annual The State of World Population report, which made the case that family planning is a basic human right that unlocks unprecedented rewards for women in terms of health, economic power and gender equality. Putting medical barriers to access the pill is by no means whatsoever a violation of human rights.
- runako 3y ago
  > There are non hormonal options out there like IUDs (and condoms) that may be a better option though. Whether one agrees or disagrees with this, the argument is not strong enough to warrant a prescription requirement. (Also and separately: human bodies are complex. If you talk to a few women you might discover that IUDs are not universally tolerated and condoms are not an acceptable substitute for a variety of reasons. There are good reasons many women choose to take oral contraceptives, even though they have a daily use requirement.) This isn't just about kids, it's also about the inconvenience and added cost (to pay for the doctor visits) placed on all women who use oral contraceptives. I'm not sure how it relates at all to this announcement.
growse 3y ago
[flagged]
- nathancahill 3y ago
  [flagged]
- hombre_fatal 3y ago
  To be fair you can’t even get dick pills in the states without a script (though these days you can get them expensively online via nonsense e-consultation). Meanwhile in Mexico you can buy generic Cialis and all sorts of drugs over the counter for $20/mo. Insulin and epi pens too.
sugarpile 3y ago
How do you think the two are equivalent? Hormone medications can have a profound impact on a person across the spectrum from mental to physical health. Secondly, taking BC wrong may lead to a false sense of security and subsequent unwanted pregnancies. I wouldn't be surprised if there was a, smallish, correlated increase in STDs, as well. Neither of those are a thing someone buying tylenol has to worry about. Disingenuous or poorly considered to think it can _only_ be about politics imo.
- ribosometronome 3y ago
  >Secondly, taking BC wrong ... Neither of those are a thing someone buying tylenol has to worry about. Taking Tylenol wrong kills you.
- giantg2 3y ago
  "I wouldn't be surprised if there was a, smallish, correlated increase in STDs, as well." I would highly doubt it. Contraception is already abundantly avaliable, including in online visits. I could see people switching from Rx to OTC. But I really don't think you could have a big enough increase in non-users to OTC to have any significant data.
- stubybubs 3y ago
  "Acetaminophen toxicity is the second most common cause of liver transplantation worldwide and the most common cause of liver transplantation in the US. It is responsible for 56,000 emergency department visits, 2,600 hospitalizations, and 500 deaths per year in the United States." Emerg docs giving out NAC like candy for acetaminophen overdoses. It would never be approved if released today, but we've got a long history with it being OTC, so I don't see that changing.
- ericmay 3y ago
  Let's get big government nanny state out of the way here. People can make their own decisions. It's not like you can't consult with a physician when taking contraceptives over the counter anyway. Everything you said here you can apply to other behaviors, ranging from alcohol/marijuana consumption, to eating fast food, to skydiving. OTC here is a result of politics specifically because access is being restricted or in the midst of being restricted. The reason this wasn't OTC was because there just wasn't a need to bother with it. Now there is. > I wouldn't be surprised if there was a, smallish, correlated increase in STDs, as well. This is really unsubstantiated and it would be nice if you didn't say things like this in the context of this conversation here unless you're going to provide a legitimate source. Even then if this were true I'm going to guess that an infinitesimal and unsubstantiated risk of higher STD rates is nothing compared to unwanted pregnancies from a public health standpoint.
tyre 3y ago
The FDA regulates both risks and efficacy. The efficacy of hormonal birth control plummets if not taken consistently, which for progestin-only pills (like this) includes the same time of day[0]. Talking to a doctor ensures that people really understand this. The downside of forgetting to take more advil in time is short-term pain. The downside of not understanding that your birth control isn't working is a child. As we've seen with patients stopping antibiotics early, even though they're prescription!, people make uninformed choices with medication. Depending on what it's for, there are more or less risks of making it OTC. All of that said, I agree that this has mostly been politics. [0]: https://www.plannedparenthood.org/blog/is-the-birth-control-pill-still-effective-if-you-take-it-two-hours-after-the-time-you-are-supposed-to-take-it https://www.plannedparenthood.org/blog/is-the-birth-control-...
- a_wild_dandan 3y ago
  Conversely, the downside of forgetting when you can take Tylenol is maybe needing an organ transplant or dying. Which...is 100% efficacy on pain reduction, I suppose. So hey, the OTC medicine gods giveth and taketh.
- kodah 3y ago
  > Talking to a doctor ensures that people really understand this. This seems antiquated at best. They could've approved some kind of app or process to streamline this. I'm sure it's not the only kind of medication this situation applies to.
- cogman10 3y ago
  I'm not sure the point you're making here. The potential danger of forgetting to use a condom or misusing one (like a condom that's too old) is also a child. Condoms are currently sold in truck stop bathrooms. I really see no distinction between a condom and a birth control pill. Even with misuse, making the pill more widely available will almost certainly be a social good. It will prevent more unwanted children.
  - helipod12 3y ago
    Well you should, hormonal pills and latex are entirely different.
neuronerdgirl 3y ago
Good time to remind people that tylenol dosages as written on the bottle are just within the safety window to avoid toxicity[1]. Having done the math myself, you can't even take the extra strength stuff at the recommended timing without skipping a dose each day. Drugs, even OTC ones, have very real risks, and gatekeeping BC is laughable given the risks of not having it freely available. [1] https://www.health.harvard.edu/pain/acetaminophen-safety-be-cautious-but-not-afraid https://www.health.harvard.edu/pain/acetaminophen-safety-be-...
- travisjungroth 3y ago
  Tylenol/paracetamol/acetaminophen also barely works. It increases the effectiveness of an aspirin and caffeine combo to relieve headaches (but not migraines). It’s generally ineffective against chronic pain, back pain, and severe pain. It’s a weak fever reducer. It’s one of the most popular medications in the world and its use isn’t especially supported by science. To the point of this thread, don’t mistake official policy for rational behavior.
  - pyuser583 3y ago
    Could you give me some sources on acetaminophen effectiveness? I’m really interested in this.
    - travisjungroth 3y ago
      This article links to a bunch of studies: https://theconversation.com/whats-the-point-of-paracetamol-66808 https://theconversation.com/whats-the-point-of-paracetamol-6... Here’s an NIH meta analysis: https://pubmed.ncbi.nlm.nih.gov/33786837/ https://pubmed.ncbi.nlm.nih.gov/33786837/ There are lots of studies out there, throw whatever symptom + acetaminophen effectiveness into Google for more. Just make sure that if a study is making a big deal about stat sig to check the actual treatment effect.
  - cogman10 3y ago
    > It’s a weak fever reducer. Anecdotal, but acetaminophen has been my goto for fever reduction. I've never had a problem with it (and it's taken me from 103->98 fairly frequently). And, unlike most NSAIDs, it's safe(ish) for younger kids. That said, I've never really noticed the pain killing effects.

apsec112 3y ago

The risks of pregnancy are much worse! Pregnancy is really tough and can lead to eleventy zillion health complications

toomuchtodo 3y ago
Also, ~40% of children born into poverty remain in poverty [1], and it costs $310k per child from 0-18 (excluding daycare and college costs) [2]. Broadly accessible reproductive healthcare is about as impactful as vaccines from a value delivered for the cost perspective. You want to avoid as many both unintended and unwanted pregnancies as possible (which ["unintended"] stands at about half of all US [3] and global [4] pregnancies annually). EDIT (hn throttling, can't reply): People who don't want children should be enabled and empowered to not have them. I am surprised that is a controversial opinion. [1] https://www.pbs.org/wgbh/frontline/article/how-poverty-can-follow-children-into-adulthood/ https://www.pbs.org/wgbh/frontline/article/how-poverty-can-f... [2] https://news.ycombinator.com/item?id=33991744 https://news.ycombinator.com/item?id=33991744 [3] https://www.guttmacher.org/sites/default/files/factsheet/fb-unintended-pregnancy-us.pdf https://www.guttmacher.org/sites/default/files/factsheet/fb-... [4] https://www.unfpa.org/press/nearly-half-all-pregnancies-are-unintended-global-crisis-says-new-unfpa-report https://www.unfpa.org/press/nearly-half-all-pregnancies-are-...
- NoZebra120vClip 3y ago
  [flagged]
  - mrguyorama 3y ago
    Helping poor people who do not WANT kids not HAVE kids is not Eugenics but rather their basic human rights in a world that invented birth control.
    - ToValueFunfetti 3y ago
      When you're doing it explicitly because 40% of their offspring will be poor, I think you've at least entered a gray area. Aligning with the interests of eugenicists is hardly an argument against a policy though.

sixothree 3y ago

I think you would be amazed how many people don't "have a doctor" and simultaneously are the same people who would benefit from this.

giantg2 3y ago
I'm pretty sure you don't have to "have" a doctor for this. MinuteClinics and such can provide this. I would guess there are websites you can get Rx through too.
- 0cf8612b2e1e 3y ago
  That’s still a needless barrier. If you are poor every dollar counts and being required to pay for a medical professional to rubber stamp a prescription does more harm than good.
  - giantg2 3y ago
    I'd like see the data that supports that. If true, we would do away with the prescription process altogether for most drugs.
    - 0cf8612b2e1e 3y ago
      That women find getting birth control a hassle? Ask anyone.
      - giantg2 3y ago
        No, that the prescription process is providing more harm than good.
        travisjungroth 3y ago
        Having a doctor rubber stamp a prescription does more harm than good. If the argument is that getting a prescription is such a simple task it should cost almost nothing and be done instantly, then it likely doesn’t need to exist as a barrier at all.

donatj 3y ago

I think you overplay how much people actually listen to their doctor. I contend people listen to packaging and doctors about equally well.

dmoy 3y ago

> Bypassing a doctor does open up access, but there may be risks, especially if folks don't take the medicine correctly. In related news, it is shockingly easy to get messed up real bad by Tylenol. But you can get it in a 500-pill bottle from Costco.

Scubabear68 3y ago
My cousin is a toxicologist and he was talking about this in the 1980s - that the public had no idea how incredibly toxic Tylenol is and how easy it is to over dose on it and cause significant damage to your liver and other organs.
- zinclozenge 3y ago
  The worst is that if you "OD" on tylenol, you won't die right away, but instead slowly and increasingly painfully over time, perfectly aware of what's going on.
- dboreham 3y ago
  Depends on the country. In the UK people typically are aware of the dangers of acetaminophen, and you can't buy giant bottles.
crote 3y ago
That's pretty much a USA thing, though. In Europe you'll usually only come across blister packs, and they don't really go beyond 50 / box. It is a lot harder to accidentally OD when you have to individually remove every single pill from a blister pack, rather than just chugging a fistful straight out of the bottle.
- dmoy 3y ago
  Sure, but the context here is why it took so long for the US to allow otc bc pills, the same country that allows 500 pill bottles of acetaminophen
Levitz 3y ago

elijaht 3y ago

A lot of that ends up being bureaucratic wastes of time though. My partner was on birth control for years and had to jump through so many hoops - Had to go to yearly appointments to continue receiving it - Could not pick up more than a month at a time, which created logistical issues since they HAD to take it daily - Had to get the prescription renewed every three months or so, which often led to delays filling it It led to a ton of needlessly frustrating situations since the pill is so dependent on taking it daily.

mustacheemperor 3y ago
You are the first commenter to relate anything like even a secondhand real life experience with oral birth control. This thread (edit: at the time I am posting this) is full of men with little real knowledge of this drug insisting on why it’s reasonable it took 50 years for this to be available OTC. I don’t think the contents of their explanations are likely to be accurate, but I think they still explain why it took 50 years to be approved.
- ModernMech 3y ago
  Your comment is at the top of the thread, so thank you for pointing this out before I waded further into the comment section. I'm sure you saved me some grief.
- SantalBlush 3y ago
  This goes for other things on HN, too. If the topic doesn't involve programming, it's mostly just uninformed people talking shit.
  - cudgy 3y ago
    Because, naturally, humans can only be informed about a single topic: their career. Therefore, programmers are only capable of being knowledgeable about programming. And doctors are only capable of being knowledgable about medicine. And plumbers are only informed about plumbing topics. Really?

renewiltord 3y ago

Wait, what exactly has a zero risk? Drinking water has a non zero risk. Breathing air has a non zero risk. I once looked up at the sky. Pretty sure the risk wasn't zero.

sonigcgg 3y ago

What is your point? Eating fast food everyday has a non zero risk. Arguably a really high risk. Do you want a prescription for what you can eat as well?

TheCoelacanth 3y ago

That's true, but there are also very large risks with becoming pregnant. Historically, I believe it is by far the single largest cause of death for young women. Things have improved, but it is still quite risky. Everything in life involves risks, but I believe on net this reduces risk.

ramesh31 3y ago

>there is a non zero risk with taking something like this that should be discussed with a doctor first, IMO. Nonsense. I can walk into any store in the country and buy enough Tylenol to kill myself for $5 no questions asked. This is an unqualified good thing.

extragood 3y ago

I agree, and I see a lot of false equivalence comparing BC to the dangers of Tylenol/acetaminophen/paracetamol in this thread. Yes, both are drugs and can be misused with disastrous or even fatal consequences. The important distinction is that you can use oral contraceptives correctly and still have seriously negative, life-altering side effects. There are alternatives which may be preferable and ideally every woman should have access to a medical expert who can guide them to make the best choice. Access to an appropriate medical resource is in the other issue, in the absence of a completely safe and effective option. And that seems to outweigh the risks in the the US. I can only hope that, when given the option, women continue to consult medical professionals even though there is now an over-the-counter option available.

kodah 3y ago
Sure, and you can use NSAIDs correctly and experience the same. For instance, if you're taking methotrexate. At some point you need to have a new avenue for disseminating that type of information, especially when doctors visits are becoming more inconvenient and expensive.
kaitai 3y ago
I think that it's really shitty that one can take hormonal birth control with perfect responsibility and encounter negative side effects. I also think it's really shitty that the US has the highest infant and maternal mortality rates in the developed world. I've had to deal with both sides (taking hormonal birth control, with some side effects; having a "high risk" pregnancy and being confronted with forced surgery that would increase my mortality burden, against empirical medical evidence but for insurance reasons). My philosophy is consistent: given that the hand of cards is shitty, I want to choose how I play the cards. Ideally, as you say, folks should have full access to knowledgeable medical experts who can help guide them. Again, our mechanisms for delivery of care in the US don't allow that, and unfortunately our physician and nurse training doesn't facilitate that either. A lot of medical professionals insist that hormonal BC doesn't have side effects, many insurance companies don't cover experimentation to find the best method for a particular person, non-hormonal woman-controlled methods are underused in the US. Since medicine in the US is built around making money & defending against lawsuits, care gets lost.

jlarocco 3y ago

Walking across the street is a risk. Should I be required to discuss it with my doctor first? If you're concerned, you can talk to your doctor first. No need for everybody to live their lives by your whims.

deleted 3y ago

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hunson_abadeer 3y ago

> there is a non zero risk with taking something like this that should be discussed with a doctor first, IMO. This costs money in the US. And it costs time and effort everywhere in the world, with doctors frequently using this as a hook to force you to visit them regularly and bill you or your insurance for that. And it's just disempowering bureaucratic bullshit when the risk is far less consequential than most other risks we take in life. Do you have a permission slip from your doctor for sitting in front of the computer all day? That's far worse to your health than oral contraceptives.

Obscurity4340 3y ago

There are a lot of OTC meds that are literally more dangerous or side effect heavy or have objectively worse risks, or are more damaging with long-term use than their superior prescription-only counterparts. Even within prescription medications, it is ironic that they often schedule more leniently based on the potential toxicity+lack of abuse potential (stick+ lack of carrot).