On the other hand, plenty of really good legal drugs fail for reasons which might not be relevant to many people-- Strange metabolism in select ethnic groups, p

On the other hand, plenty of really good legal drugs fail for reasons which might not be relevant to many people-- Strange metabolism in select ethnic groups, possible tox issues after chronic use, etc. For example, plenty of people involved with developing Vioxx bought tons of it before it was removed from the market, because it was such a good nsaid. These people decided that their mode of use wasn't problematic, or that the benefits of using the drug far outweighed the possibility of adverse reaction. While the Market and the FDA decided the drug should be pulled, the people who stockpiled it are certainly more informed than most medical doctors. If LSD were trialled for psychotherapy today, it would probably be rejected on the grounds that it could make crazy people experience severe adverse effects. With most novel recreational drugs, there's plenty of "phase 4" anecdata which suggests safety, at least in the short term and at cautious doses. Really nasty adrs usually show up fairly quickly, albeit at the expense of a few lives. If "legal" (nonrecreational) drugs could be put directly into phase 4 testing, drug development would be so much easier-- Animal models are a really crappy substitute for humans, especially with CNS stuff. I suppose it's a balance of Bad Big Pharma poisons us vs. Bad Big Pharma doesn't make cheap/new drugs...