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OTC means different things in different places

Typically, OTC stands for "Over the counter" medication, what most people consider to be some sort of pharmaceutical treatment that the average consumer can purchase without a prescription. The term derives from the old-fashioned practice of pharmacists safeguarding products and providing them to a customer, over the pharmacy counter from an inaccessible shelf or storage room. Today, many products are simply stocked on shelves consumers can freely draw from. These products require no prescription from a physician nor the intervention of a pharmacist and are considered generally safe for consumers to use.

What is considered "safe", however, is a cultural phenomenon. Most countries subscribe to UN recommendations, but each sovereign nation may interpret findings and act differently. Examining specific nations yields a glimpse into their collective psyche and approach to medication.

The United States of America

There are many things that are not shared, though. A product cannot be purchased in the USA where codeine is a significant component of the drug. Certainly, there may be remedies sold OTC in the US where codeine is a trace substance, but in general, this incredibly weak opiate is not sold without a prescription. Over the last decade, other measures have been taken by the US to combat specific situations resulting from OTC abuse. In most states, minors no longer have access to OTC cough syrups that contain DXM, as many young people were buying these products. The USA also frowns upon stocking shelves with pseudoephedrine, normally used as a decongestant component. Though most remedies containing pseudoephedrine do not require a prescription, pharmacists dispense these remedies directly, monitoring sales. The same occurs with certain emergency contraception drugs. Women 17 or over may treat them as controlled OTC items whereas younger women must obtain a prescription, in theory receiving access to counseling and education when dealing with the physician prescribing.

 

Many products are available as OTC in the USA. Some are in stark contrast to internationally accepted practices, though. In the USA, the concept of the "drug store" is an accepted fact of life. Consumers generally shop at Walgreens, CVS, Rite Aid, Kroger, and others. Here, many health and personal care products are stocked on large shelving floors with a pharmacist's dispensing counter located somewhere on the periphery of the massive space. As such, stopping at the drug store may include buying some aspirin as well as snacks, toothpaste, shaving gel, cosmetic products, the latest DVD, etc. Many drug stores are often simply areas within larger shopping areas, as evidenced by many US Walmarts offering a Walgreens as a complement. Target, Sears, and Costco don't even bother with creating a separate brand, you can simply shop OTC within a specific area of their normally massive department stores. While you're there, you can also purchase anything from clothing to home improvement materials, from electronic devices to furniture, from appliances to barbecue sauce. Many OTC drugs, then, are offered casually, a reflection of the clear gap between drugs that are OTC and those that are only available through prescription. This mindset is something the USA shares with the UK.

 

The primary drawback of the USA's drug store style is that the clear rift between prescription and OTC drugs lead many to consider anything purchased off the shelf as "safe", with anything provided by the pharmacist as requiring caution.

Directions and warnings are often overlooked.

The United Kingdom

In the UK, the concept of the drug store is similar to that of the USA. The sizes of stores are normally smaller and more focused on drugs and cosmetics or personal care items, but shelves are also stocked with numerous OTC drugs. Top chains include Boots, Lloyds, and the Numark shops. The same drawback observed for the USA is also evident in the UK - drugs purchased OTC are often not approached with the appropriate sobriety.
The cultural differences between the UK and the USA indicate where that sobriety or concern may fall. Pseudoephedrine is available OTC in the UK, in many cold relief products, as a decongestant. Cough syrups with DXM are also sold on shelves, as are pain relievers that offer codeine as a notable ingredient. What does require a prescription in the UK is antibiotic ointment. The over-use of antibiotics in Europe is a genuine health concern, making any antibiotic, topical or otherwise, a prescription item. In the USA, however, topical creams containing neomycin and other antibiotics are common OTC items. Paracetamol, a controlled and limited substance in the UK, is sold on shelves in the USA.

Unlike the USA, the UK has codified its practice of involving the pharmacist into its social milieu. POM drugs (prescription only medication) can only be dispensed with the appropriate directive from a physician. GSL (drugs on the general sale list), may be sold OTC just about anywhere. In between the two is the innovation of the P category for drugs, or those which may be sold without a prescription but require the intervention of a pharmacist adhering to Royal Pharmaceutical Society codes. The job of the pharmacist is to provide assistance, advice, and often to spot abuse of monitored substances.

Spain

Spain is somewhat different from the UK and vastly different from the US. The concept of the pharmacy as a drug supermarket is practically non-existent. The small, local pharmacy is where one goes to purchase medication. Personal care items and make-up are generally purchased at either a department store or a "perfumería" (perfumery).
The Spanish pharmacy has stock shelves where non-drug products directly linked to health are available, including sun cream, baby formula, toothpaste, contraceptives, moisturizers, and more. These products are normally of a higher quality and efficacy than those sold at the supermarket. Nutraceuticals and cosmeceuticals are also on shelves. Similar to the UK, however, Spain purposefully interposes the pharmacist between the consumer and drugs.

There are no OTC drugs in Spain. In order to purchase a drug, one must interact with the pharmacist, even if just to purchase some ibuprofen. The public health care system considers the pharmacist the first level of control in the chain of referral. Often, consumers will visit the pharmacist and ask for advice. The pharmacist will then either offer a simple OTC treatment or counsel the person to seek medical attention from his or her primary care physician. In no case can a person walk into a pharmacy and pull a drug off a shelf, all items are handled by staff. Simple OTC drug requests can be handled by shop clerks and junior pharmacists that have received training in spotting issues that need to be referred to the highly trained pharmacist.

It seems that from a simple contrast between three specific areas, it is clear that culture plays a large part in determining to what degree the concept of OTC is prevalent. It determines not only how the consumer purchases drugs, but to what level professionals intercede in the purchasing process and when.

OTC - "Over the counter" & "Of the culture"

Typically, OTC stands for "Over the counter" medication, what most people consider to be some sort of pharmaceutical treatment that the average consumer can purchase without a prescription. The term derives from the old-fashioned practice of pharmacists safeguarding products and providing them to a customer, over the pharmacy counter from an inaccessible shelf or storage room. Today, many products are simply stocked on shelves consumers can freely draw from. These products require no prescription from a physician nor the intervention of a pharmacist and are considered generally safe for consumers to use.

What is considered "safe", however, is a cultural phenomenon. Most countries subscribe to UN recommendations, but each sovereign nation may interpret findings and act differently. Examining specific nations yields a glimpse into their collective psyche and approach to medication.

 

The United States of America

Many products are available as OTC in the USA. Some are in stark contrast to internationally accepted practices, though. In the USA, the concept of the "drug store" is an accepted fact of life. Consumers generally shop at Walgreens, CVS, Rite Aid, Kroger, and others. Here, many health and personal care products are stocked on large shelving floors with a pharmacist's dispensing counter located somewhere on the periphery of the massive space. As such, stopping at the drug store may include buying some aspirin as well as snacks, toothpaste, shaving gel, cosmetic products, the latest DVD, etc. Many drug stores are often simply areas within larger shopping areas, as evidenced by many US Walmarts offering a Walgreens as a complement. Target, Sears, and Costco don't even bother with creating a separate brand, you can simply shop OTC within a specific area of their normally massive department stores. While you're there, you can also purchase anything from clothing to home improvement materials, from electronic devices to furniture, from appliances to barbecue sauce. Many OTC drugs, then, are offered casually, a reflection of the clear gap between drugs that are OTC and those that are only available through prescription. This mindset is something the USA shares with the UK.

There are many things that are not shared, though. A product cannot be purchased in the USA where codeine is a significant component of the drug. Certainly, there may be remedies sold OTC in the US where codeine is a trace substance, but in general, this incredibly weak opiate is not sold without a prescription. Over the last decade, other measures have been taken by the US to combat specific situations resulting from OTC abuse. In most states, minors no longer have access to OTC couch syrups that contain DXM, as many young people were buying these products in bulk to be used recreationally. The USA also frowns upon stocking shelves with pseudoephedrine, normally used as a decongestant component. Though most remedies containing pseudoephedrine do not require a prescription, pharmacists dispense these remedies directly, monitoring sales. Pseudoephedrine can be used as a primary ingredient of crystal methamphetamines, hence limiting dispensed quantities. The same occurs with certain emergency contraception drugs. Women 17 or over may treat them as controlled OTC items whereas younger women must obtain a prescription, in theory receiving access to counselling and education when dealing with the physician prescribing.

The primary drawback of the USA's drug store style is that the clear rift between prescription and OTC drugs lead many to consider anything purchased off the shelf as "safe", with anything provided by the pharmacist as requiring caution. Directions and warnings are often overlooked.

 

The United Kingdom

In the UK, the concept of the drug store is similar to that of the USA. The sizes of stores are normally smaller and more focused on drugs and cosmetics or personal care items, but shelves are also stocked with numerous OTC drugs.  Top chains include Boots, Lloyds, and the Numark shops. The same drawback observed for the USA is also evident in the UK - drugs purchased OTC are often not approached with the appropriate sobriety.

The cultural differences between the UK and the USA indicate where that sobriety or concern may fall. Pseudoephedrine is available OTC in the UK, in many cold relief products, as a decongestant. Cough syrups with DXM are also sold on shelves, as are pain relievers that offer codeine as a notable ingredient. What does require a prescription in the UK is antibiotic ointment. The over-use of antibiotics in Europe is a genuine health concern, making any antibiotic, topical or otherwise, a prescription item. In the USA, however, topical creams containing neomycin and other antibiotics are common OTC items. Paracetamol, a controlled and limited substance in the UK, is sold on shelves in the USA.

Unlike the USA, the UK has codified its practice of involving the pharmacist into its social milieu. POM drugs (prescription only medication) can only be dispensed with the appropriate directive from a physician. GSL (drugs on the general sale list), may be sold OTC just about anywhere. In between the two is the innovation of the P category for drugs, or those which may be sold without a prescription but require the intervention of a pharmacist adhering to Royal Pharmaceutical Society codes. The job of the pharmacist is to provide assistance, advice, and often to spot abuse of monitored substances.

 

Spain

Spain is somewhat different from the UK and vastly different from the US. The concept of the pharmacy as a drug supermarket is practically non-existent. The small, local pharmacy is where one goes to purchase medication. Personal care items and make-up are generally purchased at either a department store or a "perfumería" (perfumery).

The Spanish pharmacy has stock shelves where non-drug products directly linked to health are available, including sun cream, baby formula, toothpaste, contraceptives, moisturizers, and more. These products are normally of a higher quality and efficacy than those sold at the supermarket. Nutraceuticals and cosmeceuticals are also on shelves. Similar to the UK, however, Spain purposefully interposes the pharmacist between the consumer and drugs.

There are no OTC drugs in Spain. In order to purchase a drug, one must interact with the pharmacist, even if just to purchase some ibuprofen. The public health care system considers the pharmacist the first level of control in the chain of referral. Often, consumers will visit the pharmacist and ask for advice. The pharmacist will then either offer a simple OTC treatment or counsel the person to seek medical attention from his or her primary care physician. In no case can a person walk into a pharmacy and pull a drug off a shelf, all items are handled by staff. Simple OTC drug requests can be handled by shop clerks and junior pharmacists that have received training in spotting issues that need to be referred to the highly trained pharmacist.

 

It seems that from a simple contrast between three specific areas, it is clear that culture plays a large part in determining to what degree the concept of OTC is prevalent. It determines not only how the consumer purchases drugs, but to what level professionals intercede in the purchasing process and when.

 

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  • Modified 12 Jan 2016
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