they never stay 😔

I do find Lidl are better for cured meats

There are already lots of poisons available over the counter. And there are other countries that don’t put every drug behind a medical gatekeeper. And while I’d say civilization ain’t looking so hot right now, I don’t think those are the main causes of our decline.

So you’re saying that I shouldn’t take 3 stimulants at the same time?

I’m not sure this is the best way to approach solving that problem, though. As a system it makes no distinction between users, gatekeeping is applied equally regardless of medical status or knowledge of the drug. I know a trans man IRL who went months without T due to communication problems between the doctors and his insurance, and he told me his joints started deteriorating after living without sex hormones in his body for so long.

Gatekeeping causes harm; lay people having easy access to and using drugs without sufficient knowledge of interactions, dose, route of administration, etc. also causes harm.

It would be nice if instead of or in addition to a short-lived prescription, there were an option to get educated and then licensed to have access to certain drugs; you could combine informed consent with medical training with the goal that patients are trusted and empowered to make their own choices once they can responsibly do so.

You see variance on this even with trans healthcare, where some providers (notably I’ve heard the VA does this) won’t allow patients to inject their own medication and patients have to come to the clinic for every injection, while plenty of other providers trust their patients to educate themselves on how to administer injectable drugs to themselves (though the patients are not always offered training to learn how, that would be nice).

If I can learn to inject myself, I can also get educated on the appropriate doses, routes of administrations, and clinical risks associated with the medication I’m taking.

I’ve had several doctors explicitly ask me to educate them about trans healthcare, so it’s not even like the doctors are particularly educated on trans healthcare anyway, and they make poor gatekeepers because of their profound ignorance.

One doctor I had even believed and said many empirically false things about trans healthcare, like the idea that starting HRT doubles you risk of suicide (it actually significantly lowers your risk, this is the reason it’s the gold standard of care for gender dysphoria and he should know this as a doctor who prescribes HRT for trans patients).

Patients usually will not know more than their doctor, but it should at least be an option for people to pursue the education deemed necessary to allow them that autonomy responsibly.

Also, for what it’s worth, access to a drug doesn’t always guarantee harm - people have plenty of unfettered access to harmful drugs in nature (like posionous nightshade plants), yet it rarely leads to abuse or misuse. It’s important we don’t mistake the problem here, which is more social and cultural than strictly about access. When grifters start exploiting young men’s insecurities to sell them testosterone replacement therapy, the context of that drug use is clearly exploitative and likely to lead to harm. There is a lack of medical basis and plenty of reasons to expect harm from TRT clinics like that. Yet trans healthcare has a broad base of evidence that it saves lives, and having access to those hormones become as crucial and necessary as the endogenous sex hormones most people take for granted in their bodies. There is a very different medical need and justification for a teenage boy who watched a TikTok video and came to believe they need TRT to be more of a man, and a trans man who needs those hormones to live.

All this to say, harm often comes in the form of combatting social problems, and that’s probably where most of the solution should be as well, rather than pretending the danger is inherent to the drug.