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Because
drugs can produce harmful effects when manufactured
or taken improperly, most governments control drug development
as well as availability. In the United States, the FDA
determines how drugs are produced and how they are sold.
Drugs that can be sold over the counter (OTC)-that is,
without a prescription from a physician-are called proprietary
drugs. They are considered safe for unsupervised use
by the general population. Drugs that must be prescribed
by physicians and dispensed by pharmacists are known
as ethical drugs. Their use is monitored closely by
medical personnel.
The FDA regulates the sale and manufacture of drugs
in the United States as outlined in applicable laws
enacted over the past century. Legal standards for composition
and preparation of drugs in the United States are found
in the publication known as the United States Pharmacopeia
(USP). Drugs that can be abused, such as the powerful
narcotic heroin, are regulated by the Drug Enforcement
Administration (DEA) of the U.S. Department of Justice
to ensure that they are not prescribed or sold illegally.
Before 1900 any individual could sell a drug and claim
it offered therapeutic benefits without medical proof.
This changed after 1906 with the passage of the Pure
Food and Drug Act, which required drug manufacturers
to state the content, strength, and purity of each drug
they produced. The Pure Food and Drug Act ended the
practice of including morphine, cocaine, and heroin
in drugs without the public's knowledge. In 1914 the
U.S. legislature began to strictly regulate the trade
of narcotics with the enactment of the Harrison Narcotic
Act; in 1937 the government added marijuana to this
list of controlled substances (the Marijuana Tax Act).
The Federal Food, Drug, and Cosmetic Act was enacted
in 1938 requiring that new drugs be safe for humans;
however, it did not require that manufacturers prove
their drugs' effectiveness. It would be 24 years before
legislation was passed that would require proof of the
efficacy of new drugs (the Kefaver-Harris Amendments,
1962). Enforcement of this law was entrusted to the
FDA.
Two laws enacted in the 1960s strengthened the FDA's
efforts to reduce drug abuse. The Drug Abuse Control
Amendments of 1965 provided penalties for the illegal
sale or possession of stimulants, sedatives, and hallucinogens,
and the Narcotic Addict Rehabilitation Act of 1966 set
up a federal program for addicts that provided them
with the option of receiving treatment for their drug
problems in place of a prison sentence.
In 1970 the Comprehensive Drug Abuse Prevention and
Control Act established rules for manufacturing and
prescribing habit-forming drugs. It stipulated that
physicians can prescribe all drugs, but a special license
is required to prescribe drugs with a high abuse potential.
This license is issued by the Drug Enforcement Administration.
The Anti-Drug Abuse Acts, signed into law in 1986 and
1988, set up funding for the treatment of drug abuse
and for the creation of law-enforcement programs to
fight the illegal sale of drugs. These acts also detailed
severe punishments for individuals selling and possessing
drugs illegally. Harsh penalties for using anabolic
steroids (hormones that promote the storage of protein
and the growth of tissue that are sometimes abused by
competitive athletes) were included in the 1988 act,
along with the requirement that all alcoholic beverages
be labeled with warnings about alcohol's potentially
dangerous effect on the body. The 1988 act also established
the Office of National Drug Control Policy to develop
an action plan that would involve the public, as well
as private agencies, in eliminating the illegal sale
of drugs; in helping individuals who use drugs to stop;
and in preventing nonusers from ever starting to use
drugs.
The U.S. government and its regulatory agencies continually
monitor the development and use of all drugs sold in
the United States to ensure that the American public
has access only to drugs that are safe and effective.
Recently, the FDA introduced legislation requiring warning
labels on all over-the-counter medication after research
indicated that the nonaspirin pain reliever acetaminophen
can cause liver damage when taken in high doses with
large quantities of alcohol.
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