Americans are buying antibiotics from pet stores as a cheaper alternative to going to the doctor – or to stock up in the case of an apocalypse.
For uninsured Americans – the millions of working poor people – a visit to the doctor can costs hundreds of dollars, and prescription drugs aren't easily affordable either. Online, though, drugs that are given to fish, and are essentially the same substance as those being prescribed to humans, can be had for a few dollars.
The US media is treating this like a new story – following the presentation of a new study that found a significant number of "liked"comments on pet store websites that were clearly posted by people using the drugs. But the practice goes back at least 20 years, when it was apparently rife among US military personnel.
In a somewhat notorious 2002 letter to the New England Journal of Medicine, a doctor wrote: "I recently treated an Army Special Forces soldier who presented with a three-month history of purulent sinusitis that was not responding to self-medication.
"After much prodding, he related that he had been taking a combination of penicillin and sulfa antibiotics, which he had purchased without a prescription “in the fish medication aisle” of a local pet store. He went on to explain that this over-the-counter source of antibiotics is common knowledge among all branches of the American Special Forces community."
Despite this well-reported letter, and subsequent news stories about extensive human consumptions of these drugs, there has been no legislation curbing access to them.
These antibiotics are marketed for aquarium fish – and are obtainable without a prescription, courtesy of a loophole in regulations.
The Smithsonian Magazine has published two stories on the issue in the last two years. In a 2017, the Smithsonian advised why it's such a bad idea to take these drugs – adverse side-effects, treatment failures, and antibiotic drug resistance for a start.
Fish are given many of the same antibiotics as humans – amoxicillin, ciprofloxacin, penicillin, tetracycline and so forth – "and sometimes even in the same doses," the author advised.
"These pills, which are intended to be dissolved in fish tanks and be absorbed through fishes' skin, can also look extremely similar to the human versions."
Ordinarily, antibiotics and other medicinal and veterinary drugs are regulated through the US Food and Drug Administration. Somehow pills for fish slipped through the cracks and are as easily accessed as a packet of jelly beans.
In Australia, antibiotics for animals are regulated by the Australian Pesticides and Veterinary Medicines Authority (APVMA) and, according to a statement from a spokesperson, ""are available only via a prescription from a veterinarian."
However, these antibiotics are readily available online.
The Australian Medical Association told The New Daily there wasn't an overall strategy for the use of antibiotics in Australia, notably in the veterinary and agriculture sector.
Dr Chris Moy is Chair of the AMA Ethics and Medico-legal Committee and a GP. He said because the Australian healthcare system, with its subsidised pharmaceutical scheme, there were "no barriers to people appropriately obtaining antibiotics cheaply."
He said if there was an emerging issue of Australians using fish antibiotics, it came at a time when doctors are trying to reign in the use of antibiotics because of the "catastrophic" problem of bacteria developing resistance to what we once hailed as wonder drugs.
"There are still people who are completely misguided coming to me, and I'm telling them I'm not going to give them antibiotics because they have a viral infection," said Dr Moy.
"We know there's a problem with people self-treating and it's possible they are obtaining antibiotics that are meant for fish."