what metric would you use to measure ability to take responsibility? 
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I don't know. You could in principle use tests, similar to a drivers license, and a process by which the license can be revoked if you turn out to be irresponsible or become senile?
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It would look like India, which does just fine
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Can you say more? Are all drugs freely available in India? What is the outcome, what are problems?
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libertarianism?
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I thought libertarianism is not an actual option for designing a society, but the ludicrous idea that all people are responsible adults if you let them?
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One in which the media swarmed over each case of someone using a medicine irresponsibly with bad result, clamoring for prohibition to be reimposed. Hence, for this thought experiment work, you need to posit deep cultural change (which I would favor), not just legal change.
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There is a real and substantial question about outcomes. What number of additional deaths and disabilities among vulnerable populations is acceptable, in exchance for making healthcare cheaper and more convenient for 60% of adults?
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- Increased antibiotic resistance - Increased Teledoc appointments, of a "I'm planning to take this, does that seem like a decent idea?" - Increased consultations with pharmacists about drug interactions - Insane increase in drug marketing - Opiod epidemic on steroids
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We could still outlaw drug advertising, and we could introduce something like a "weed card" for addictive and easily harmful medications. It's also not clear if liberalization would increase drug abuse, since neither supply nor cost of illegal drugs seems to be a problem.
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