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IMO the only criteria should be safety. Medicine doesn't have to work for everyone to be useful for a lot of people.



A great many drugs are grossly unsafe if you even minorly exceed the clinical dosage threshold, but are still regularly used by people because we haven't found better replacements.

A much larger set of drugs fall into a gradient of "as far as we can tell you'll just excrete it if you take too much" to "it's probably not _good_ if you unnecessarily take it, but it won't really be detectable in 4 weeks" to "oh god why would you ever prescribe that".

So if we were purely grading on safety, we'd be out quite a lot of pharmacology.




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