BOISE, Idaho — It was a scene that doctors saw play out over and over during the COVID-19 pandemic, said David Pate, the former president and CEO of St. Luke’s Health System.

People brought critically ill family members to the hospital and were “in shock” when they learned that a family member had been infected by the coronavirus even though he or she had been taking ivermectin, an anti-parasitic drug. The family member had been assured that taking ivermictin meant they couldn’t get COVID and didn’t need a vaccine.

Some families asked doctors whether their loved ones could be vaccinated there at the hospital. But “it’s too late at that point,” Pate told the Idaho Statesman in February.

“It’s heartbreaking, because those families were devastated that they had been deceived, and now one of their family members was paying the price,” he said. “They were duped, and they were just in disbelief.”

Those scenes are top-of-mind for Pate these days amid the continued popularity of — and inaccurate information around — ivermectin. Dubbed a “wonder drug” for its ability to treat a wide range of parasitic infections, the drug gained a following during the pandemic for its supposed ability to treat the respiratory virus.

To the extent that studies have found that ivermectin could actually treat COVID-19, it was only in large doses that would cause serious side effects in humans, Pate said. At such a large concentration — up to 100 times the dose approved for humans — the drug might stop the virus but also harm the patient, NPR reported in 2021.

Still, it has remained sought-after. Right-wing influencers advertise that it can cure a host of ills, even though the Food and Drug Administration has not approved the drug for use beyond its original anti-parasitic properties, The New York Times reported in March. Taking the drug has become an indicator of distrust in pharmaceutical companies and medical expertise — an “enduring pharmacological MAGA hat,” the Times wrote.

Many Idahoans — including several of the state’s lawmakers, according to comments made on the House and Senate floors — have been clamoring to use the drug to treat a wide range of maladies, from cancer to the common cold, for which it is not approved by the FDA. Many have been impeded by the requirement to get a prescription.

On Monday, their wish was granted. Idaho Gov. Brad Little signed into law a bill to allow Idaho pharmacies to sell ivermectin over the counter. The law will “give people in Idaho the freedom to access” the drug, said Sen. Tammy Nichols, R-Middleton, one of the bill’s sponsors.

Especially in rural Idaho, where doctors are scarce and doctors’ appointments can be hard to come by, the law could increase Idahoans’ access to the drug, said Rep. Jordan Redman, R-Coeur d’Alene, another sponsor and a pharmacy owner. He said selling the drug in pharmacies would increase the likelihood that patients would consult with a medical professional about whether ivermectin could help treat their condition.

Idahoans are taking the drug anyway, he reasoned — and many are buying a version at animal feed stores intended for de-worming livestock, without any information about human dosages or recommended uses.

“I do think it will be handled more responsibly now, rather than getting some horse paste or whatever,” Redman told the Statesman. “I think you could see people thinking that they can take it for anything, and that’s not really the case.”

But the “biggest issue” right now, he said, is that “we know that Idahoans are taking it — so having them have a conversation is probably a better solution long-term.”

Pharmacy customers aren’t required to speak with pharmacists to buy over-the-counter medications, so there’s no guarantee those conversations will take place.

Despite the law, pharmacies face practical hurdles to getting ivermectin on the shelves: Ivermectin manufacturers don’t produce labels about the medicine’s side effects or interactions with other drugs — an FDA requirement for the packaging of over-the-counter medications.

During a committee hearing, a lobbyist for Idaho pharmacies said the bill would put pharmacists in a “sticky situation.”

Pharmacies “are not going to be able to put it out there to sell it as an over-the-counter until the manufacturers make that change,” said Pam Eaton, the CEO of the Idaho Retailers Association. “Yet customers are going to hear that they can get it as an over-the-counter, so they’ll be there arguing with the pharmacist.”

Pate said in April that he doubted legitimate pharmacies would put themselves at risk by selling the drug without proper labeling — but anticipated that a raft of online pharmacies may spring up ready to sell the drug to anyone who asks for it.

“They’re not going to say that you have to have a doctor’s order, or you have to see a doctor first,” Pate said. Instead, he predicted, they’ll say, “ ‘We’ll just send it to you, because you know what? We can make money.’ ”

Ivermectin a ‘fantastic drug’— for its intended uses, doctor says

Still, Pate called ivermectin a “fantastic drug.” It has few severe side effects, and it works effectively against parasitic diseases, such as river blindness and African eye worm. There are early indications that, in combination with other drugs, it may have anti-cancer effects— though that has been tested so far only in labs, not on humans.

“I don’t have anything against ivermectin,” Pate said. “But like all drugs, I think it should be used for the right condition in the right amount for the right amount of time, and with consideration for other factors about the person, such as potential medication interactions and underlying medical conditions.”

In hearings about the bill, lawmakers expressed no such caution. Senate Pro Tem Kelly Anthon, R-Rupert, a sponsor, told lawmakers that the drug had had “immeasurable impacts on improving the lives of billions and billions of people throughout the world” and had served in “treating and in many ways curing human diseases.” He did not directly address concerns about Idahoans using the drug for conditions it’s not intended for.

Allowing pharmacies to sell ivermectin over the counter would allow people to “self-treat some common conditions without needing a prescription,” he said in a committee hearing. It would present an affordable option for people in rural parts of the state with limited access to health care providers, he argued.

Most of lawmakers’ discussion of the drug centered around individual anecdotes of family and friends who had taken the drug. Other than Eaton, no medical or pharmaceutical experts testified.

Sen. Glenneda Zuiderfeld, R-Twin Falls, told fellow lawmakers that she took ivermectin during the pandemic and still takes it every time she gets a cold.

“It heals, it fixes, it does more good than harm,” she said on the Senate floor.

She said parasites cause cancer, and ivermectin is a cure. Some parasites can increase the risk of developing cancer, but they are not a direct cause, according to the American Cancer Society, which says the parasites that heighten cancer risk are not found in the U.S.

Zuiderfeld and other lawmakers expressed distrust of the medical establishment’s position on the drug, suggesting that pharmaceutical companies were withholding ivermectin as a treatment for a wide range of conditions.

“There’s only money where you can keep us sick,” Zuiderfeld said.

Sen. Carl Bjerke, R-Coeur D’Alene, expressed skepticism about relying on the FDA’s approval of the drug, or the lack thereof.

“I’m willing to throw caution to the wind, so to speak, to give my constituents the opportunity to look after their own health,” he said on the Senate floor.

Redman told the Statesman he was surprised to learn how many fellow lawmakers said they regularly use the drug. “That actually shocked me,” he said.

Pate agreed with some of the lawmakers’ assertions about the relatively low short-term risks of taking the drug — that users are unlikely to develop an addiction, and that most people tolerate it well. But he said they failed to consider another significant risk: that Idahoans would try to use the drug to fight illnesses it can’t treat.

It won’t work, and they’ll waste valuable time when they could be receiving a proven, effective treatment, he said.

If studies of ivermectin show that it can effectively treat some cancers, then “praise God, that’d be fantastic,” Pate said. “But I think we’re a long way from that.”

For now, “you’ve got someone that does have early cancer, and they’re trying ivermectin, but it doesn’t work. And now, by the time they seek medical care, it’s no longer treatable.”

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