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The phrase over the counter is widely used to characterise the drugs that can be legally bought without a physician's prescription, and is so used in the countries in which these drugs are not in fact bought over any kind of a counter, in the literal sense. They are displayed on self-service shelves and the customers simply pick them up and pay for them; the payment may be done at a counter, but the transaction does not involve their being handed over the counter.

That is, of course, not particularly puzzling in itself: one could point out that, once upon a time, such drugs were handed to the customers over the pharmacy counters (as they still are in many parts of the world), and that the phrase then remained after the modernisation of the pharmacies. It is not at all uncommon for the meaning of an expression to be stretched in such a way. After all, the phrase over the counter itself is also used in the world of finances, and the kind of stock to which the phrase refers is not bought and sold over any kind of counters in the literal sense.

What is, however, puzzling about the use of the phrase in the context of drugs is that its only purpose is to convey that the drug in question is not of the kind for which a prescription is required, and the drugs of the latter kind are always dispensed over the counter, in the literal sense. To obtain such a drug a customer has to walk to some counter, hand the prescription to a pharmacist who is standing on the other side of the counter, and the pharmacist then, after getting the drug ready, hands the drug over the counter to the customer.

So the question is not how did the phrase end up being stretched beyond its literal meaning (that itself wouldn't be strange), but why was it chosen as the term for something (non-prescription drugs) that stands in contrast to things to which it readily does apply in the literal sense (prescription drugs).

General-purpose dictionaries provide the meaning of the phrase, but are of no help in resolving this puzzle. Readily available sources of general information about over-the-counter drugs do not discuss why they are so called.

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  • Related but without a satisfactory answer: What does over-the-counter mean literally? (Essentially a request about the earlier etymology of the phrase, which may inform the 'non-prescription' usage.) Jul 19, 2020 at 16:11
  • @EdwinAshworth, yes, I was aware of that question, but did not refer to it as it seemed specifically focused on the finances-related use of the phrase.
    – jsw29
    Jul 19, 2020 at 16:16
  • Webster's Revised Unabridged Dictionary has the usage: Over the counter (Stock Exchanges) in an office; -- said of business so done, as distinguished from that done at an exchange. I'm guessing that the fact that you can buy these directly from the chemist[']s rather than [first, in the case of the doctor] having to go to the place where the head honcho works is the key. Jul 19, 2020 at 16:20
  • Where I live, (UK), OTC drugs may be sold (and some can be bought in ordinary grocery stores), but, under the National Health Service, prescription drugs are dispensed. A standard prescription charge may have to be paid, which is not related to any market value the drugs may have. In Scotland, Wales, and Northern Ireland, prescriptions are dispensed free of charge. In England they are free to many categories of patient. In cases where the charge is payable, we would not think of the drug as being 'sold' to the patient. Jul 19, 2020 at 17:39
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    Ngram indicates that "over the counter drug" appears at least as early as the 20th c. when pharmacies were configured a bit differently. Perhaps "over the counter" might have referred to the placement of the product itself. In other words: certain drugs and preparations would have been pre-packaged and displayed on shelves "over (and behind) the counter" and one would simply ask the pharmacist for a bottle or box of whatever - rather than having to request a specific prescription be dispensed. (Just spitballin', here)
    – Oldbag
    Jul 26, 2020 at 17:06

6 Answers 6

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To summarise your question, you are asking about the phrase “over the counter” and you use as an example the experience at chemists/druggists in which “over the counter” items do not necessarily and literally go “over the counter”, whereas prescription only medicines do go “over the counter.”

You seem to assume that there is a literal passing of the purchase over the counter. There would have been at one time, but this is not the essence of the phrase.

Language and phrases develop: We say we dial a telephone number - but modern telephones have no dial.

The earliest mention (that I can easily find) of “over the counter” in a retail sense is from a publication by “The Business Historical Society Inc. 1823” entitled "Past, Present & Probably the Future State of the Wine Trade" By James Warre:

Mr. Barker, a licensed victualler in Holborn, “sells retail over the counter, in glasses, a pipe and a half of Port wine in a week. Some drink at the counter, others take it away in small bottles. The principal customer are small tradesmen, ..."

Here, “over the counter” has already taken on a figurative meaning: “directly to the consumer and without formality and restriction” and this is in contrast to sales of wine to a restricted group, i.e. members of the trade.

The figurative sense of “over the counter” is thus “without restriction/formalities” and it has been for over 200 years.

So he took me on a tour of the multiple gun stores and pawn Shops not far from the famous Vegas Strip. Our mission - to see if I could buy a gun over the counter. SBS News (2017) https://www.sbs.com.au/news/i-tried-to-buy-a-gun-at-a-las-vegas-department-store

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    The question is not about over the counter in general, with its drugs-related sense used as an example; it is specifically about its drugs-related sense, because it is in that sense that the phrase is, paradoxically, used in contrast to something that is actually sold over the counter, in the literal sense. The sales of port by Mr. Barker do not exhibit any analogous paradox, as it is clear that he was selling glasses of port over a literal counter, while the large quantities sold wholesale to other merchants were not likely to have been handed to them over any such counter.
    – jsw29
    Jul 26, 2020 at 21:44
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    This answer provides some useful historical insight, but I don't think it's entirely a fair interpretation of the OP. For instance, the OP had made it clear that languages and phrases develop. This was not an issue.
    – Pound Hash
    Jul 27, 2020 at 2:50
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    @jsw29 The sales of port by Mr. Barker do not exhibit any analogous paradox, In fact, they do. You will note the title and publication. From these, it can be seen that the two aspects of trade (wholesale and retail) are addressed and I assume import as well. Wholesale was (is still?) restricted to wine merchants. The phrase should not be restricted merely to the example of the medical context that OP has given as it has a much wider application.
    – Greybeard
    Jul 27, 2020 at 12:07
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    This is the correct and only answer. (There is no "paradox" whatsoever, paradox is an irrelevant concept. As perfectly mentioned in the answer, we "dial" a phone or "film" a movie. "Paradox" is utterly uninvolved.)
    – Fattie
    Nov 30, 2022 at 12:03
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    It's no more a paradox than "why do we drive on the parkway and park on the driveway". I've bought lots of pharmaceuticals: some have been over counters, but many have not, both prescription and non-prescription. These days you can get prescription drugs delivered or from lockers like vending machines; sometimes the pharmacist comes out a door and hands you a packet. OTC drugs may be on shelves, or kept under a pharmacist's counter or on the wall behind the counter.
    – Stuart F
    Nov 30, 2022 at 22:28
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The phrase "over the counter" in the context of retail transactions appears in English publications at least as early as the 1830s. For example, the phrase "all retail over the counter" appears seven times in the description of the action in Filmore v. Hood (November 21, 1838), a case in the Court of Common Pleas, reproduced in The [London, England] Law Journal Reports (1839), starting with this instance:

The declaration alleged, that the defendant entered into an agreement with one B. for the sale of a lease of a public house for a certain sum; and that, at and before and after the said agreement, the defendant falsely, fraudulently, and deceitfully pretended and represented to the said B, that the trade of the house had been, and then was, 180l. per month, all retail over the counter ; and the said B. not being able to complete the contract, it was agreed between the plaintiff, the defendant, and B, that the plaintiff should become the purchaser instead of B, and at and before the agreement, B. communicated to the plaintiff the statement and representation as to the value of the house, made by the defendant to him, of which the defendant had notice, and the plaintiff confiding in such representation, agreed to become the purchaser of the premises for a certain sum, which he paid to the defendant.

In this case, the phrase "all retail over the counter" seems to mean something like "all in the form of direct transactions between the host/server/seller behind the counter and retail customers on the other side of the counter." Implicit in this understanding of "over the counter" is the idea that it applies to discrete, ad hoc, relatively informal exchanges of goods or services for money between a seller and a buyer.

In the context of drugs and medicines, however, the phrase "over the counter" seems originally to have applied not to the place where the sale of the item occurred or to the nature of the medicine itself, but to the source of the prescription. That is, an "over-the-counter" prescription was one made by the chemist or apothecary on the premises, rather than by a trained physician in a medical office. Two early examples—one from England in 1865 and one from Australia in 1873—seem to support this understanding. From "The Twenty-fourth Anniversary Meeting of the Pharmaceutical Society," (May 17, 1865) in The Pharmaceutical Journal and Transactions (1865):

Mr. COLLINS (who came in late) said then he must not complain. He must say, however, that he thought the Medical Council had put forward a most extraordinary recommendation with regard to the Bill [the pending "Chemists and Druggists Act" updating the Pharmacy Act of 1852]. He hoped that those who had charge of the Bill would not allow such a monstrous clause to be inserted. He and many others had no desire to prescribe in the strict sense of the word over the counter ; but whilst medical men sent out medicine, he thought they ought not to object to chemists and druggists prescribing any simple remedy over the counter. If they dealt in those matters they knew the penalty which attached to it, and, should application be made to them, every sensible man, when he saw a case of difficulty, would advise the applicant to apply to a properly qualified man.

Mr. HILLS said that he had never heard it mentioned that the Medical Council wished to prevent Pharmaceutical Chemists from prescribing over the counter.

...

Mr. COLLINS said he thought there was something behind it, and asked for an explanation of what was meant by "any branch of medicine." Hi opinion was, that under that clause a chemist and druggist might be prevented from prescribing a simple chalk mixture, under the plea that he was practising a branch of medicine, and he called upon the Council to strongly oppose any restriction being placed upon their present liberty with regard to prescribing.

The bill in question evidently included language that might be interpreted as disallowing chemists and pharmacists to prescribe medications to their customers if such prescribing were viewed as "practising medicine":

An extract from the Minutes of the proceeding of the [Medical] Council (which will be found elsewhere in this Journal) sets forth the general view taken of Sir Fitzroy Kelly's Bill, and more particularly enters on this question of counter practice, proposing an addition to the 17th Section (which now declares that no provisions of the Act are in anywise to interfere with the vested interests of medial practitioners) of these words:—"or to entitle any person registered under this Act to practise Medicine or Surgery, or any branch of Medicine or Surgery."

Mr. Collins's concern appears to have been that the proposed wording might prohibit the common "counter practice" of a pharmacist's informally prescribing patent medicines or other common nostrums to customers without guidance from a certified "medical man."

And from "Women as Chemists," in the [Toowoomba, Queensland] Darling Downs Gazette and General Advertiser (February 5, 1873):

Of shops kept by druggists and chemists there are two kinds. Those who study the physiognomy of our streets must have observed that in poor and densely populated districts druggists shops spring up with amazing rapidity, and appear to meet with a tolerably uniform success. One which is at first represented by a few bottles, plasters, and half a dozen tooth-brushes, may be seen before long adorned with plate-glass, colored jars, &c. This is an "over-the-counter business." Proprietary or patent medicines, pills, plasters, horse medicine, rat poison, and specific remedies for every known disease are sold ; but the pennyworth or two-pennyworth of physics are paid for on the spot, and form the staple of the trade and profits. The men who keep these shops are often exceedingly ignorant : but they, nevertheless, prescribe largely for the poor, the advice being as it were thrown in gratuitously with the medicine, and paid for in ready money; it need hardly be said that young and needy medical men are in this way very heavily handicapped. But by the recent change in the law certain drugs may not be sold at these shops, nor may the owners assume that title of pharmaceutical chemists. The other class is that presided over by those who pass the prescribed examination of the Pharmaceutical Society, and is chiefly employed in compounding and dispensing the prescriptions ordered by medical men. To these persons certain privileges are secured, and they are legally entitled to announce themselves as pharmaceutical chemists.

Here, again, we see "over-the-counter" prescriptions contrasted with medical prescriptions. In my Google Books and Elephind database searches, instances of "over the counter" as a description of pharmacists' prescriptions were more frequent (until the 1910s) than instances of "over the counter" as a description of specific classes of medicines.

Missing from either of these early accounts is any mention of instances in which customers march into a pharmacy and summarily demand a bottle of Aunt Granny's Bitter Bristle Root for what ails them. Such self-directed prescriptions—based on personal experience, informal advice from friends and relatives, or recommendations appearing in TV commercials—may well account for most "over-the-counter" drug sales today. Nevertheless, some customers still undoubtedly ask the counter clerk at CVS for advice about which preparation they should buy to treat a particular ailment, thereby summoning the old form of "over-the-counter prescription."


Conclusions (added on December 4, 2022)

My answer attempts to distinguish between "prescribing over the counter" and "selling over the counter." The goal of the proposed Chemists and Druggists Act of 1865 was evidently not to forbid pharmacists to sell potentially hazardous drugs over the counter to a customer who had received a prescription for them from a qualified physician, but rather to forbid pharmacists to prescribe such drugs—or to recommend other treatments in a manner that amounted to "practising medicine"—over the counter. The actual sale—the physical exchange of money for drugs "over the counter"—would of course be the same, regardless of the source of the prescription.

I see a fundamental distinction between (on the one hand) drugs prescribed in a medical office or at a patient's home by a doctor but sold over the counter by a pharmacist and (on the other hand) drugs prescribed by a pharmacist in a pharmacy and sold over the counter by that pharmacist. The latter, I think, is what Mr. Collins has in mind in talking about prescribing over the counter. He further tries to distinguish between "prescribing any simple remedy over the counter" and prescribing treatments requiring professional medical expertise over the counter—what he calls "to prescribe in the strict sense of the word over the counter."

The acceptable subset of "simple remedy" treatments that (according to Mr. Collins) ought to be within a pharmacist's rights to prescribe "over the counter" may well have included, in 1865, any number of simple drugs that were not prepackaged for off-the-shelf purchase. Over time, however, as prepackaged drugs and other medicines became the norm for "simple remedies," the term "over the counter" seems to have migrated from the prescription to the prepackaged product itself.

Even so, the old distinction between "prescribing by a physician" and "prescribing over the counter [by a pharmacist]" might help explain why people today divide pharmaceutical drugs into "over-the-counter drugs" (those that can be purchased off the shelf, without a doctor's prescription) and "prescription drugs" (those that must be specially bottled by the pharmacist and sold only to buyers who have a doctor's prescription for them), despite the fact that the pharmacist ultimately sells both types of drugs to customers over a counter.

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  • Unfortunately everything here from "seems originally to have applied..." is unfortunately basically wholly confused and wrong. The writer of the obscure example sentence "prescribe in the strict sense of the word over the counter" is indeed using OTC in exactly the usual way!!!!!! OTC is a metaphor meaning "direct retail sales (without salesmen, formalities, invoicing, etc). The writer of the witty example sentence is actually referring to the literal meaning of over the counter in the joke he makes.
    – Fattie
    Dec 4, 2022 at 20:38
  • This is a brilliant and very promising hypothesis, and the only thing that makes it less than completely convincing is that it relies on an example from 1865 to explain the usage that, as the answer makes clear, emerged half a century or so later (the 1873 example seems less relevant as 'over the counter' appears away from 'prescribe'). Are there any examples where over the counter directly qualifies prescribe from, say, the turn of the century?
    – jsw29
    Dec 5, 2022 at 17:57
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    @jsw: Yes, there are many instances of "prescribing [or prescribe or prescribed] over the counter" after 1865. An Ngram graph for these phrases for the period from 1866 to 1980 indicates that instances of the phrase peaked around 1880 but continued at some level of frequency into the 1930s. Eventually the "matches" become instances of "prescribing over-the-counter drugs"—a very different phrase. ...
    – Sven Yargs
    Dec 5, 2022 at 20:11
  • ... But the vast majority of matches through the 1920s are on point, and even as late as Robert Nixon, Corner Druggist (1941), we find this sentence: "Just as the doctor was condemned for dispensing drugs of whose properties he was for the most part ignorant , so the druggist was criticized for taking upon himself the prerogative of the physician by prescribing over the counter."
    – Sven Yargs
    Dec 5, 2022 at 20:11
  • ... And this one from an unidentified item in Memphis and Mid-South Medical Journal (1961): "There are still a couple of matters and complaints—such as pharmacists complaining that the doctors are telling patients the exact cost of drugs rather than a relative idea of the cost and the complaint that specific instances of druggists prescribing over the counter continue to occur."
    – Sven Yargs
    Dec 5, 2022 at 20:21
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In many, if not most, pharmacies the qualified pharmacist or pharmacists work in dispensaries which are separate from the front of the shop where the counter is. "Over the counter" medicines which do not require reference to a pharmacist are sold, literally, over the counter by counter staff but dispensed drugs are often handed to the customer through a hatch into the pharmacy or by a pharmacist who has left the dispensary in order to hand the drug directly to the patient. The handover is often accompanied by words of instruction or caution. The customer also has to wait until the prescription has been filled when buying prescription-only drugs whereas over-the-counter drugs are handed over immediately.

This distinction was particularly true of pharmacies before the advent of self service shops when the "over the counter" drugs were kept behind the counter and retrieved by sales staff when requested rather than being selected from displays by the customers. Prescription-only drugs were and are kept in the pharmacy so counter staff have no access to them.

Also, in days gone by, pharmacists often prepared many medicines themselves rather than dispensing factory-made ones, they would mix drugs into liquids and pour them into bottles or mix them into pastes and roll them into pills. Over-the-counter medicines were factory made much earlier.

It should be noted that, in the UK at any rate where NHS prescriptions attract a fixed charge per item unless the customer is exempt, pharmacists do not use the till much, payment for prescription drugs usually being taken by counter staff. What happens in countries without government-funded healthcare I do not know.

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  • This answer seems to be using the word counter in some peculiarly restricted sense. Could you explain why the structure that separates the space in which the pharmacist works from the customers would not be called a counter? Even at the places where there is, as you describe, a hatch through which the drugs are handed to the customers, isn't that hatch on top of a counter?
    – jsw29
    Dec 1, 2022 at 16:28
  • @jsw29 The word "counter" means, not only practically but also etymologically, a structure across which financial transactions are completed and which, under modern conditions, supports or includes a till. The point about the separate hatch, and separate dispensary, is that the financial transaction is separate from the dispensing of the drugs. With over-the-counter drugs the exchange of goods for money takes place immediately across the counter; in the case of dispensed drugs it does not.
    – BoldBen
    Dec 2, 2022 at 17:27
  • I realize that one issue on this totally bizarre QA may be that OTC is a rather American business term. If I'm not mistaken, all of the (utterly bizarre) tortured explanations here are from us Brits!
    – Fattie
    Dec 4, 2022 at 20:46
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It could be that the idea in specifying those sales as OTC is that only a counter is involved, this counter standing symbolically as a transaction solely between buyer and pharmacist, whereas "not OTC" involves a third party in the transaction.

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    Actually I think this is a pertinent answer—an OTC drug is one you can get simply by paying for it at the counter, which is where the money is counted, without the permission of another person or entity.
    – Xanne
    Jul 19, 2020 at 21:05
  • This answer seems be arguing that over the counter in this context really means over the counter, without any third parties involved. Perhaps this is so, but then the question becomes: how did over the counter turn into over the counter, without any third parties involved? This is still puzzling, given that the presence of a counter, in a literal sense, has nothing to do with whether third parties are involved. The word counter may indeed be used symbolically here, but for symbolic use to be intelligible, it has to be visibly connected to the literal meaning.
    – jsw29
    Jul 20, 2020 at 15:42
  • @jsw29 As is often the case in the coining of such phrases, we can surmise that the process of identifying the form " over the counter" (literal) to a an abstract notion (sale not involving a an extra procedure that is not part of what takes place over the counter) is not a strictly reasonned one, but a transcendental one in which the thinker all at once identifies "over the counter" with "what usually takes place over the counter", and that is never the delivery of prescriptions. What is used symbolically according to this point of view is "over the counter", not just "counter".
    – LPH
    Jul 20, 2020 at 16:05
  • Actually over the counter drugs are simply taken off the shelf. They are not behind the counter, but in front of it. “Off the shelf” items can be bought without third-party permission (e.g., some drones are available off the shelf). So too much is being made of “over the counter.”
    – Xanne
    Jul 27, 2020 at 5:23
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    @Xanne As I sort of mentioned in my answer originally all goods in almost all shops were kept behind the counter and retrieved by sales assistants in response to customers' requests. The self service shop is an invention of the last 60 or so years.
    – BoldBen
    Dec 5, 2022 at 21:39
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This source [1] suggests comparing the expression to under the counter (and its American variant 'under the table'), the meaning of this expression being secret and often illegal transactions.

If we examine the etymology for under the counter, there are two origin stories found here:

a [2] "In Britain, during the Second World War, shopkeepers sometimes kept articles that were in great demand under the shop counter. They only sold them to special customers, often charging very high prices for them."

b [3] "the counter [is] the flat-surfaced furnishing or table over which legal business is conducted."

This background suggests to me the following suspicion. Perhaps non-prescription drugs are referred to as over the counter because there isn't much chance of their being involved in secret or illegal transactions. Such a loss of opportunity for underhandedness entails a loss of opportunity for under the counter business dealings. Moreover, we may also surmise, with inference from the first origin story, that non-prescription drugs are in less demand than their counterparts and hence provide less incentive for being kept under the counter for those special customers.

[1]: McGraw-Hill Dictionary of American Idioms and Phrasal Verbs. S.v. "over the counter."

[2]: Collins COBUILD Idioms Dictionary, 3rd ed.. S.v. "under the counter."

[3]: The American Heritage Dictionary of Idioms by Christine Ammer. S.v. "under the counter."

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The phrase "over the counter" has nothing to do, in particular, with pharma.

The phrase "over the counter" is used in retail and marketing to simply mean direct, immediate, retail, sales to a consumer.

(Note that "off the shelf" is another phrase with the identical meaning.)

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    You didn't even address the question.
    – Pound Hash
    Nov 30, 2022 at 21:17
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    You may think it's a non-question not worthy of an answer, but that doesn't mean you can post just anything in response.
    – Stuart F
    Nov 30, 2022 at 22:29
  • You both must have trouble reading the question. What is it you're having trouble understanding?
    – Fattie
    Dec 1, 2022 at 2:00
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    The question (see title) is "Why are over-the-counter drugs so called?" The answer is very simple: this phrase is used commonly in all retail and marketing for all products. (Much like say "expensive", "on sale", "top-shelf" and so on.) The OP is, simply, mistaken in thinking it has anything to do with pharma in particular.
    – Fattie
    Dec 1, 2022 at 2:06
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    @Fattie You might neglect the condition on which the question was asked, but more careful readers would attend to it nonetheless.
    – Pound Hash
    Dec 1, 2022 at 2:21

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