Tennessee’s 2022 legislation allowing pharmacies to dispense the antiparasitic drug ivermectin without individual doctor prescriptions has expanded access to highly concentrated doses, according to KFF Health News and ABC News reporting. The change has raised concerns among public health authorities about misuse, misinformation, and potential health risks associated with unregulated use of the drug.
What Happened
In 2022, Tennessee became the first state to pass a law permitting pharmacies to sell ivermectin using a pre-signed blanket prescription, bypassing the need for patients to see a doctor before purchase. Pharmacies now offer ivermectin in doses up to 10 to 20 times stronger than standard FDA-approved human tablets. These sales occur statewide in retail locations, with advertising promoting availability without prescriptions. The Tennessee Poison Center reported over 60 calls related to ivermectin poisoning symptoms in 2025, the highest number since 2021, including cases of vomiting, blurred vision, neurological issues, and difficulty walking.
Key Facts
- The law enables pharmacies to dispense ivermectin under a “collaborative pharmacy practice agreement” with a designated doctor who holds pre-written prescriptions for all customers.
- Denise Sibley, a Tennessee doctor and vaccine critic, is a key figure in facilitating these agreements and endorsing ivermectin use; she has claimed to have treated approximately 4,400 people with ivermectin without payment.
- Ivermectin is FDA-approved for parasitic infections in humans but has no authorized use for diseases such as COVID-19, cancer, or hantavirus, despite false claims promoted by some groups.
- Clinical trials have shown ivermectin is ineffective against COVID-19, and the World Health Organization reports no evidence supporting its use for hantavirus.
- A UCLA study noted a spike in ivermectin prescriptions following a January 2025 podcast episode in which Mel Gibson claimed the drug helped cancer patients.
- The Tennessee Poison Center’s reports highlight rising adverse reactions linked to the drug’s improper use.
Why It Matters
The easy access to and marketing of high-dose ivermectin outside of standard medical supervision increases the risk of misuse, adverse effects, and delayed treatment of genuine illnesses. It also illustrates how political and ideological narratives can influence public perception of medical treatments, potentially endangering patients. The legislation provides pharmacists broad immunity from legal or professional repercussions related to ivermectin dispensation, further complicating regulatory oversight.
Background
Ivermectin is a Nobel Prize-winning medication primarily used to treat parasitic worm infections in humans and as a dewormer in animals. During the COVID-19 pandemic, some fringe medical voices and anti-vaccine activists promoted ivermectin as a treatment despite a lack of clinical evidence. The FDA has cautioned against its use for COVID-19, famously tweeting to discourage self-medication, a tweet later retracted during a lawsuit settlement. Tennessee’s 2022 law was passed by a Republican supermajority and is part of a rising trend, with over two dozen states considering similar measures.
Analysis
Timothy Caulfield, a University of Alberta professor studying health misinformation, described ivermectin as “an ideological flag” exploited during the pandemic to promote distrust in biomedical institutions and generate profit. John Mafi, a UCLA internal medicine physician, called off-label use of ivermectin “19th-century quack science,” expressing concern it diverts patients from proven therapies. The Tennessee Poison Center’s Rebecca Bruccoleri noted rising poison control calls linked to ivermectin misuse and highlighted the drug’s unsafe use as a supposed panacea.
Who Is Affected
Tennessee residents accessing ivermectin through pharmacies, including those with COVID-19, cancer patients, and others falsely seeking treatment for various conditions, are directly impacted. Pharmacies and collaborating doctors statewide participate under the blanket prescription system. The broader ideological movement promoting ivermectin use also influences communities beyond Tennessee, drawing people from other states and countries to access the drug.
What Remains Unclear
- The long-term health consequences of widespread ivermectin use at high doses remain unstudied.
- The full extent to which the 2022 law affects overall public health in Tennessee is not yet assessed.
- The regulatory response to pharmacists’ broad immunities and oversight gaps related to ivermectin sales is pending.
What Comes Next
This information was not confirmed in the reviewed sources.
Sources
This article is based on reporting and publicly available information from the following source:
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