Four years ago, Tennessee became the first state to allow adults to buy the antiparasitic drug ivermectin from a pharmacy without first seeing a doctor. Pharmacies can use a pre-written, blanket prescription to sell to just about anyone who walks through their doors. The drug is now marketed and sold across the state in roadside shops and small-town strip malls with little oversight from health authorities. Highway billboards advertise ivermectin as "Available Without a Prescription in Tennessee!" while dozens of pharmacies offer highly concentrated pills, sometimes at 10 or 20 times the potency of a standard tablet. Some pharmacy websites now offer the drug as a treatment for COVID-19, "long haul vax symptoms," diabetes, or cancer -- despite no evidence of its effectiveness for those purposes -- while the new law largely gives pharmacists immunity from lawsuits or professional sanctions related to ivermectin.