Only certain documents are accepted: photo documents issued by a US state and certain federal documents. There are some exceptions in the initial act text, but in practice, nobody is going to accept your nursery school record.

There are certainly 10s of millions of people who don't have direct access to this drug.

I wouldn't be surprised if that's actually an underestimate, because this saga has had a knock on effect on decongestant formulations sold outside the US as well. I don't know exactly why this has happened but my guess is it may be due to economies of scale in manufacturing or licencing overheads.

It's hard to find a pharmacy which even sells pseudoephedrine based decongestant if you're in the UK, for example.

Is that true? I honestly don't know. I thought it went away entirely. I guess that's what hiding it behind the counter does to those who aren't in the know.