Could you test if the sounds are better if you decrease the ingame sound effect volume (to like 20% or below) and increase your computer sound volume to make up for it? I have the feeling that this might help your particular problem. Anyhow I'll test an adjustment to see if that helps / fixes long distance sounds.

Regarding the pills and vials, I think there was one valid point Akimbo had, which was that the majority of CWers used pills and vials, which led us to believe that they were indeed better than meds, therefore needing a nerf to even the playing field. Aren't they fine / equal now?