In France they used to have 2+1 roads and it was a major cause of carnage. It's mostly an attitude thing.
I live in the UK, and the only +1 roads I can remember seeing have clear markings showing which side of the road can use the extra lane (never noticed one that included both sides).
I can imagine low speed 2+1 roads being OK. It's the 50mph+ ones that lead to horrific crashes - human beings aren't great at negotiating closing speeds of 100+mph.