The potential risks of self-medication among many others include incorrect self-diagnosis, complications, and resistance and addiction to such drugs.
In Nigeria, the open sale of drugs – both traditional and pharmaceutical – through unregistered outlets is a major concern. It is not strange to see unregistered ‘doctors’ and ‘pharmacists’ advertising and selling medicines in commercial buses and by the roadsides. These drug hawkers are sometimes seen selling prescription-only antibiotics and other powerful painkiller drugs.
They do not only prescribe drugs, but they also go as far as recommending the dosage to be taken to these unsuspecting commuters. Some street hawkers have their shops, stores and makeshift ‘clinics’ located in motor parks and market places where they offer ‘general body checkups’ and also display their medicines for sale.
It is observed that people who opt to patronise these drug hawkers do so from time to time to treat common illnesses like malaria, stomach upset and general body pains chiefly because it saves time, effort and money going in search of doctors and drug stores. These buyers claim the drugs from hawkers are cheap and easily available.
A popular proverb in Yoruba goes, “ikunnjeogede, ikun n redi, ikun o mopeohunti o dun niipani”. This is interpreted to mean: “a rodent is exuberant as it feeds on banana, it does not know sweet things kill.”
Little did Nigerians know that they endanger their lives by buying drugs from these hawkers. When drugs which are meant to be stored properly in a cool, dry place are exposed to extreme temperature in the course of hawking, they lose their quality and efficacy and ultimately expire early. Drugs not properly handled due to their delicate nature become dangerous to the body when administered. The sale of drugs by the roadsides and in commercial buses gives room to drug counterfeiters to market their dangerous products to unsuspecting public. These drugs are sometimes crudely packaged with fake or relabeled expiry dates and also do not carry National Agency for Food and Drug Administration and Control (NAFDAC) registration number.
The Human Development Index (HDI) 2015 report attributes about 15 percent of deaths in Nigeria to wrongly prescribed medications and expired drugs. Despite these staggering statistics and various other sensitisation campaigns by concerned authorities, many Nigerians still patronise these drug hawkers. Also,it is sad and unfortunate that there is an existing law (Pharmacists Council of Nigeria Law No 91, 1992) that prohibits drug hawking, yet these drug hawkers are increasing everywhere.
Sometime this year, NAFDAC boss, Professor Christianah Adeyeye, in her quest to end the menace and to sensitise Nigerians on the need to shun patronage of drugs from hawkers, advised the public to be mindful of the medicines they purchase and also from where they buy them. In her words, “The Agency has noticed with dismay the upsurge in street and bus hawking of drugs in Lagos and its environs. Enforcement officers have commenced intensive raids…and have arrested some hawkers and confiscated their wares. This exercise will be intensified until the agency completely dislodges them.”
She added by advising that, “Medicines should only be purchased from registered premises; you should always look out for the manufacturing and expiry dates, manufacturer’s name, full location, addresses and NAFDAC registration number on regulated products.”
Wikipedia defines self-medication as a human behaviour in which an individual uses a substance or any exogenous influence to self-administer treatment for physical or psychological ailments. Put simply, self-medication is treating self-recognised or self-diagnosed disorders, conditions, or symptoms.
The most widely self-medicated substances are Over-The-Counter (OTC) drugs. Treating a real or imagined condition without professional advice poses grave dangers. The potential risks of self- medication among many others include incorrect self-diagnosis, complications, severe adverse reactions, incorrect choice of therapy and manner of administration, and resistance and addiction to such drugs.
Self-medicating with some first aid and non-prescription drugs maybe regarded as self-care and an immediate personal response treatment to common and simple health issues at home. But self-medicating with prescription-only drugs and other painkillers and antibiotics can be harmful and potentially life-threatening. Also, appropriate self-medication can cure some diseases, saving time and money which would be spent on visiting doctors; it may even save the patient’s life in acute conditions.
However, inappropriate self-medication can create a lot of fatalities for the citizens and the society at large.
Inappropriate self-treatment may eventually lead to drug addiction. This addiction manifests initially as pleasure, and then the pleasure increases with an uncontrolled urge for always self-medicating to treat or cure any assumed or self-diagnosed ailment. Research done by clinical pharmacists showed that self-prescription is a common form of drug abuse.
Some experts also hold the view that people with depression may try to cope with feelings like sadness, loss and anger on their own by “self-medicating”. People with such tendencies are advised to see psychotherapists, psychologists, psychiatrists or even counsellors as the case may be, rather than resorting to self-medication for depression.
Until we learn to administer drugs responsibly and cautiously, we are at risk of becoming addicted to such drugs. Self-medication is self-destructive. To deal with this deadly urge, there should be no delay in seeking medical advice by always consulting physicians, medical experts and health care practitioners for drug prescription and guidance on dosage when ill or indisposed.
Drugs can heal; but alas they can also kill. Government at all levels is advised to make healthcare delivery affordable to all in order to nip the nefarious activities of drug hawkers in the bud and discourage self-medication.
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Ojewale writes from Idimu, Lagos via [email protected]