Self-medication, the practice of purchasing and
administering drugs on oneself without ever
consulting a doctor or some medical practitioner for
a prescription, could be a self-issued passport to
death. It doesn’t matter if the drug is a common
analgesic, such as Panadol or Tylenol; an antibiotic,
such as Amoxicillin or Penicillin; or strictly controlled
drugs, which lawful countries would have made
impossible to purchase over the counter without a
prescription.
Yet, self-medication is the order of the day in
Nigeria, where anyone could walk into a Pharmacy
or Patent Medicine Store otherwise called “chemist”
in local parlance to purchase any drug in any
quantity. It doesn’t appear to matter much what
category of Nigerians we are talking about,
although, according to various studies, such
practice is more rampant among the poor, rural
dwellers, and the middle age bracket between 25
and 45.
For example, in a recent study of the prevalence of
self-medication practice among university
undergraduates in southwestern Nigeria, published
in the Journal of Pharmaceutical Research, Prof.
Adebayo Lamikanra and K. P. Osemene found that
age, gender, and a student’s level of study in the
university influence self-medication practices
among university students. This is particularly true
of antimalarial and antibiotic drugs, which were
targeted in the study.
There are three major reasons for self-medication in
Nigeria. First, health care facilities are grossly
inadequate in terms of personnel, equipment, and
drug supply. As a result, you are lucky if you find a
doctor who could correctly diagnose your health
problem. This is not to say that there are no good
doctors. The problem is that doctors are only as
good as the diagnostic equipment, medical
laboratory, and the allied health workers at their
disposal. You can never be sure that all will be well
with all necessary variables in your treatment. So,
why go to hospital at all? There are, of course, good
private hospitals, where the slacks associated with
government hospitals are minimised. But then their
services are priced out of reach for the common
man.
Second, the vast majority of patients come to ill-
health with a twin deficit, namely, illiteracy and
poverty. On the one hand, illiteracy breeds ignorance
about how the body works and how to evaluate
symptoms of disorder. This often leads to
patronage of neighbourhood patent medicine stores,
where the store owner doubles as a “doctor” and
“pharmacist”. On the other hand, poverty
complicates matters by keeping many ill-patients
away from the hospital. My wife recently took a sick
child near her workplace to the hospital. The
parents could not afford the cost of the registration
card let alone the cost of treatment, all of which my
wife paid.
The third factor responsible for self-medication is
the absence of regulations and guidelines as to who
can purchase what drug and for what ailment. Such
regulations will make it difficult for patients to have
access to certain drugs without a doctor’s
prescription. I use the word “difficult” advisedly,
knowing full well that such regulations could be
flouted as is the case with other regulations in this
country. As they say, it often takes something
inside a clenched fist to get what you want.
I must hasten to add that the educated elite are not
immune to self-medication, especially of analgesics,
antimalarials, antibiotics, and cough medicine.
When I questioned one of them recently about the
practice, he said he only needed something to bind
him over until he went overseas for his annual
checkup! When I noticed that what he bought were
antimalarial drugs, I further questioned him as to
why he thought he had malaria. His next response
was dismissive: “I know my body”.
Incidentally, the negative consequences of self-
medication are oblivious to how much of your body
you know. Without a proper diagnosis, various drug
complications await you. To start with, you may be
taking the wrong medicine. Assuming the medicine
is right, you may be under- or overdosing. You may
even be combining two or more drugs that interact
because they are contra-indicated. The best way to
avoid these complications is to see a doctor for the
proper evaluation of your condition, your medical
history, and your drug allergies so that drugs to
which you may react will not be prescribed for you.
Let me tell you my experience. My doctor once
prescribed a particular drug for me. But before I
started taking it at all, I looked up its information.
Low and behold, it contained sulfur, which is contra-
indicated for G6PD, a hereditary condition in which
red blood cells break down when the body is
exposed to certain drugs or the stress of infection. It
was quickly changed to another drug. The rejected
drug contains sulfur, which could lead to a serious
allergic, if not fatal, reaction. What if I had bought
the drug over the counter, without knowing my drug
allergies?
Another negative consequence of self-medication is
drug dependency or addiction. This is particularly
true of pain killers and anti-allergy drugs, which
many people take to maintain their sense of well-
being. The accumulation of such drugs in their
system may take a toll, especially on the liver which
processes most oral drugs. It is now common
knowledge that two popular music stars, Michael
Jackson and Whitney Houston, died of drug
dependency and overdose.
Yet another consequence of self-medication is that
it may obscure your real health condition and lead to
wrong diagnosis, when you are eventually rushed to
the doctor’s office or hospital. The problem is
further complicated when patients do not, or are
unable to, provide necessary information about the
drugs they’ve been taking.
That’s why many countries are now counting the
number of deaths arising from self-medication and
devising various ways of curbing the practice. Data
from the Brazilian Association of Pharmaceutical
Industries indicate that at least 20,000 deaths are
caused annually by self-medication in Brazil alone.
That’s a country with some measure of drug
regulation. Imagine the situation in Nigeria where
there are no such regulations and where the
illiteracy and poverty levels are higher. Isn’t it a
great pity that we don’t even have the statistics to
count our losses?
Statistics or no statistics, self-medication is a big
medical problem in Nigeria, which the federal and
state governments, traditional rulers, the Nigerian
Medical Association, educational institutions, the
civil society associations, religious institutions, and
local government administrations should urgently
address. Public education is the starting point. It
may well begin with sharing this article with others.
by ROTMANLUV 2023-07-08, 17:34
