Two years ago I heard of a fatal case of a man who died because he took some medication that was supposed to make him better. This man (we will call Mr. X) at one of his Men’s fellowship meetings intimated his concerns about his chronic joint pains to his very good friend. This good friend recommended something that had worked well for him when he went to the hospital with a similar problem.
He had a few strips of the medication in the “carrier bag pharmacy” he carries with him around. Mr. X quickly took it, desperate for relief, and downed the first two tablets. He continued the 3 day course at home. Unbeknownst to both of them, Mr. X had been mistakenly given an antibiotic, instead of an analgesic (pain killer). Unfortunately for Mr. X he had reacted very badly to this same antibiotic in the past and had been warned to avoid it. Not too long after completing the course, he began reacting to the medication, only this time more severely. Medical intervention could do only so much and Mr. X succumbed after a few days.
[contextly_sidebar id=”lDpQ3T2YjGWAbqwhX0gjqIOKObPIU1mP”]There are a few lessons to learn from this anecdote and I will use this to elaborate on the problem (effects) of self-medication.
The issue of self-medication is fast becoming a public health problem. Some researchers have reported that about 70% of adults (in a study population) self-medicate on a regular basis. The most widely self- prescribed medicines are analgesics (including paracetamol and ibuprofen), antimalarials, antibiotics (like amoxicillin and septrin), and Herbal medicines.
Many reasons have been advanced to explain the phenomenon, chief of which are the limited access to health facilities and the cost, financial and time, involved in seeking expert medical care.
The above reasons notwithstanding, self-medicating can be a dangerous venture for the individual and the community as a whole.
What are you treating?
Mr. X thought all he needed was a pain killer and likely didn’t even know exactly what he was treating. Many different conditions may produce the same set of symptoms. Just because you have fever and chills for three days doesn’t mean you have malaria. You may actually have typhoid fever, which if left untreated for long (because you were treating malaria) could end up in a complication which may require surgical intervention. In this case you would have unnecessarily delayed treatment and worsened the prognosis.
It is also fallacious to think that once something has worked for someone or even you in the past, it will work every time.
What are the side effects of the medication?
More often than not, people are not aware of the possible side effects of the medication they are taking. Did you know that prolonged use of a drug as seemingly harmless as ibuprofen can result in peptic ulceration, a condition which can be fatal if complications develop? And what about unlicensed herbal preparations? What do we know about their side effects? What I know is we are seeing a rise in acute kidney failure from herbal preparations. And there are probably more undocumented effects.
The other concern here is drug-food and drug-drug interactions. Some foods and drugs can potentiate or diminish the action of certain drugs and as such certain combinations must be avoided. One who self-medicates is unlikely to be aware of these possible effects, which can lead to treatment failure or other undesired effect.
Self-medicating can delay diagnosis
People self-medicate for relief, which can actually be a hindrance to diagnosis sometimes. E.g. A young man is experiencing some severe abdominal pain, and decides to douse the pain with a mélange of pain meds.
He succeeds in his quest to be pain free. Meanwhile the cause of the pain is an acute inflammation of part of the intestines and the process continues unnoticed.
He will walk into a health facility only when vomiting sets in. At this point, because he is pain free, doctors will probably not elicit the classical signs that will aid a quick diagnosis. When the pain recurs later, it will probably mean a complication has set in. In his desire to feel better, he has actually made his condition worse.
One drug may look or sound like another
Mr. X took an antibiotic instead of an analgesic. His friend probably confused the two because they look alike. This confusion is rifer than you may think. Paracetamol tablets are usually white and round, but so are many other drugs. Sometimes it’s the name that confuses people: instaead of taking Celebrex (a pain medication), one asks for Celexa (a medication for depression). One drug can be easily mistaken for another and this can be a fatal mistake, as we’ve seen with Mr. X. Let’s be weary; not every red pill is a multivitamin and not every drug that starts with “P” is Paracetamol.
The communal effect
The effects of self-medication sometimes go beyond the individual. For instance, people who take antibiotics indiscriminately may actually be fomenting the development of resistant strains of bacteria. These so called superbugs will in the future make treatment of certain simple conditions like pneumonias and skin infections very difficult.
The ripple effect of such a situation, financial, economic and even socio-cultural can be staggering. We may be creating a public monster from our private incautiousness.
In conclusion
To those who carry mini-pharmacies around, please be careful. You may inadvertently give someone poison for medicine, or some poor child will see them to be toffees, or you may yourself get confused and take one instead of the other.
Our drug control machinery should be shored up. Not every medication can be sold over the counter. This is what is perpetuating the indiscriminate use of antibiotics and turning the problem of self-medication into a menace. We need to enforce the rules.
Lastly, we all have to be more responsible. Our health and safety is chiefly in our hands. Our individual decisions are the most important. We choose to self-medicate or not.
This conversation will continue on Wednesday 11th February, 2015 on the Citi Health Chat. Join me at 1pm and let’s get your questions answered and your concerns addressed.
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By: Dr. Kojo Nimako