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Self- medication: What you should know before you swallow that tablet
Medicines are used by people when they feel sick without a doctor’s advise. As a result, many end up taking the wrong drugs. Photo by Rachel Mabala.
What you need to know:
Taking medication without a doctor’s prescription, even for a minor ailment, can be dangerous. Doctors warn that it is a growing problem which many Ugandans have not taken seriously yet.
With the stress and anxiety that has come to dominate today’s schedules, cases of headaches, fevers or minor illnesses are likely to come by more often.
And with the increase in such cases comes the urge and temptation to pick a drug off the shelf or hit the pharmacy to buy a drug over the counter, all without the hassle of a doctor’s advice or prescription.
Such a scenario is known as self-medication.
Dr Vincent Karuhanga, of Friends Poly Clinic says self-medication has reached “rife and dangerous proportions in Uganda.”
More common cases, according to Dr Karuhanga are where dispensers in pharmacies give prescription only drugs to patients without prescriptions from a doctor. It is not only lay people who are culprits of self-medication.
Dr Karuhanga explains that self-medication can also apply to a qualified doctor who takes medicines without consulting their qualified colleagues in the event of illnesses-a problem he says is worrying. Dr Karuhanga said medical workers should also be aware that it’s not right for them to self-medicate.
The numbers
Mr Martin Otebo, the assistant commissioner in charge of pharmacy at the ministry of health says that government has not compiled data to know the extent of self-medication but notes that “at least 50 percent of the population has taken medication without professional guidance.”
Self-medication, Mr Otebo says can also happen when drugs are taken inconsistently, based on an initial reaction a patient experiences in the course of a dose. It is common for patients not to complete prescribed doses after feeling better, only to resume the dose when the sickness recurs, exposing them to negative effects of the medication.
Dr Alfred Mubangizi, the medical director at Rainbow City Hospital blames growing poverty and the high cost of healthcare which he says is pushing people to resort to self-prescription.
“People resort to self prescription in order to avoid paying consultation and laboratory investigation fees to establish the right illnesses so that doctors can prescribe the correct diagnosis,”Dr Mubangizi says.
Drug resistance
The dangers of self-medication can be wide ranging, including affecting macro-health policy at a national level. Commissioner Otebo explains that when people over self-medicate, it results into drug resistance.
And when drug resistance develops, government is forced to identify new drug combinations to replace the medicines that would have been rendered ineffective as a result.
Mr Otebo points out that malaria developed resistance to chloroquine because majority of the people were taking the medicines without consulting pharmacists, forcing the Ministry of Health to come up with a new drug--Artemisinin-based Combination therapies (ACTs).
The new therapy, Mr Otebo says required reforms in the health systems with government having to train health workers on how to administer the new drug. He explained that ACTs are more expensive than chloroquine, with a dose going for between Shs2000 and Shs8000, making it unaffordable for majority of the poor patients.
Misdiagnosis
Dr Karuhanga explains that when people self-medicate, the chances of wrong diagnosis, dangerous doses, risk of taking drugs with toxic substances and chances of taking a drug that should not be taken by humans can be high.
Another danger of self-medication, doctors note, is patients may end up treating an ailment, suspecting it to be a minor complication yet in the end it could turn up to be a chronic or life-threatening condition.
“You may feel headache and take painkillers when the actual problem is a sight, ear or dental problem because you are treating the surface of the illness,”Mr Otebo warns. He cautions that self-medication may result in patients taking over or under doses of drugs.
“Wrong diagnosis resulting from self-medication may lead to cases of pancreatitis and renal failure because the kidney and the liver which are supposed to metabolise and excrete drugs may not perform these functions on wrong drugs,”said Dr Mubangizi.
Toxic drugs
Because all drugs are toxic, doctors warn that their long term exposure to organs like the liver or kidney may lead to knock-offs like ulcers depending on the type of medication.
Another disturbing trend that health experts are grappling with is the emergency of herbalists who hawk drugs in public places including transport systems like buses and taxis plying upcountry routes. The herbalists expose the drugs to harsh conditions like heat and coldness that might result into intoxication.
Self-medication can also be particularly dangerous for pregnant mothers as they may take drugs which could lead to mental or physical abnormalities and deformities of their unborn babies.
“Self-medication can lead to pregnant women taking drugs they are not advised to use or drugs that are not to be prescribed to people of a certain age,”Dr Karuhanga says.
Mr Otebo warns against possible addiction to drugs, if self-medication is not regulated.
