Healthy Slide

A Sad Outcome of Self Medication

A nine months old baby developed watery diarrhea and had to expel faeces six times each day. The baby’s mother had some metronidazole suspension already at home so she decided to give her baby. Two days after, the baby’s condition didn’t get any better and the diarrhea persisted.

The mother then decided to go to the pharmacy to get drugs for her baby. The pharmacist gave her co-trimaxazole suspension. After two days, the condition only got worse. The baby developed oral thrush and refused feeding.

The mother then stopped the medication and took her baby to a traditional healer. This traditional healer had the baby’s uvula cut for reasons known only to him. The baby’s condition deteriorated and the mother was so distraught.

The mother finally decided to take the baby to the hospital to see a physician. The baby was diagnosed with sepsis, as well as malnutrition and was admitted for 15 days. The physician gave appropriate management and advised the mother on how to manage her child in such situations.

Now imagine if this woman called a physician just as she noticed signs of illness in her baby. Time, money and pain would be saved.

What exactly is self-medication?

I personally look at self medication from three different angles with the same concept which leads to psychological dependence and they are as follows:

1. The use of medication without prior medical consult.
2. The use of food, alcohol or medication to change ones emotional state i.e. pain, anxiety, stress etc. A famous quote from Ann Wigmore, a “holistic health” practitioner and raw food advocate states that; “The food you eat can either be the safest and most powerful form of medicine, or the slowest form of poison.”
3. The self-administration of drug under one’s own supervision.

The Pharmacy

The drugstore is the premier culprit of promoting self-medication culture. It’s the source made available for the fulfillment of medical prescriptions and general medical advice on the purchase and usage of specific drugs.

The World Health Organization estimates that greater than 50% of all drugs are wrongly prescribed or sold inappropriately to patients and about half of these patients do not take drugs as prescribed or do not take them at all.

The US Commissioner of Food and Drug Administration stated that, “The FDA accepts the concepts of self medication. The consumer depends on it, the law provides it, and it’s in fact a vital part of our nation’s health care system.”
The European Parliament also stated that, “Consider that responsible self-medication should be promoted, which will foster the growing desire of the European Union’s citizens to take responsibility of their own health and also help reduce health expenditures.”

In recent times, responsible self medication is seen to be an important route in long term health policies. The earlier we accept and do it right, the better for everybody.

Pharmaceutical companies these days market their product to be useful and accessible with self-medication option. They create a concept independent of the necessity to see a physician. Most of these claims are also very often inaccurate.

Two Ends of the Spectrum

Practically, there are some very important reasons why self-medication is encouraged:

1. Allows easy access to medication and relief for the patient in a short time.

2. Aids in an active role of the patient in their own health care.

3. Reduces burden on hospital facilities or government policies (e.g. NHIS) for managing minor conditions.

4. Contributes to a reduction in prescribed drugs than if patient had visited the hospital. This corresponds with a reduced cost for the patient.

However, there are some very important reasons why self medication is discouraged:

1. Increase in the fear of misdiagnosis

2. May lead to adverse drug effects

3. May lead to incorrect dosing of drug i.e. overdose or under-dose

4. Leads to drug reaction masking the initial condition

5. Leads to a high risk of dependence and abuse

Typical Fear

At this point I just want to throw more light on the dangers of two drugs most often abused by individuals.

1. Paracetamol

This may seem, a very basic drug for everyday use and essential for first aid in treating fever, headache and pain. But do you know that the damaging effect that alcohol has on the liver is also seen in paracetamol poisoning? Typically you may experience abdominal pain and the urge to vomit. A few days may pass without symptoms after which presentations such as yellow skin, blood clotting problems and confusion occur due to liver failure. Overdose quickly requires an antidote of Acetylcysteine or Activated charcoal after initial presentation but self medication will cause a patient to treat initial presentation of nausea and abdominal pain as another condition which will further deteriorate the condition.

2. Ibuprofen

Another popular drug due to it’s everyday use to relief pain.This drug is not supposed to be taken on an empty stomach as its mechanism tends to induce stomach ulcers. The use of this drug may induce headache as well as other adverse effects. Aspirin, a similar drug to Ibuprofen and can induce asthma attacks in about 20% of asthma patients. Also, about 20% of people allergic to aspirin are also allergic to Ibuprofen. So Ibuprofen could also induce allergic asthmatic episodes.

Solution

The development of a monitoring system is necessary to maximize the advantages of self-medication and minimize harm. This process will allow one to safely medicate.

Develop a relationship with your Physician or Pharmacist and receive guidance and permission before you self-medicate. This could be through a visit, phone call or text message. This monitoring system allows safety, independence, trust, improved patient education, reduced cost, customized care, as well as many other positives. Disadvantages like non-compliance and ignorance of current mental health of patient should also be anticipated by the Physician.