The silent epidemic: how self-medication puts health at risk

At 22, Ayesha was a university student multitasking between assignments, exams, work and much more. Getting more than 5 hours of sleep was rare and having headaches became the usual. Rather than saving a trip to the doctor, she opted for over-the-counter (OTC) painkillers, assuming they would be harmless.

In the beginning the pills were very affective, she found herself taking one daily. One evening after taking two pills she felt nauseous and dizzy. She decided to finally go to the doctor’s office, upon which she found out that the prolonged use of painkillers had caused stomach inflammation. 

For years, Ayesha had been self-medicating taking only in account the convenience and benefits not the damage.

Salman a 47-year-old office worker, had a similar experience. After getting a flu, he started taking antibiotics. The antibiotics seemed to work really well in the start however, as time went on they stopped working. After getting checked he was diagnosed with antibiotic resistance and that’s when he realized the damage.

Like Ayesha and Salman, millions rely on self-medication, they believe that they are making an informed choice. But behind this seemingly harmless habit of their lies a dangerous practice.

Understanding the Self-Medication Crisis:

Self-medication, the practice of using drugs without consulting a healthcare professional, is a worldwide concern which is growing alarmingly. While it offers convenience and cost savings, it also poses substantial health risks, which include incorrect diagnoses, drug dependency, and adverse reactions.

A survey conducted recently, revealed alarming statistics: although 70% of surveyed individuals believing healthcare was accessible, 62% admitted to regularly self-medicating (largely due to headaches, fevers, and colds).The study found a strong link between limited healthcare access and higher self-medication rates.

Something even more worrisome was the disconnect between knowledge and behavior. While 85% of respondents were aware of the dangers, including antibiotic resistance and dependency, this did not ensure safer practices. Many continued self-medicating, influenced by habit, misinformation, or a lack of trust in doctors.

The Psychology Behind Self-Medication:

Although many may think economical factors are the leading cause for self-medication, psychological factors also play a vital role. Many individuals prefer the control and convenience of treating themselves rather than seeking professional medical help.

According to a study published in the National Academy of Sciences, patients looking to save are more inclined to self medicate, even after knowing the risks which will be associated. The fear of a serious diagnosis, skepticism in trusting medical professionals, and social rebuke around mental health issues motivate individuals towards self-medication.

This tends to be common in many developing economies, where disorders regarding mental health and others are overlooked. Patients use painkillers, alcohol, or sedatives as alternatives for proper medical care.

The Role of Pharmacies and Unregulated Drug Sales:

Pharmacies play a vital role in boosting self-medication. Around the world, including Pakistan, antibiotics, painkillers, and even steroids are bought and sold over the counter with close to no regulation.

Dr. Hashir, a practicing surgeon, told us that many of his patients had already taken antibiotics or painkillers before visiting him. Some even went as far as taking steroids without knowing the long term harms it carries. “People assume that because a drug is available without a prescription, it must be safe. That’s far from the truth,” he warned.

Case Study: The Indian Pharmaceutical Market:

A cross-sectional study conducted in Karachi committed to find out the relevance, attitudes, and knowledge of self-medication among university students. The research, carried out over the span of two months in 2007, surveyed 572 students from both medical and non-medical universities. The findings revealed a high prevalence of self-medication, with 76% of students admitting to self medication.

The most common illness encouraging self-medication were headaches (72.4%), flu (65.5%), and fever (55.2%). Commonly used medications included analgesics (88.3%), antipyretics (65.1%), and antibiotics (35.2%). A significant portion of students (43%) reported modifying the regimen of prescribed medicines on their own, and 61.9% admitted to discontinuing prescribed medications without the consultation of a doctor.

They found out that the primary reason for self-medication was the prior experience they had with similar symptoms. These customs increase concerns about potential health risks, including misdiagnosis, drug interactions, and the development of antibiotic resistance (Zafar et al., 2008).

The Hidden Dangers of Self-Medication:

• Masking Underlying Conditions: You may think that self medicating is helping you get rid of your disease however that may not always be the case. It can often mask symptoms of an underlying medical condition.
• Drug Interactions: When you take two or more drugs together, it can affect the impact it has on your body by having a reaction between themselves, further damaging the condition.
• Dependency and Overuse: Drug use for an extended length of time can lead to dependence. Because of this, your body requires the medication in order to function correctly.
• Antibiotic Resistance: Excessive use of antibiotics makes it harder to treat viruses as they get stronger and more resistant to the antibiotics.
• Medical complications: Taking wrong medicines in the wrong amounts can lead to worsening your condition and also result in the development of new diseases.

Regulation and Solutions: Is There a Way Forward?

Despite laws already existing requiring prescriptions for antibiotics and other substances, enforcement needs to be worked upon. The Drug Regulatory Authority of Pakistan (DRAP) has issued guidelines, but pharmacies and consumers continue to ignore them.

Lessons from Other Countries:

• The United States: Implemented the Physician Payments Sunshine Act, requiring transparency in how pharmaceutical companies interact with doctors (FDA,.
• Sweden: Introduced mandatory prescriptions for antibiotics, which resulted in a significant dip in antimicrobial resistance cases.
• Brazil: Launched nationwide education campaigns, making its citizens aware of the risks of self-medication, which reduced OTC antibiotic sales by 30%.

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