Addiction and self-prescription

When the term addiction comes to mind, one usually thinks of alcohol or recreational drugs like hash or cocaine or heroin. But what about medication? The definition of addiction states that it involves being physically and mentally dependent on a particular substance, and being unable to stop taking it without incurring adverse effects.

Doesn’t this definition apply, at least in Pakistan, to our habit of popping pills? More specifically, to our habit of prescribing medication, not only to ourselves, but to friends and family alike? Are we not addicted to self-prescription of medication? How many times have you been unwell and been given a list of medicines by someone who once had a similar condition? And you have just taken those pills without calling a doctor.

Growing up in Lahore, I never really noticed that a whole generation of older women had started sleeping or looking like zombies. I just thought that’s what happens to women when they cross 45 — they ‘calm down’. Rather, they had actually discovered relaxants and sleeping pills.

Two months ago, I ended up in the emergency room of a hospital with a severe migraine. All I needed was a painkiller injection, along with an anti-nausea pill. Instead, I was prescribed one nerve relaxant, one sleeping pill and two extremely strong painkillers for two weeks! That combination would have put someone my size to sleep for at least 20 hours! I asked the doctor on duty why I needed so many pills for a simple migraine. He said this was usually the cocktail that people with migraines demanded. I was flabbergasted. Since when did patients start dictating to doctors?

Many parents self-medicate their children. I spoke to Dr Sajid Maqbool, my paediatrician and now my son’s doctor. He says that parents often medicate children themselves before they bring them to him and they demand antibiotics. They simply refuse to understand that overuse of antibiotics can produce immunity to their effects. One of the reasons for this problem is the internet. All it takes is a few minutes on Google and we all feel that we have turned into the local version of House MD.

When people start self-medicating or taking medication on the recommendation of people who aren’t qualified, they tend to get addicted to certain medicines. Many people take medicines to alleviate depression, anxiety and insomnia, and often these medicines are  harmful.

According to a study, 70 to 80 per cent of patients going to doctors are actually there for non-health related issues. People aren’t really sick: they are just projecting their emotional or psychological issues. Doctors are trained to recognise this problem and to deal with it. But when we become our own doctors, who’s going to stop us from popping pills?

Pharmacies in Pakistan sell all kinds of medication over the counter, including medicines that are banned in most parts of the world. I tried an experiment and sent my driver to purchase four different kinds of sleeping pills without a doctor’s prescription note. He came back with 30 pills of each kind. What if this was a suicidal person sending someone to get these pills? Why are there no checks and balances in this country? Pharmacies are regulated in other countries and for good reason. Drugs are dangerous. It is the combined responsibility of the citizens of Pakistan, drug companies and doctors to bring some sort of control over the sale of medicines. Otherwise, the consequences could be horrible.

Published in The Express Tribune, November 24^th, 2014.

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