THE HIDDEN EPIDEMIC Part 1: The Dangers of Unprescribed Medications.

THE HEALTH EVANGELIST: EMPOWERING HEALTH AND BRIDGING GAPS, Volume 1, Issue 1

Introduction

Our communities are facing a serious health problem! Have you ever watched an African drama whereby someone rushes to a 'roadside chemist' ( a person who sells medications in a community, usually not as trained as a pharmacist) and says "Please give me Chloroquine", or some other medications like antibiotics or anti-malarial medicines for their loved one? The retailer who doesn't bother to know for whom the medication is required, would just pick a package hand it over, and collect his money. Period.

Well, although common in African dramas in Nigeria, Ghana, and South Africa, that scene reflects a troubling reality that many face daily. The misuse of medicines is not just a cinematic trope but a pressing public health crisis. The Misuse of medications whether prescribed or over-the-counter, is not confined to Africa but it is a global concern, evident in regions like the USA and Europe. However, the situation is particularly dire in Sub-Saharan Africa where fragile healthcare systems amplify the consequences.

The Impact of Medication Misuse: A Real-life Scenario

I remember vividly a hardworking laborer (let's call him John) who, after long hours of work, would buy painkillers and antibiotics from a roadside chemist—a term used to describe informal vendors or small shops selling medications without prescriptions. Believing that the medicines would ward off illness and provide strength for his daily routine, John unknowingly harmed his health.

Due to the nature of his work, John developed a condition that needed surgery to correct. After the surgery, he was in such much pain that doctors had to prescribe very strong pain medications because John had built a tolerance to the painkillers he regularly took from the roadside chemist. Taking these stronger pain medicines may lead to more serious issues like substance abuse. Substance abuse is a big problem in Africa but let us not handle that today.

Over time, John also was constantly visiting the hospital with either an infection or Malaria. It wasn't easy to treat him because the antibiotics and anti-malarial medicines didn't work for him anymore. He had developed resistance to them. Drug Resistance is a serious concern. If an underlying infection cannot be treated because the available medicines are ineffective, it can lead to severe complications, adversely affecting the quality of life and even costing lives.

John's experience highlights the dangers of self-medication and underscores the importance of seeking professional medical advice.

Why Is It Important To Urgently Address Medication Misuse?

Unsafe medication practices such as medication misuse can lead to significant harm that could have been avoided. Medication misuse is estimated to cost health systems around the world approximately USD 42 billion annually. Medication misuse can be initiated by healthcare workers who overprescribe, to patients who buy without a prescription or consume prescribed medications without control and it is usually made worse by weak Healthcare systems and policies. Misusing medications can result in serious harm, disability, and even death.

According to the World Health Organization, approximately 50% of all medications globally are inappropriately prescribed or sold, leading to significant health risks. In Africa, the impact of unprescribed medication use is staggering. Recent reports estimate that out of approximately 700,000 people who die annually due to drug resistance, about 100,000 occur annually in sub-Saharan Africa, and if nothing is done more than 4 million people will die from drug resistance by 2050 in sub-Saharan Africa.

The frequently consumed anti-malaria medicine like Chloroquine may become ineffective in cases of severe malaria. This places people at risk of developing complicated malaria. Sub-Saharan Africa is also witnessing a surge in non-communicable diseases, partly attributed to the rampant use of unprescribed medications.

The burden that Medication misuse places on individuals and families, ripping communities and Nations of productive years, and further burdening the already weakened healthcare systems in Sub-saharan Africa is the reason why this should be addressed, urgently. To address this we must first identify what causes the Misuse of Medications

What Causes People to Misuse Medications?

Several factors contribute to the increased consumption of unprescribed medications in Sub-Saharan Africa:

• Policy Gaps: Weak regulatory frameworks and enforcement allow easy access to medications without prescriptions.
• High Health Costs: Many people turn to informal vendors for cheaper, unprescribed alternatives due to the high cost of healthcare services.
• Lack of Trust in Healthcare Systems: Many individuals lack confidence in the healthcare system due to previous negative experiences, pushing them to self-medicate or seek advice from unqualified sources.
• Lack of Education: Limited awareness and understanding of the risks associated with self-medication drive people to seek quick fixes from unqualified sources.
• Social influence: Many people facing stress and mental health challenges turn to easy-to-get medications due to social influence to quickly address their physical and emotional health issues. This reliance on self-medication is influenced by social factors, psychological and mental health issues, and the impact of a fast-paced lifestyle.
• Circulation of Fake Medications: The high demand for medications has led to a proliferation of counterfeit drugs, further endangering public health.

How Can We Address the Issue of Medication Misuse?

The World Health Organization (WHO) has identified medication misuse as a significant public health concern and has initiated the "Medication Without Harm" program to tackle this issue. This initiative aims to address medication misuse by targeting various sectors, including patients, healthcare systems, healthcare workers, and the public. However, policies alone cannot bring about change; they require conscious efforts from individuals within our communities to drive this transformation.

Key Strategies to Address Medication Misuse

1. Testing Before Antibiotic Use: It is crucial to perform culture and sensitivity tests before using antibiotics. This process ensures that the prescribed antibiotic is effective against the specific infection, as not all antibiotics are suitable for every type of germ. Proper testing can prevent ineffective treatment and the development of antibiotic resistance.
2. Consult Healthcare Professionals: Always seek advice from healthcare professionals before taking any medication. Professional consultation ensures accurate diagnosis, appropriate treatment, and ongoing monitoring, which significantly reduces the risks of adverse effects and drug resistance.
3. Strengthen Policy Regulations: Implement and enforce stringent regulations on the sale of medications. This includes ensuring that medications are only sold with a valid prescription and that pharmacies and other outlets adhere to these regulations.
4. Improve Healthcare Systems: Investment in better diagnostic centers to reduce the incidence of self-diagnosis and self-medication. Access to accurate diagnostic services allows for proper medical evaluation and treatment, minimizing the risk of medication misuse. Robust healthcare infrastructure is key to supporting informed and safe medication practices.
5. Responsible Prescription Practice: Healthcare providers should avoid overprescribing medications, consider evidence-based non-pharmacological treatments when suitable, and educate patients on proper medication use.

By implementing these strategies and fostering a culture of responsible medication use, we can mitigate the risks associated with medication misuse and enhance the health and well-being of our communities. Each individual plays a crucial role in this collective effort, and together, we can drive meaningful change.

Conclusion

The irrational consumption of medications poses a severe threat to public health in Sub-Saharan Africa and beyond. It can lead to drug tolerance, drug resistance and promote drug abuse. Addressing the issue of medication misuse would therefore require comprehensive strategies, including stricter regulations, increased public awareness, and improved access to healthcare services. To protect your health and the health of your loved ones, always consult a healthcare professional before taking any medication. Support stronger regulations to ensure medications are safe and used appropriately.

Stay Tuned for Part 2

Thank you for reading. If you found this interesting and educative please like, comment, and share. In our next issue, we will delve deeper into the rise of illicit medications (fake drugs) as a consequence of increased demand for medicines. We will explore the impact on public health and the measures needed to combat this growing menace.

?????????? ???????????? ??????????????

???????????? ???????????????????? (??.??)

???????????? ????????????-????????

????, ??????, ?????? ???????????? ???????????? ????????????

Reference

1. World Health Organization: Medication without harm
2. World Health Organization: Promoting more responsible use of medicines
3. The Lancet: Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis.
4. World Health Organization: Antimicrobial Resistance Global Report.
5. Review on Antimicrobial Resistance: Tackling Drug-Resistant Infections Globally.
6. The Lancet Infectious Diseases: Antibiotic use in low and middle-income countries