Self Medication Is Drug Abuse
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Introduction
Self-medication is a global phenomenon and a potential contributor to human pathogen resistance to antibiotics. The adverse consequences of such practices should always be emphasized to the community and steps to curb them. Rampant irrational use of antimicrobials without medical guidance may result in a greater probability of inappropriate, incorrect, or undue therapy, missed diagnosis, delays in appropriate treatment, pathogen resistance, and increased morbidity. This review focused on the self-medication of allopathic drugs, their use, their safety, and the reason for using them. It would be safe, if the people who are using it, have sufficient knowledge about its dose, time of intake, and side effect of overdose, but due to lack of information, it can cause serious effects such as antibiotic resistance, skin problem, hypersensitivity, and allergy. There is a need to augment awareness and implement legislations to promote judicious and safe practices. Improved knowledge and understanding of self-medication may result in rational use and thus limit emerging microbial resistance issues. Articles that were published in peer-reviewed journals, World Self-Medication Industry, and World Health Organization websites relating to self-medication were reviewed.
Every day, we are practicing self-medication in the form of self-care for our health. Around the 1960s in the West-self-care and self-medication were regarded as unnecessary and potentially even unhealthy practices. This paternalistic approach to medicine, supported by health systems designed to treat sickness (rather than to prevent disease) remains a familiar aspect of health care in many countries to this day.
Self-medication has traditionally been defined as “the taking of drugs, herbs or home remedies on one's own initiative, or on the advice of another person, without consulting a doctor.”
Families, friends, neighbors, pharmacists, previously prescribed drugs, or suggestions from an advertisement in newspapers or popular magazines are common sources of self-medication. Nowadays, self-medication should be seen as the “desire and ability of people/patients to play an intelligent, independent and informed role, not merely in terms of decision-making but also in the management of those preventive, diagnostic and therapeutic activities which concern them.”
Some governments are increasingly encouraging self-care for minor illnesses, including self-medication. Although responsible self-medication helps to reduce the cost of treatment, traveling time as well as doctor's time i.e., consultation time.
Major problems related to self-medication are wastage of resources, increased resistance to pathogens, and causes serious health hazards such as adverse reactions and prolonged suffering. Antimicrobial resistance is a current problem worldwide, particularly in developing countries where antibiotics are available without any prescription. Hence, the government should take the necessary steps to regulate responsible self-medication. This can be done by making the availability of safe drugs along with proper instructions about their use and if in need consulting a physician.
In India, it is very common to see self-medication practice and which is an emerging challenge to health care providers.
Extracting and synthesizing data
Articles that were published in peer-reviewed journals, World Self-Medication Industry (WSMI), and World Health Organization (WHO) websites relating to self-medication were reviewed.
The trend of “Rx-to-Over-the-Counter Switch”
The transfer of prescription (“Rx”) medicines to non-prescription or OTC status is known as the “Rx-to-OTC switch”. Many new medicines are first introduced as prescription medicines. After sufficient time has passed in the use of the medicine by many patients and large-scale experience and scientific information has been gathered, for suitable conditions, a manufacturer may elect to submit an application to the appropriate authority for the medicine to be given OTC status.
Statistics
Studies carried out on self-medication states that it is a very common practice, especially in economically deprived communities. Self-medication also has some advantages and disadvantages.
Nowadays healthcare services getting costlier and in developing countries, healthcare facilities are not available. Hence, at that time self-medication becomes an obvious choice of healthcare service. Furthermore, it has been noted that the purchase of drugs and many drugs that can only be purchased with a prescription in developed countries are OTC in developing countries. In addition, lax medical regulation has resulted in the proliferation of counter-free drugs that are in high demand for the treatment of highly prevalent diseases.
Self-medication is very common nowadays and it is being used worldwide, given in
Prevalence of self-medication
India
Self-medication is very common among the educated population. In Punjab, the prevalence of self-medication was 73%.
Why do People Use Self-medication?
Modern consumers (patients) wish to take a greater role in the maintenance of their own health and are often competent to manage (uncomplicated) chronic and recurrent illnesses (not merely short-term symptoms) after proper medical diagnosis and with only occasional professional advice, e.g. use of histamine H2-receptor blocker, topical corticosteroid, antifungal, and oral contraceptive. They are understandably unwilling to submit to the inconvenience of visiting a doctor for what they rightly feel they can manage for themselves, given adequate information.
Self-medication is very common and a number of reasons could be enumerated for it. The urge for self-care, feeling of sympathy toward family members in sickness, lack of time, lack of health services, financial constraint, ignorance, misbelieves, extensive advertisement, and availability of drugs in other than drug shops are responsible for the growing trend of self-medication.
The Story of Self-care and Self-medication (1970-2010)
1970-The World Federation of Proprietary Medicine Manufacturers Association renamed WSMI with an objective to stress for worldwide regulatory classification of medicinal products into two classes: Prescription and non-prescription.
1975-First international symposium on the role of the individual in primary care was held at the European Regional Offices of the WHO-stress on “self-care”.
1977-World Health Assembly adopted the resolution calling for “health for all” by the year 2000 and in 1978, the Declaration of Alma-Ata.
1981-World Medical Association stressed the responsibility of people for their own health in a “Declaration on the Rights of the Patient.”
1986-Ottawa (Canada) and launched “the Ottawa Charter for Health Promotion”, in which self-care was identified as one of the three key mechanisms for health promotion.
A new era of access to modern, effective medicines was heralded in the early 1980s when medicines that had previously only been available on prescription began to be switched to non-prescription status. Among the first products switched to non-prescription status was ibuprofen for pain treatment, in the UK (1983) and the US (1984). In Canada, hydrocortisone became available without a prescription in 1986. A statement of the WSMI Policy on Consumer Information and the Role of Labeling was formally approved and released by the WSMI Board of Directors at the Fifth General Assembly in October 1979 in Australia. The policy emphasizes that the role of labeling is “to provide all information necessary to enable an individual without medical training to use the medicine appropriately.”
The 1990's-Guiding Principles in Self-Medication
In the 1990s, there was an increasing recognition in many parts of the world that people were managing or treating a large proportion of their ailments without always consulting a health professional.
1998, Role of pharmacists in self-medication was explained by WSMI and the International Pharmaceutical Federation (FIP).
1993-WSMI's 11th?General Assembly in Acapulco, Mexico, where the theme is “Globalization of the self-medication market: challenges and opportunities.”
1997-WSMI publishes its first global review of consumer surveys: “Health care, self-care, and self-medication.”
1999-A joint statement is produced by WSMI and FIP entitled “responsible self-medication”.
WSMI's 13th?General Assembly in Berlin, Germany, where the theme is “self-care, a vital element of health policy in the information age.”
2000-2005-The Benefits of Responsible Self-Medication
2000-The WHO publishes “guidelines for the regulatory assessment of medicinal products for use in self-medication.”
2006-2010 and the future-A globalizing world. Prevention of disease through self-care and responsible self-medication.
Sources
The common sources of self-medication are previous prescriptions, friends, advertisements, chemist shops, and books.
Factors influencing
Self-medication is influenced by many factors such as education, family, society, law, availability of drugs, and exposure to advertisements.
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Potential benefits
In a world of scarce government and in many countries' scarce individual resources, responsible self-medication should be a cornerstone of healthcare provision and health policy.
Potential risks
Community level
Improper self-medication could result in an increase in drug-induced disease and in wasteful public expenditure.
Prevention of Potential Risks Associated with Self-medication
Role of the health profession
Health professionals are one who has a potential role in preventing risks of self-medication. Because he is the one who works on three main therapeutic aspects of professionalism in his daily practice: Information, therapeutic advice, and education.[3]
Information?Whenever health professionals are prescribing drugs, they should give proper instructions and explanations for what is prescribed so that it will be helpful for the patient to understand and make his own decisions. The given information should be at the patient's comprehension level so that it will be helpful for them to understand its management.
Therapeutic advice?Lack of therapeutic compliance is a serious problem in both acute and chronic treatments and reflects a poorly understood or incomplete description of the treatment aims. If patients are not well-informed they are unlikely to use the medication correctly. However, if the directions for use and the limitations of a given drug are explained-for examples, dose, frequency of dose, treatment course, how to take it, etc., then patients have a set of guidelines that will help them to use the drug correctly, both now and in the future. Inappropriate and erratic self-medication, along with lack of compliance, will only be reduced if patients are informed and understand clearly why certain advice has been given.
Education?Inappropriate self-medication is the result of the medical model from which people have learned. Proper health education should be given to the patients. By regularly adopting an educational attitude we can have an effect on large sectors of the population, on people who, in turn, may directly influence their friends and family. This aspect is of particular importance with respect to the self-medication of children by their parents or takes care.
Role of pharmacist
He is one of the key role players in educating his customers about the proper use of medicines, which are intended for self-medication. For that necessary steps have to be taken in his training and practice.
Pharmacists play a valuable role in identifying, solving, and preventing drug-related problems for the purpose of achieving optimal patient outcomes and quality of life. Ambulatory-based pharmacists have the opportunity and responsibility to foster safe, appropriate, effective, and economical use of all medications, especially those therapies patients are self-selecting. Pharmacists should guide their customers to consult the physician before taking any medication by themselves. Unlike the above role, pharmacists have the following function:
Communicator
In order to address the condition of the patient appropriately the pharmacist must ask the patient key questions and pass on relevant information to him or her (e.g. How to take the medicines and how to deal with safety issues).
Quality drug supplier
The pharmacist must ensure that the products he/she purchases are from reputable sources and of good quality.
Trainer and supervisor
To achieve this pharmacists must develop a protocol for referral to the pharmacist, and protocols for community health workers involved with the handling and distribution of medicines.
Collaborator
It is imperative that pharmacists develop quality collaborative relationships with other healthcare professionals, national professional associations, the pharmaceutical industry, governments (local/national), patients, and the general public.
Health promoter
As a member of the healthcare team, the pharmacist must participate in health screening to identify health problems and those at risk in the community, participate in health promotion campaigns to raise awareness of health issues and disease prevention, and provide advice to individuals to help them make informed health choices.
Promotion of Responsible Self-Medication
The OTC Committee of the Organization of Pharmaceutical Producers of India is working toward the promotion of responsible self-medication with a view to growing the OTC sector. It is aiming to get regulatory support for issues such as the accessibility of household TC remedies and increase the awareness of the importance of responsible self-medication with the general public and the government.
Many healthcare organizations have made important statements on self-care and self-medication, singly or jointly with WSMI.
Some selected illustrations only are given here:
The WHO: “It has become widely accepted that self-medication has an important place in the health care system. Recognition of the responsibility of individuals for their own health and awareness that professional care for minor ailments is often unnecessary to have contributed to this view. Improvements in people's general knowledge, level of education, and socio-economic status in many countries form a reasonable basis for successful self-medication.” (Guidelines for the regulatory assessment of medicinal products for use in self-medication. 2000).
The FIP: “To have good health, people are becoming more responsible, getting proper information as much as possible to decide in their own care. Pharmacists and the manufacturers of non-prescription medicines share the common goals of providing high-quality service to the public and encouraging the responsible use of medicines.” (Joint Statement by The FIP and the WSMI, 1999).
The international council of nurses (ICN): “Self-medication is a key component of self-care that is particularly significant in an era of increasing chronic illness and well-informed health care consumers. Optimizing responsible self-medication is an important and underused resource for health and provides an opportunity for collaboration and consultation among consumers, nurses, pharmacists, and physicians.”
Conclusion
Self-medication is an alarming concept. This review focused on the self-medication of allopathic drugs, their use, their safety, and the reason for using them. It would be safe, if the people who are using it, have sufficient knowledge about its dose, time of intake, side-effect on overdose, but due to lack of information, it can cause serious effects such as antibiotic resistance, skin problem, hypersensitivity, and allergy. Hence, developing countries like India where have poor economic status, education status as well as poor health care facilities. People have less knowledge regarding the risks associated with their self-medication. We are on the edge of the sword about whether to promote self-medication or not. Hence it is recommended that a holistic approach should be taken to prevent this problem, which includes proper awareness and education regarding self-medication and strictness regarding pharmaceutical advertising. Dispensing modes in need to be improved through proper education, and strict regulatory and managerial strategies to make health care easily accessible and cost-effective.
Health professionals have to spend some extra time educating patients regarding the same. Improved knowledge and understanding of self-medication may result in rational use and thus limit emerging microbial resistance issues.
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2 年Interesting Article.