Being in good health and shape is priority, before any other thing follows. Health is wealth, so they say, but what happens when you realize that your health is now fighting against you. My uncle who came to visit us few weeks ago have been complaining of his inability to sleep, arm ache as well as body ache, breathing difficulty and discomfort. One act that I do not like, and I kick against, is self-medication. Self-medication, is responsible for the majority of simple health complications, including incorrect and dangerous drug combination and so on pubmed. I immediately asked that we go to the hospital to see a doctor. When we got there, the doctor diagnosed Hypertension. My Uncle started to wonder how he could be diagnosed with high blood pressure, and decided to go to a different hospital for medical confirmation, and he got the same result. I began to wonder why he didn't trust the first doctor, and I learnt that he is too used to self-medicating, that he has his mind tuned to believe, that the only illness he usually has is Typhoid and Malaria, and he made it clear to me that once he notices any symptoms, he is quick to self-medicate himself. In this post, as much as I want to talk about my Uncle's Hypertension experience, because it was funny and there is a lot to learn, I will be looking into self-medication.
It is a Global Phenomenon
You start to wonder if it is a thing of the south, the east, or the west. Anywhere you come from, it is no doubt that there are people who self-medicate. It is quite surprising how self-medication is found around educated people. According to the article, Self-medication: A current challenge, published on the NCBI journal, 73% of people who self-medicate in Punjab, India are educated. The same journal shows that 13% of the US population self-medicate.
In growing and underdeveloped countries, where health care is expensive and/or not available, self-medication becomes a choice when people have to care for their health. While this is the case for developing countries, it can be different in the developed world, as people could self-medicate without the intention of self-medicating. In developed countries, people trying to use pain relief for simple headaches without visiting a physician after, because the ache disappeared. If this person keeps doing it over and over, then it could be regarded as self-medication.
An article published on dovepress.com showed that 71.1% of the cases in the research self-medicates because they believe the illness is less serious. These less serious illnesses would include gastrointestinal diseases, headache, and respiratory tract infection.
While some people love to party, be with company, and associate with other people, some people do not like to mingle with others, they do have social phobia and to get away with this, self-medicating as a way to overcome it could lead to illicit drug usage and drug abuse.(Science Direct).
Self-Medication and Pregnancy
While self-medication is a fundamental part of self-care, but then, it has caused great concern. According to research in Peru and Ethiopia, Diclofenac and Paracetamol has been seen to be the commonly used self-medication with pregnant women.(europepmc). It is also no doubt that pregnant women who follow through Antenatal Care, are 75% less likely to self-medicate, proving that lack of money, or the proper fascility will be the major cause for the usage of those medications. (bmcresnotes). To set it straight, most drugs are advised to be avoided during pregnancy, unless when prescribed by a physician. In an article posted on mothertobaby.com, pregnant women are to avoid ACE inhibiting medications for high blood pressure during their second and third trimester, as it affects the amniotic fluid level surrounding the baby, which could affect the development of the baby. High blood pressure medications are sold over the counter, but when a woman with High BP gets pregnant and decides to use an over the counter medication for high blood pressure without a doctor's prescription, there is a possibility that she will be taking a medication that could hurt her child.
Handing a Bulletproof to Microbes
In my previous post Malaria, Typhoid Coinfection|| An Experience with Drug Resistance Coinfection, I explained how Malaria and Typhoid have become resistance to medications in recent times. It is no doubt that self-medication, when used by people, they do not either complete the dose, they use the wrong doses, or combine wrong medications together. The major causes of antibiotic resistance microorganism are; incomplete treatment and wrong medications. (NCBI). When it comes to the use of antibiotics in some areas including Nigeria, Sudan, Greece, Kenya, Spain, and so on, medications such as Amoxicillin is one of the most frequently used for self-medicating. This was established in a research published on Bmcpublichealth as Amoxicillin is a well known antibiotics which can be easily accessed by people.
Conclusion
Self Medication is a sword which in some cases has its side of good in the part of first-aid, but the other edge of the sword seems to cut more, as it has become a reason for concern in the health world. A lot of conditions could be responsible for allowing people to self-medicate, but one factor I believe is a major cause of self-medication is pharma companies and their marketing. The way pharma companies market their product make it something that people can use first before visiting their doctors, and this allows people to believe in the medication as a solution before visiting a hospital, instead of visiting a hospital first to be diagnosed and treated accordingly.
Image from pixnio
It is a nice topic and very common in countries that don't control prescription medicines. I have experience of living in two countries with two different policies. I was born in Brazil and now I live in Canada. When I used to live in Brazil any medication was free of prescription, except some considered black label (such as psychotropic drugs and other drugs that can cause addiction). My mother-in-law was one of those who when feels sick she takes anything by herself without going to the doctor, so I know many people like your uncle.
Now I live in Canada for almost 5 years and not many drugs we can buy without a prescription, some analgesics (like Tylenol), antihistaminics and flatulence drugs are the ones that we can buy without a prescription. That avoids most of the problems that you cited. However, I have a chronic disease and I take the same medication since 2005. In Brazil was easy to buy it all the time. Now I need a prescription every time that it ends. It is easy when you have a family doctor. But for example, recently I moved to another province here, 4,000 km away from my previous home. When I arrived at my new residency place, I didn't have a family doctor for me, so I had to go to an emergency room from the hospital, and stay in a line for a couple of hours, just to get a prescription from a doctor. So, there are some cons to being very restricted. In my point of view, the two are:
. Chronic disease patients
. The decision about what drug can be bought with or without a prescription is questionable sometimes.
For the second point, I will give an example. Here there is one or two brands of nasal corticosteroid spray that you can buy without a prescription, but some other types you can't, and mostly it is the same mechanisms. Corticosteroids in the bloodstream can cause lots of problems if the usage is abused. But since in this case they are used localized in a topic way in your nose, not much is absorbed by the bloodstream. Why only two brands can be bought without a prescription and others similar we can't? I know that it is a burocratic way to release drugs here, all antihistaminics in here were recently added to the called over-the-counter medicines without a prescription.
Well thanks for bringing the topic.
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Whereas I understand your specific case (and this is a pity you need to go to the hospital for a prescription), I am afraid that it is impossible to account for all specific cases when designing rules. They are just statistically too rare. In other words, can we put all the people suffering from chronic disease in the same sample or do we need to consider them as individual cases? What do you think?
Well I am not a public health politics expert! but in my case I wish that there was a more easier method to reach a health care practitioner once you move. For example, I used to have a family doctor in my former province, I moved because of work, so I start from 0. And it is difficult to find a family doctor in Canada. But for my luck, I was lucky again, I applied for a family doctor and he accepted us, even being full. I don't know what was the criteria to be accepted, but maybe my condition and/or the fact that we have a 18 months old baby with use influenced a bit. They should create a way that even with this not availability of family physicians, to facilitate the life of chronic disease patients, maybe for those patients the prescription being accepted in all provinces? I don't know we can think lots of different things but I don't know-how are easily implemented.
The situation is similar to France. it is damned hard to find a family doctor when you don't have one, and things need to be restarted at every change of place (believe me, I moved more than 10 times in my life, so that I know what I am talking about).
Where are you know in Canada? I know a bit how it works in Quebec as my in-laws are from there, but I have no idea about the rest of the country.
I agree. In your case, an online appointment may work out smoothly and nicely, for instance. However, I am by far not a public health expert too :D
I was closer to Quebec before when I was living in Atlantic Canada, now I am in the praries, in Alberta. Where I was living was the only official bilingual province in Canada, New Brunswick. I was investing a lot in my French because of that. Now I am living in a place where no one speaks French. So weird! The only guy that I practice french with, now, is the security guy from my job.
The language situation in Canada is very interesting. My impression is that for many, they just either hate the other language and anything related to it, or at best don't care about it. This is also what is on-going in other countries (that I know) with several official languages. I think here about Belgium.
I believe this two-language situation should be used instead as a strength, but it is rarely the case.
everyone thinks about that...it is crazy. It is part of the government's fault as well. For example I was living in New Brunswick, it is the only officially bilingual province. It should be paradise right? But no. You have two health authorities (francophone and one anglophone), the anglophone schools have what they call French Immersion, but it looks like it isn 't enough to transform kids into bilinguals in most cases. So Lots of jobs requires you to be bilingual and the anglophones gets some anger about that and they hate francophones. In the other hand, the francophones there feel also the pressure to learn English , and even if they know English, they prefer to talk in French; I heard people suing nurses in the hospital because they didn't talk in french with them. It is a crazy situation like you mentioned...
Similarly in my country, there are a lot of medications that do not require prescriptions to purchase. The fact that there are no standard healthcare and following the fact that a lot of people live below the poverty line allows people to purchase medications from roadside medicine shops.
To be factual, both have their sides, but it is better to have a priscription from a medical practitioner, than to purchase a medication you feel is good because of pharma advertisement. I have heard a lot of people use ciprofloxacin tablet when they suffer from Typhoid (Salmolena typhi) only to get to the hospital and the doctor tell them the medication wasn't doing well to inhibit the growth more less cure the patient. Intravainous treatment is then employed.
This is very touching, i must say. Having to wait in line for long to get prescriptions isn't a good thing.
Thanks a lot for reading through my post
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As you mentioned it further in the blog, I would even add that the main problem I see with self medication is that it is definitely a catastrophe for bacteria resistance to drugs. We may end up with a super disease very soon, to which we may just have no known treatment :(