By: Victoria Iyeduala (Freelance Health and Wellness Writer)
Drug misuse is when you treat yourself with drugs without following directions from an authorised health professional or the directions on the drug packaging.
Although self-medication often leads to drug misuse and abuse, misuse and abuse of drugs are quite different practices. At the core of the difference is the motivation for use.
According to the Institute for Safe Medication Practices in the USA, drug abuse is the use of medication either without a prescription or in a way other than prescribed for the experience or feelings it evokes.
But drug misuse includes:
This article will talk about the following:
Prescription or prescription-only drugs can only be used when prescribed by an authorised healthcare professional.
It means you can only take or buy these drugs with a written prescription from an authorised healthcare provider, such as a medical doctor.
Using prescription drugs to treat yourself without a prescription or proper medical advice is drug misuse.
Examples of prescription-only drugs are:
Commonly misused prescription drugs are antibiotics, antimalarial drugs, higher-dosage analgesics and antidepressants.
Non-prescription drugs are drugs that you can use without consulting a health professional or without a prescription from a doctor.
They're also called over-the-counter (OTC) drugs.
Usually, there's information on the drug packaging with instructions on:
Over-the-counter drugs are considered safe for consumption or use when you use them according to the instructions on the packaging.
They're drugs that are meant to be used for self-medication and are used to treat minor illnesses and symptoms like aches, stomach upset, skin infections and fever.
Examples of non-prescription drugs are:
They can be gotten in pharmacies and chemist stores. You can also find some in supermarkets.
Some drugs, such as some analgesics, are OTC medications at a lower dosage and prescription medications at a higher dosage.
Analgesics, such as ibuprofen, paracetamol (acetaminophen) and aspirin, postinor (an OTC contraceptive), dietary supplements and antifungals are commonly misused non-prescription medicines.
Herbal medicine is a form of traditional medicine that uses herbs or plants and plant-based products to treat illnesses.
Some herbal drugs are plants industrially processed into liquids, powder form, capsules and tablets, while others are made traditionally at home on a small scale.
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Common examples of potent medicinal plants in Africa are:
Many of these drugs contain one or more medicinal plants. Since many of these plants haven't undergone any processing to extract the particular constituent or chemical needed or believed to treat a particular illness like is done for pharmaceutical drugs, the user consumes all the constituents in these plants when they use them.
The body uses the constituents it needs and either passes out the unnecessary and unused ones or stores them. These chemicals can threaten your health if they become too much in the body.
From minor ailments like headaches and fever to severe ones like diabetes and ulcer, herbal medicines are used to treat and manage several health conditions.
Herbal medications are easily accessible to the public. They're sold on the streets, in markets and in drug stores.
Home remedies are medicines we make ourselves at home. They're usually made with common household materials like food and cooking ingredients.
Some of the examples of traditional herbal medicines listed above are also used to prepare home remedies.
The user can make home remedies or buy from others who make them.
People misuse drugs for several reasons, including:
Some people misuse drugs because they live in communities where inappropriate self-medication is common and seen as a normal practice.
An example is rural areas where people are more likely to depend on treatment with herbal medicines or the local chemist store owner for diagnosis, advice and treatment.
With little access to proper care in public health centres, people turn to self-medication when they can't afford quality healthcare from private clinics.
They end up depending on cheaper alternatives that may include using various herbal concoctions and consulting the wrong people for medical advice. This may lead to misusing medications.
Patients want to get better immediately after they start taking medications. So, they may misuse drugs to get the quick recovery they want.
One way they can misuse medications is when they take doses contrary to the prescription from the doctor or the information on the packaging.
For example, your doctor may instruct you to take two tablets three times daily – morning, afternoon and evening – but you decide to take four tablets because you believe that taking more will fast-track your improvement.
Believing you don't need your medication anymore
Some people stop taking their drugs sooner than instructed by their healthcare provider when they start feeling better.
This also leads to using drugs prescribed to you by your doctor without his instructions or advice when the sickness returns because you didn't complete the previous medication.
Some people self-medicate with drugs they know little about.
Some may also treat themselves with drugs for an illness without adequate information. This may lead them to
Some people unintentionally misuse drugs because they follow the advice of a health professional who is not licensed to prescribe or counsel about drugs.
This may happen when they go to get drugs from a pharmacy, chemist store or supermarket. They're advised to take the drugs contrary to what the doctor prescribed or instructions on a non-prescription drug.
It could also be advice from a friend or relative who has used a drug based on a prescription and believes that using the same prescription will work better for you.
Although prescription drugs can only be prescribed to you by an authorised medical professional such as a medical doctor, people can easily get them in drug stores without a prescription in some African countries.
According to research, prescription drugs such as antibiotics are sold to customers without prescription daily in these African countries.
A person may also misuse prescription drugs issued to another patient, like a friend or relative. For example, you use a drug that is prescribed to your relative for an illness that is perceived to be the same or similar.
Self-medication is common in many African countries, which also means that the possibility of drug misuse is high.
One of the reasons for the high popularity of self-medication in Africa is the lack of access to quality healthcare.
This could be because of
The inability of the government to take some necessary actions fosters the misuse and abuse of drugs in Africa.
Laws and policies guiding the importation, production, distribution and sale of medications should be improved to ensure proper drug surveillance and enforcement of these laws.
Many people turn to irresponsible or inappropriate self-medication because they can't access public healthcare services and can't afford proper healthcare from private hospitals.
The quality healthcare the government should provide to its people is sometimes unavailable because of the lack of adequately equipped healthcare facilities, a low number of healthcare professionals and high out-of-pocket healthcare costs and lack of universal health insurance.
There isn't enough sensitisation around drug use, misuse and abuse. The government and related public health bodies should continually create awareness around medication use, misuse and abuse.
Herbal medicines are unregulated in many parts of Africa and are easily accessible to people. They're very popular in Africa.
Some medical practitioners don't educate their patients sufficiently on their sickness and required treatment plans. When patients get information from the wrong source, this may lead to drug misuse and abuse.
Some pharmacists, without the required license, prescribe prescription-only drugs to customers. They also sell these drugs to customers without a doctor's prescription.
Studies in Nigeria, Zambia, Tanzania and Egypt show that pharmacists and other drug retailers frequently sell antibiotics to customers without a prescription.
Healthcare providers of different persuasions need continuous education on best practice in patient-centered communication and hold themselves to higher standards in this respect.
Several retail drug stores sell prescription-only drugs to customers without a written prescription from a doctor.
Even when they're not authorised to prescribe drugs for customers or give a diagnosis, they encourage self-diagnosis and offer or suggest prescription drugs to customers with advice on how to use them.
Sometimes, they may offer advice contrary to the information on a written prescription or instructions on the packaging of a non-prescription medicine.
Some herbal medicine and home remedies vendors entice customers with fake promises about their products.
Continuous public service education and surveillance of vendors for appropriate sanctions would help to curb these inappropriate actions.
Self-medication is a major cause of drug misuse. Patients or drug users end up misusing drugs while self-medicating or undergoing professional treatment to get better faster and spend less.
Some patients don't request adequate information about their illness and treatment from their healthcare provider. As a result, they may accept any advice they get from other people and misuse medications.
Apart from public health challenges that the government can solve, some people deliberately self-medicate because they're too busy to go to the hospital for treatment.
For personal reasons, others don't like seeking professional healthcare or going to hospitals but only depend on traditional medicine, such as herbal and home remedies.
Again, continuous patient-centered education on appropriate drug use would help to improve patient compliance with appropriate drug use.
Several health complications can arise due to drug misuse.
Some of the common consequences of misusing drugs are:
Antimicrobial or drug resistance occurs when drugs become ineffective in treating illnesses because the bacteria, virus, fungi or parasite that causes the illness no longer responds to the drug.
Misusing and abusing drugs can cause AMR. AMR makes illnesses difficult to treat and thereby increases the risk of complications.
This leads to suffering from an illness for a long time and a higher cost of treatment. It may also lead to premature death.
Antibiotic and antimalaria drug resistance are becoming increasingly common in Africa.
Drug misuse can lead to drug dependence and substance use disorder or drug addiction.
Drug dependence is when your body gets so used to a drug that you experience unpleasant symptoms called withdrawal symptoms when you stop using the drug.
Drug addiction or substance use disorder is when you have an uncontrollable urge to abuse drugs because of the effects you get from them, such as feeling "high' or energetic.
Drug dependence and addiction disrupt one's life. They lead to unnecessary spending, lack of focus and concentration, family, job and social disruptions and health complications.
Misuse of drugs can lead to drug overdose. Drug overdose causes drug poisoning.
Drug poisoning or drug toxicity is when your body gets too much of a drug that it becomes toxic to your system. This can damage vital organs, such as the liver and kidneys.
Commonly used medications that can lead to drug poisoning are prescription drugs and herbal concoctions.
Death can occur as a result of drug misuse and abuse. Complications from drug resistance, drug poisoning and substance use disorder can cause death.
The high prevalence of self-medication in Africa increases the chances of drug misuse.
Prescription drugs, non-prescription drugs, herbal medicines and home remedies are commonly misused drugs among patients and drug users.
The government, healthcare providers, medicine vendors and patients all have a role to play in curbing the misuse of drugs in Africa.
Drug resistance, drug dependence, substance use disorder, organ damage and even death are some unforeseen consequences of drug misuse that Africans should be made aware of in efforts to discourage the practice of drug misuse.
Related: Self-medication in Africa: What you need to know
Published: April 19, 2023
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