Hazards of self-medication
Long-term use of certain drugs can lead to organ damage
Self-medication is a potentially lethal practice that everyone should be cautious of, warns Meera Murugesan
FOR most of us, falling ill means a quick visit to the doctor but for some people, going to the clinic is the last resort. Most families have at least one such person — parent, aunt, cousin or sibling — who firmly believes in self-medication.
They avoid consulting a doctor as much as they can and prefer to heal themselves, usually with knowledge they have picked up from others or the Internet.
While it is admirable to take charge of one’s health and be better informed about diseases, popping pills on our own is never safe.
Self-medication involves the use of either illicit or legal drugs without proper supervision or a prescription, says Dr Shiamala Devi Saravana Muthu, assistant director of primary care and wellness at Sunway Medical Centre.
It also includes taking more than the prescribed dosage, consuming medicine for a longer duration than required, consuming medication prescribed for a prior illness, sharing medicine among family members or switching from Western to herbal medicines without consulting a doctor.
SHALLOW SELF-DIAGNOSIS
Dr Shiamala says most people do it because they want to eliminate the cost and time of seeing a doctor. Others assume their condition is too mild for a doctor’s intervention and some believe they have acquired enough information to self-diagnose and self-medicate.
Common ailments which lead to self-medication include headache, flu, cough, joint pain, constipation and flatulence. Menstrual pain, stomach discomfort and food poisoning are also often self-medicated and painkillers and antibiotics are the two drugs which are most commonly misused.
THE BIGGER PROBLEM
Self-medication can be hazardous and even fatal if left unchecked, cautions Dr Shiamala. “Whenever there’s pain, some people pop a painkiller. They want quick relief but don’t realise that this pain may be linked to a serious medical problem,” she says.
A recurring headache, for example, may be due to a sinus problem or worse, a brain tumour. Women who regularly suffer painful periods may also have a cyst, fibroid or a serious gynaecological problem and this bigger issue is not getting addressed because the individual refuses to see a doctor.
Overdosing on certain drugs can also lead to organ damage and long -term use of some medicines may result in addiction. Dr Shiamala has seen liver damage in a patient due to the long-term over-use of paracetamol, a common painkiller.
“Antibiotics should also be used judiciously as over use can lead to antibiotic resistance and severe allergic reactions,” she says.
Some people don’t complete their course of antibiotics and assume they can use the remaining pills the next time they fall ill, which is also very wrong.
DANGEROUS TREND
Those who suddenly stop taking their prescribed medicines and don’t attend follow-ups because they have switched to herbal therapy are also self-medicating. Herbal medicines are not necessarily safe and some can affect the kidney and liver.
Parents who medicate their children are also practising a dangerous habit. Dr Shiamala says research shows that most parents are very cautious up till a child is 2-3, when they start to medicate the child.
Overdosing can easily happen and this is highly dangerous. What’s worrying is that some parents even allow siblings to share medicines without realising that different children react differently to a drug.
They do this as young children fall ill very often and with two or more children in a family, they want to avoid the cost of seeing a doctor regularly.
But Dr Shiamala says parents must be very careful as children may suffer more adverse reactions than adults to any medication, including basic ones.
DANGEROUS PRACTICE
CURRENT regulations call for a registered pharmacist to be stationed at pharmacies selling restricted medicines. If the pharmacist is not available for any reason, the poisons counter must be locked, says Tan Sok Kheng, acting head of pharmacy at Pantai Hospital Kuala Lumpur.
This is to safeguard against abuse and misuse of drugs classified as poisons. However, in certain pharmacies, senior sales assistants instead of pharmacists are stationed at the poisons counter.
Not only is this illegal but it is also highly dangerous, given that these people are not qualified to advise consumers and don’t have the knowledge to deal with medicines.
“When consumers purchase such medicines at the pharmacy, they must know who they are dealing with. Make sure it’s a pharmacist.”
UNDERSTAND THE LAW
In Malaysia, medicines which fall under Group B poisons can only be purchased with a doctor’s prescription. The pharmacist will review the prescription and then dispense the medicine. Medicines in this category include antibiotics and high blood pressure medication.
Group C poisons are those which the pharmacist can prescribe and dispense without a prescription, such as certain types of allergy and fever medications and some types of cough mixtures.
The third category involves Over The Counter (OTC) medicines. These are items which consumers pick up from the shelves of a pharmacy or supermarket and include very mild painkillers, herbal cough medicines, vitamin supplements and certain types of eye drops.
“It is these OTC medicines patients generally use to self-medicate as they can obtain them without consulting a doctor or pharmacist,” says Tan.
The danger lies when consumers self-medicate without knowing the exact dosage they need to take and the duration they need to take the medicine for.
Some do not even read the instructions leaflet and the contraindications of a particular medicine.
ETHICAL PRACTICES
She stresses that pharmacists must also be ethical and professional in their conduct to prevent self-medication.
They should always ask for a doctor’s prescription when required and never dispense medicines they are not allowed to sell.
They also need to spend time talking to consumers to better understand their symptoms and underlying medical problems.
She says many people today feel it is unnecessary to consult a doctor for minor problems when there’s so much information on the Internet and with pharmacies, Chinese medicine halls and supermarkets in every residential area. However, information from the Internet may not be reliable or people may misunderstand the medical terminology used in certain sites.
In the same manner, exchanging health information with a friend is also not reliable as what works for him may not work for you.
“You and your friend may both have a cough but that doesn’t mean you can use the same medicine. There are many different types of cough such as productive cough, non-productive cough and nocturnal cough. One medication may be suitable for one type but not for another,” says Tan.
HEALTH HAZARD
It is also common for people who have already obtained pain relief medication from their doctor to purchase additional painkillers from the pharmacy.
Tan says these patients assume that because the brand name is different, they are trying a different type of painkiller.
In actual fact, the underlying ingredient in both drugs may be the same and this can result in poisoning or overdosing. Many drugs today are also manufactured in combination, meaning one, two or even three different medicines come combined in one tablet and consumers who don’t understand this can easily end up taking too much if they self-medicate.
Lots of children’s cough mixtures today also come in combination formulas, they target both cough and fever in one bottle so if parents add other drugs on top of this, they will end up overdosing the child.
There is also the risk of one medication interfering with or reducing the efficiency of another.
Old people, for example, who are already consuming a variety of medicines for various ailments should be particularly cautious about self-medicating.
Tan says the elderly should always carry a list of their current medications whenever they go to a pharmacy so the pharmacist can make a clear and informed decision before dispensing.
Pregnant and lactating women, people with chronic diseases and those with kidney or liver problems should also be especially careful about self-medicating.
Drug interaction can also happen between herbal and normal medicines so patients must always alert their doctor if they have taken herbal solutions. Patients on blood thinning medication, for example, should avoid taking ginseng as it can be dangerous.
Tan says it’s crucial that consumers understand their bodies well and never take anything for granted where health is concerned.
