Quick fix or a ticking time bomb? The dark side of self medication

Self-medication is the use of pharmaceuticals to treat illnesses or symptoms, or even to promote health, without a prescription from a healthcare provider. It has subtly become commonplace in today's frenetic life style, where time is limited and medical appointments are increasingly viewed as a burden. Most people are reluctant to visit a doctor's clinic for minor ailments they believe will go away with self-medicated drugs. Many people in Assam and across India are taking care of themselves without medical advice, from swallowing leftover antibiotics for a sore throat to popping a painkiller for a headache. Hence, self-medication is a widely prevalent practice here.

It is actually growing in importance since it empowers patients by encouraging them to make decisions about the treatment of minor ailments with more autonomy. It is, on one hand, beneficial to healthcare systems by improving access to medication and facilitating better use of clinical skills for more complicated issues, rather than focusing on mild headaches or an upset stomach. But on the other hand, it is hazardous, often leading to misdiagnosis, overdosing, and the possibility of chronic use and polypharmacy,

Of course, self-medication cannot be viewed as completely detrimental since it saves patients both time and money. For a patient suffering from an acute migraine attack, it is reasonable for them to swallow a migraine medicine rather than book an appointment with a doctor and wait for a consultation. Often in remote locations, where it is difficult to reach a proper doctor's clinic, patients heavily rely on self-medication.

There are numerous factors, such as the type of ailment, level of education, and unavailability of clinical experts, which influence this prevalence. Studies show that around 87% of patients in India with chest symptoms started taking medicine on their own to get better, and this figure is much higher in urban and semi-urban populations than in rural areas. This national tendency is reflected in Assam as well, particularly in areas with limited access to healthcare or where cultural customs favour informal, local advice over expert consultation.

The most popular way to obtain medicines is by recalling the names from past prescriptions. A study confirms that every third client who visits a pharmacy is given medications without prescriptions, and the majority of these respondents also use and recommend the product to others they know.

The simplest reason behind this pattern of drug use could be that people tend to ignore minor ailments to avoid losing money by staying in hospitals. The most prevalent conditions are fever, headache, and abdominal pain. Although shocking, it is also observed that people exhibit this behaviour to treat some chronic illnesses, such as diabetes and arthritis, using Ayurvedic or other alternative forms of medicine.

The most commonly and frequently used drugs for self-medication are antibiotics, cough syrups, antacids, painkillers, and vitamins. The fact that many people use these medicines based on information from the internet, recommendations from friends, or prior experiences makes this even more worrisome. Despite regulatory guidelines for the use and sale of some of these medications, most are readily available over the counter in pharmacies. The widespread use of antibiotics, in particular, directly contributes to the rising threat of antibiotic resistance to public health. Many people take them incorrectly, without any clinical knowledge-for the wrong illness, in the wrong dosage, and for the wrong duration. As a result, not only do they fail to recover, but their immune systems also become weaker, while the bacteria culture becomes more resilient and ultimately more difficult to eradicate in the future.

One of the most pressing issues is the misconception that once a medication works, it will always work. People ignore the fact that certain symptoms may have a variety of causes, and a proper diagnosis is essential before being treated by a qualified medical practitioner. Common side effects include gastrointestinal problems and skin reactions such as rashes; more specific effects include nephrotoxicity and changes in teeth colour.

Painkillers, too, are among the most commonly self-medicated drugs and are not as safe as they seem, a fact now widely known through social media. Long-term addiction to painkillers can lead to ulcers and renal damage. A lot of individuals, however, ignore the long-term effects they may suffer. Although self-medication may appear to be a safe shortcut, it ultimately puts one's health at risk. The appropriate medication in the wrong hands or at the wrong time can cause more harm than good, and as a community, we must acknowledge this. Nearly 68% of Indians admit to self-medicating, with the percentage much higher again in urban and semi-urban areas.

Self-medication is dangerous because it is subtle and seems harmless even beneficial. However, the truth is harsh. A 2023 research study by the Indian Council of Medical Research (ICMR) found that 10% of hospital admissions in India are related to adverse drug reactions, many of which result from improper self-medication, and that India is also one of the nations with the highest rates of antibiotic misuse.

The issue is especially pervasive in rural Assam, where pharmacies serve as de facto health consultants and public health infrastructure is frequently inadequate. Raising public awareness is essential to addressing this silent epidemic. People need to be made aware of the dangers of using medications without supervision.

To stop pharmacies from dispensing prescription medications without conducting the necessary checks, stronger enforcement of drug sale laws is also required. Telemedicine, community health awareness initiatives, and mobile health clinics can all help close this gap. Self-medication is a ticking time bomb. Though it may seem like a quick remedy, this silent threat could escalate into a serious health emergency unless we take proactive measures to inform, regulate, and improve access to safe medical care.