Self medication Essay


This paper sketches the self-medication state of affairs in the development states. From a biomedical view-point the hazards that are involved in developing states are reportedly higher than in industrialised states. This can be related to the fact that in many developing states prescription drugs are freely available over the counter. Drug ordinances are limited or non implemented and wellness attention is misfunctioning. The economic-infrastructural and cultural-cognitive contexts that determine differences in self-medication patterns are reviewed. Cardinal words: Developing states ; Review ; Selfmedication. Introduction Paper presented at the Symposium on Self-Medication Consumer Aspects. Stockholm. Sweden. April 2-1. 1990 We have come to recognize that self-medication utilizing pharmaceutical merchandises is the “rule” instead than the exclusion in medical attention in the industrialised states of Europe. North America and the Pacific.

This is surely true if we include “non-compliance” with prescriptions in the definition of self-medication. Depending on how the construct is defined and the methodological analysis used to mensurate it. it is estimated that self-medication constitutes 50-90 % of all curative intercessions. For some perceivers the high prevalence of self-medication is a ground for optimism. It demonstrates the uninterrupted growing of consumers’ self-awareness and autonomy and their flight from the dependence and aliention brought about by medicalization. It reflects. as Bezold comments. “a new attitude toward wellness. including increased self-responsibility for health” [ 1 ] . Others cu: vitamin E less pleased. Some are disquieted about the biomedical effects of “irrational” self-medication. Others regard self-medication non as an flight from medicalization but instead as the visual aspect of a more elusive. less seeable signifier of medicalization. To them. self-medication constitutes self-imposed subjection to medical engineering. whereby the medical government is rendered “invisible” .

The consumer no longer subjects himself to the directives of a physician whom he meets face to face. but to the more cloaked persuasions of pharmaceutical and related industries. We tend to believe that the optimists and pessimists – as so frequently is the case- are both right. Self-medication is a profoundly equivocal phenomenon. However. our pessimism gets the upper manus if we consider self-medication in developing states. Let us be clear right from the start: self-medication may be really common in the industrialised universe but is barely tantamount to that in developing states. Both in a quantitative and qualitative sense. self-medication in Sweden. for illustration. dwindles to nil if we compare it to similar patterns in any underdeveloped state. This may look to be a provocative statement. particularly if we take into history the fact that no solid information on this issue are available for developing states. The patchy informations from a few instance surveies are so overpowering. nevertheless. that we need no longer doubt that self-medication in the Third World is of tremendous magnitude and constitutes a grave job.

In this paper. we can make little more than chalk out the state of affairs in really wide footings. It will be a cheerless image. There are many cheerful things to state about developing states. even in the field of medicine { e. g. . refering herbal medical specialties ) . But any history of the usage of Western pharmaceutical merchandises is bound to be a sad one. peculiarly if it is examined through biomedical spectacless. Hazardous self-medication Children The biomedical hazards of self-medication are best illustrated by analyzing it in vulnerable groups such as kids and pregnant adult females. With respect to the first class. a survey by Hard on in a rural small town in the Philippines revealed that antibiotics are routinely given in self-medication for non-severe childhood diarrhea ] unwellness. despite the fact that antibiotics are officially merely available by prescription ( 2 ] . This pattern is non in conformity with the established biomedical norm qualifying that acute childhood diarrhea must be treated by unwritten rehydration therapy.

The widespread usage of suboptimal doses of antibiotics in the intervention of non-severe diarrhea is a major public wellness menace. Not merely do female parents erroneously believe that they are assisting their kids get better. the widespread inappropriate usage of antibiotics contributes to the development of immune bacterial strains. Though non frequently publicized. opposition to antibiotics is one of the chief jobs confronting healing medical specialty in developing states [ 3 ] . In a more recent survey in two urban Filipino communities [ 4 ] and in a comparative instance survey in Brazil [ 5 ] . similar forms of antibiotic abuse were reported. In fact for Bra- zil. Haak reported that between 50-66 % of all medicines given in self-care were used irrationally – in a biomedical sense – while onethird were potentially unsafe [ 5 ] .

Preparations incorporating dipyrone. piperazine. penicillin unctions. local germicides incorporating quicksilver. merchandises uniting one or more antibiotics or antibiotics with steroids were the “dangerous” drugs most frequently used. All of these drugs have been banned in one or more states. Other – less elaborate – ratings of the rightness of self-medication patterns suggest that irrational and risky drug usage is prevailing in the intervention of childhood upsets all over the universe [ 6-11 ] . The consequence is that kids dice of preventable diseases. even in state of affairss where a possible remedy exists. Pregnant adult females With regard to the 2nd vulnerable group. pregnant adult females. another – less acknowledged – self-medication job can be identified: the usage of powerful drugs to bring on a menses if a adult female thinks that she is pregnant. Quinine. high-dose hormonal drugs. acetylsalicylic acid and antibiotics are used by adult females as aborticides. even though they are in fact non effectual as such and may do birth defects. The usage of these drugs as aborticides follows traditional patterns of utilizing herbal medical specialties for this intent.

Womans believe that Western drugs can end early gestation when the fetus is still vulnerable. The belief in the drugs’ effectivity is reinforced by hot and cold rules in some societies where the drugs are classified as “hot” : “hot” substances are thought to do substances to spread out. liquify and leave the organic structure. The usage of Western pharmaceuticals to bring on abortion has been reported in surveies in Colombia [ 12 ) . Ghana [ 13 ) . India [ 14 ] . Peru [ 15 ) and the Philippines [ 16 ] . It most likely occurs in many developing states where adult females do non hold entree to safe abortion installations. These illustrations are symptoms of a wellness. attention context in which drug distribution is uncontrolled and in which people use drugs harmonizing to their ain thoughts refering efficaciousness. To understand the pattern of self-medication. we believe it is indispensable that both the economic-infrastructural and cultural-cognitive context of self-medication in developing states be understood. It is these two types of context that make self-medication patterns in developing states so different from those in industrialised societies.

Economic-infrastructural context Economic factors encroaching on the pattern of self-medication operate both on the macro and micro degrees. The glooming economic state of affairs in which most developing states find themselves is one of the chief causes of the faulty operation of their wellness services. In Cameroon. for illustration. new wave der Geest found that the public wellness system functioned severely [ 9 ] . Hospitals were often shortstaffed and lacked medical specialties and other indispensable points ; when doctors were available. they could make little else than write prescriptions for medical specialties which were unavailable in the infirmary and had to be bought elsewhere. sometimes far off.

The state of affairs was worse for rural wellness Centres many of which were without medical specialties ( and sometimes forces ) several times per twelvemonth. Although the authorities promised free wellness attention. including free medical specialties. people frequently had to fend for t~emselv~s. bving drugs outside the wellness service and VISiting private practicians. ~ome of whom ~~re legal and qualified. some illegal? ~t qualified and others both illegal and unqualified. The effect for self-medication was that beside the non-functioning functionary system a comparatively well-functioning alternate system had come into being in which medical specialties were su. ppiied and “prescribed” . Frustrated by the absence of medical specialties at the local wellness Centre. people had no other pick than to self-medicate. They bought their ain medical specialties at pharmaceuticss. general proviso shops. ma_rket stables and booths alongside the route or obtamed them from itinerant drug sellers sing their small town. Developing states. one could state o/nicallv. are a “paradise” for self-medicatiOn. One can acquire about anything witJ: ~ut h~ving to confer with a phvsician. These med1cmes mclude both nonprescription drugs and alleged prescription-only drugs.

The latter could possibly be termed • “under-the-counter” although there is nil close about their sale. Even in the pharmaceuticss. which. ~perate lawfully under the supervising of a qualified pharmac~t. prescription-only drugs can ~ bou~ht without a prescription. Peoples acqurre therr cognition about the usage of these medical specialties from relations. neighbors. gross revenues people and old prescriptions. as we will see below I. •Recentlv Odebivi and Femi-Oyewo have reported on the correspanding state of affairs in Nigeria. Self- ) . ledication with Prescription Drugs: A Pattern of Health Behaviour among Students in a Nigerian University.