Why self-medication is a double-edged sword

Self-medication is the process of taking medicines, herbs, or home remedies on one's own initiative or based on the advice of others, without seeking professional help from qualified medical personnel. It also involves self-evaluating the intensity of signs and symptoms, which may lead to the use of pharmaceutical products. Medicines used in self-medication include both non-prescription/over-the-counter drugs and prescription-only medicines. The practice of using prescription-only medicines for self-medication is especially prevalent in low-and middle-income settings where weak enforcement of regulations governing the sale of medications allows for liberal access to all classes of medicines.

Self-medication is widespread globally and can be particularly beneficial for the prevention or treatment of minor ailments or symptoms. When practiced responsibly and appropriately, it can alleviate simple medical problems, save time spent waiting to see a doctor, reduce travel costs, and prove economical for non-serious medical issues. Additionally, self-medication can be life-saving in emergency situations such as severe allergic reactions, where any delay in administering medical interventions can be fatal. In the context of chronic or recurring illnesses, patients may self-medicate after an initial diagnosis and prescription, with the doctor maintaining an advisory role.

On the other hand, self-medication can lead to unwanted consequences. Acting without sufficient knowledge may result in the irrational use of drugs, causing serious negative health and economic impacts-including adverse drug reactions, drug interactions, and resource wastage. Furthermore, the unjustified use of medications without medical guidance increases the likelihood of inappropriate, incorrect or excessive therapy, missed diagnoses, delays in suitable treatment, pathogen resistance, increased morbidity, and even death from untreated or under-treated conditions. Notably, one of the most significant public health challenges facing the world today-antimicrobial resistance-is largely fueled by rampant self-medication with antibiotics.

So, what drives self-medication? Acquiring medications without a prescription may be triggered by factors such as improperly reutilising old prescriptions, taking medicines on the advice of relatives and friends, or consuming leftover medications. Furthermore, the growing trend of self-medication can also be attributed to factors like the human predisposition for self-care, the instinctive urge to alleviate the suffering of sick family members or friends, inaccessible and unresponsive healthcare services, and time and financial constraints that prevent individuals from seeking proper health services. Ignorance, misconceptions, extensive advertising, and the easy availability of drugs in retail establishments also contribute to this trend.

There is significant public and professional concern regarding the irrational use of drugs in the form of self-medication. In low-and middle-income countries, the easy availability of a wide range of drugs, coupled with inadequate healthcare services, results in an increased proportion of drugs being used without medical supervision. While self-medication plays a role within the healthcare provision framework and has even been encouraged by governments in some areas, it is imperative for policymakers and citizens to recognise that all medicines have the potential to cause harm, and their justifiable use in therapy is based on calculable risk.

Dr Ambale is a consultant Pharmacist, Pharmacoepidemiology & Pharmacovigilance