Manish* lives with his wife and kid in a Mumbai suburb. He works as academic staff in an educational institute while his wife, Chaya*, is a paramedic staff in a hospital. Recently, they came back tired from a fun trip to Goa. To bounce back to work they usually rely on “energy shots” which they deem fit as per Chaya’s knowledge. What are these energy shots? Injections of an antibiotic (Monocef) and a steroid (Dexa). Both are very much aware that it is steroid but unaware that it may lead to kidney problems and osteoporosis.
Asha* was on a trip abroad with her son and daughter-in-law’s family. She had chronic irritable bowel syndrome for which she was prescribed an antibiotic in India. Suddenly, she realised that she was running out of tablets and the search began in local medicine shops in Bali (Indonesia), followed by another hunt in Singapore, and Kuala Lumpur (Malaysia). Every shop denied her the medicine, stating the unavailability as it falls in the category of prescribed medicine. Asha managed to see a doctor in Kuala Lumpur where the doctor explained how the medicine can weaken the intestines and may stop working in the long run. He recommended switching to simple probiotics and antacid instead. When insisted, he said that only an IBS specialist has the right to prescribe this antibiotic. But guess what? The switch worked, Asha is doing just fine with probiotics.
Niyati* was a Ph.D. student and stayed in a college hostel. One night, when she had a slight cold, she searched for cetirizine (an anti-allergen) in the hostel. Mansi*, her friend, offered her another medicine called azithromycin (a strong antibiotic) and said, “This is what I take whenever I have a cold or throat pain.” Niyati’s parents are doctors, so she understands the importance of completing an antibiotic dose which otherwise leads to drug resistance. The incidence led to knowledge sharing between the two for social good. But she thought about the thousands out there who still pop antibiotics like candy!
Tanvi* was at the Mumbai International Airport, ready to fly to Delhi. She had had her wisdom tooth removed a day before and hence was experiencing some inflammation in the gums. With a doctor’s prescription, she approached the reputed pharmacy at the airport only to find that they did not have the prescribed medicine. Instead, the pharmacist offered a combination of dychlophinac which she bought. A few minutes later she discovered that the drug provided has been recently banned in India. She went back and complained, to which pharmacist responded by returning her money and said that we have received the ban list but it is still under consideration. Please do not complain.
All four stories signal the rampant use of over-the-counter drugs. What is the other common thread among them? The stories are about the educated section of society. So who is at fault? Doctors, government policies, pharmacies, or consumers? Let us get into their shoes one by one.
We consumers often refrain from going to doctor for possibly two reasons: 1) it saves on doctor’s fee, or 2) we trust our local pharmacist for a diagnosis; 3) once we see a doctor, we see it fit to use the same prescription for a lifetime.
Why do doctors prescribe heavy medicines? 1) Maybe to provide quick relief and gain a patient’s trust; 2) Because of their beneficial ties with medical representatives of giant pharma companies; or 3) Their own lack of knowledge.
Why is the government so lackadaisical about it? 1) Changing prescription rights is a tough nut to crack; 2) There is a heavy monitoring cost; and 3) the lobbying from strong pharmaceutical companies and medical council.
The above list of reasons appear like a complex network that has given rise to the current situation. Of course, there can be a solution to this complex issue, but let us limit this article for people like you and me: the general public.
It is said that half-knowledge is more dangerous than ignorance. Fortunately, or unfortunately, we have multiple sources to gain incomplete medical information: the internet; interaction with “someone who works at the hospital”; our local buddy pharmacist; neighbours with similar illnesses as us.
Firstly, we should understand that self-medication is a dangerous recourse. Popping a pill without complete knowledge about it can weaken your immune system and deposit toxins inside the body. After all, medicines are nothing but chemicals. Second, once you take an incomplete dose of antibiotics, it makes the disease-causing microbe stronger, and causes drug resistance. And stronger microbes are a problem for society as a whole, as they are untreatable. Multiple drug resistance is a real problem which has killed many people as drugs simply stop working! Mind, it takes almost 10 years for a new drug discovery. To combat antibiotic resistance is among the top priority of World Health Organization. Third, always be a vigilant consumer. If you witness a similar scenario Tanvi’s, blow the whistle without a second thought. Pharmaceutical companies often push banned medicines to refrain from loss. Your awareness can save you, and others.
Medicine is a cure, and not a prevention. And prevention can only come from healthy habits, which are certainly lighter on your pocket.
Please do not be your own doctor!
Take care.