We Indians are always looking for self medication. If you are in an office just say I have a stomach ache and your staff will immediately advice you go to a medical store and buy the medicine they are suggesting. Most people avoid hospitals and clinics to save money—because if they will consult a clinic, then the doctor will prescribe too may tablets, which will mean spending more money. So, people directly go to the pharmacies and buy over-the-counter drugs according to their needs.
A survey conducted by Lybrate among 20,000 people across 10 cities showed that 52% of people in India practiced self-medication. The survey also found that 52% of these people don’t want to visit a doctor due to the lack of time, wanting to save consultation fee and reliance on the internet for solutions to their disease.
A paper published in the International Journal of Community Medicine and Public Health and a study done by Dnyanesh Limaye and others indicated that having old prescription(s) (rural: 53.5%, urban: 39.8%) and saving the time (rural: 23.3%, urban: 35.9%) were the main reasons for self-medication among studied participants.
Even my father relies on his ‘friendly’ pharmacist who prescribes him medicines when any health issue occurs. He relies on him more than an MBBS degree-holder and an authorized doctor! Generally, people practicing self-medication rely on their neighborhood pharmacists, who are their go-to ‘doctors’ prescribing them medicine for cough, cold, fever, pain, acidity, eye drops, ear drops, weakness, skin-related issues, and what not.
Sometimes people buy medicines which require a prescription from a doctor, but they just take it from a medical counter and use it in their own way. Although any drug should be taken only after a doctor’s consultation, in case of prescription drugs, the risks are higher—as without proper information and diagnosis, taking such drug may have a potentially harmful effect as well as other side effects.
Now people are even purchasing drugs from Amazon, Flipkart, and other online platforms. E- Pharmacy is growing day by day. Because self-medication is a rampant practice in India, the online sale of drugs is encouraging it even more. The issue of self-medication would further get a boost due to the easy availability of medicines. This would aggravate the problem for drug-resistant diseases such as TB, and the rise in antibiotic-resistant pathogens.
As per the existing Drugs and Cosmetics Act, ‘scheduled’ drugs should be sold by licensed pharmacies against a doctor’s prescription, but this Act does not have any guidelines in place for e-commerce players in the pharmaceutical industry. Selling drugs online is quite different from selling drugs over the counter. There is an element of anonymity involved in purchasing drugs online. The chances of drugs being misused or being purchased with forged prescriptions are high. It is quite difficult to trace out the identity of the individual buying it.
With no government guidelines available for selling medicines online, the network can be used by anti-social elements like drug peddlers and smugglers. There is no defined responsibility of the e-marketplace operator due to which, any deterrence on their part is absent—which is not the case in brick and mortar pharmacies whose responsibilities are properly defined.
Using forged prescriptions online for procuring drugs is quite easy as well. With the availability of editing software and applications, changes in a soft copy can be made. This forged prescription could then be used for some illegal purchases. Though forgery is possible in the real world too, there are some limits. In developing countries, reported self medication prevalence rates are much higher, for example, 84% in Pakistan, 78% in Saudi Arabia, 67% in Nigeria and 79% in India. The developing countries need an immediate policy on over-the-counter drugs and e-pharmacy.
India is already facing the danger of antibiotic resistance and drug menace. Cybercrimes are on the rise with no comprehensive law to tackle them. With the growing e-pharmacy market and its possible danger, the need for a well-documented comprehensive law to tackle the online world is iterated. Thus, an order should be brought out by the Indian government permitting only certain classes of drugs to be sold online which are relatively harmless and imposing strict monitoring and compliance mechanism on online companies, including penal provisions.
At the same time, awareness should be created by the government about the potentially harmful impact of consuming drugs without medical supervision. There is a pressing need to have better campaigns to give a signal or pass on the message to people about risks associated with self-medication. There should be monitoring of jholachaap doctors and medical stores, both in rural and urban areas to avoid the risk of self-medication. There is no doubt that sometimes self-medication saves the life of a person—like in rural areas where people do not have access to well-practiced doctors. Therefore, they are forced to self-medicate. But self-medication poses a lot of risks and people should understand them.