March 25, 2022
While the explicit advertising of medicines and drugs does not surprise anyone, their uncontrolled use it got worse with the pandemic. According to 2017 data from the Argentine Drug Observatory, 6.2% of the population aged 12 to 65 consumed opiate painkillers without a medical prescription at some point in their lives. This percentage is 2% for thinners, 3.2% for tranquilizers and 0.2% for stimulants.
The recreational abuse of these legal drugs is only one side of the problem. There is also self-prescription and self-medication, which is the chronic use of over-the-counter drugs. One and others cause problems for people’s health.
The World Health Organization (WHO) estimates that more than half of medicines worldwide are prescribed, dispensed or sold inappropriately and that 50% of patients do not take their medicines correctly.
Self-medicate is not the same as self-prescribe. The first involves administering an over-the-counter medication to relieve a recognizable, transient, moderate symptom such as a headache, digestive upset, menstrual pain, or mild contractures. But just because it’s over the counter doesn’t mean it’s harmless and can be taken for life.
Self-prescription happens when the person decides to take a drug for which a prescription (or prescription) from a doctor is required because its administration must be supervised, as are the cases of psychotropic drugs, contraceptives and antibiotics.
A product of the market: the advertising of medicines and drugs
For Carlos Damin, Head of Toxicology at Hospital Fernández and director of the NGO FundarTox, the problem is not the over-the-counter sale of medicines, but the advertising of medicines and drugs.
“Advertising trivializes drugs and turns them into a market product and ceases to be a social good. The medicine can be prescribed by a doctor or the person can be advised by the pharmacist in the case of over-the-counter drugs.
But under no circumstances should it be advertised. In this way it remains in a place of respect, so that people do not believe that they can self-medicate or self-prescribe”, he explains.
Increased consumption of drugs in a pandemic
The pandemic led to an increase in the use of drugs not only intended to treat the problems caused by Covid-19, but also psychotropic drugs to help cope with stress and depression.
Until 2019, the sale of medicines was falling. But in 2020 there was a global increase of 1.35%, according to data from the Health, Medicines and Society Observatory of the Argentine Pharmaceutical Confederation (Cofa).
Those that increased the most (6.5%) were those that act on the central nervous system (CNS), including psychotropic drugs such as clonazepam, diazepam and alprazolam.
In 2021 the trend continued upwards. In total, 9% more units were sold than in 2020. Those that act on the central nervous system increased by 10.4%.
The greatest increase was seen among those indicated for the respiratory system (27.9%). “Although during 2021 we continued with preventive measures against the pandemic, the transmission of respiratory pathologies increased. People also eased the trend of self-medication as there was a significant increase in demand for expectorant syrups, anti-flu and decongestant drops that belong to the over-the-counter segment,” says the report.
Antiparasitic drugs increased dispensing by 28.5%. This is due to the sale of ivermectin, a drug that was advertised to treat Covid-19, but is not recommended by international health organizations, nor does it have scientific evidence in its favor.
Problems due to the irrational use of psychotropic drugs and anti-inflammatories
Damin maintains that there are many drugs that produce health problems if not taken rationally. “The main ones are psychotropic drugs, where there is a lot of self-prescription. But there are also non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, paracetamol and aspirin. And the misuse of antibiotics also generates health problems”, he exemplifies.
- Anti-inflammatory. Ibuprofen is the most popular over-the-counter drug. The uncontrolled consumption of this and other Aines can cause the cause of the pain to never heal (the drug acts on the symptom and not on what causes them). At the same time, ibuprofen can cause kidney failure, liver damage, gastrointestinal bleeding and cardiovascular problems.
- Benzodiazepines. Many people take clonazepam and other drugs these days to be able to sleep well or to relieve the stress of the day. Teenagers mix them with alcohol to make the “crazy jug”. But they are drugs that can lead to addiction and tolerance, that is, increasing the dose as time goes by. Consumption in inadequate doses produces drowsiness and decreased reflexes. Combined with alcohol or painkillers it can slow the heart rate and cause death. In many cases, it is not possible to abandon the consumption without medical help.
- opiates. Controlled use of oxycodone, morphine or codeine can treat pain without addiction. But its abuse can lead to addiction and cause everything from drowsiness to a drop in heart rate.
- stimulants. Stimulants include amphetamines, but also caffeine. Its irrational use can lead to a dangerous increase in blood pressure, heart rate or blood glucose. Excess caffeine can cause insomnia, dizziness, anxiety, in addition to generating dependence.
Problems with other drugs that are consumed without control
- Contraceptives. Self-prescribing contraceptives can cause bleeding, severe abdominal pain, breast pain, depression, nausea, fluid retention, dizziness, migraine, and weight gain.
- Gastrointestinal. Some drugs show adverse effects after years of study. Ranitidine was the most commonly used remedy to treat heartburn. In 2019, it was withdrawn from the market after a substance included in its formulation was found to be carcinogenic.
The replacement was omeprazole, another drug that seems safe. However, it shows mild adverse effects such as headache or constipation and more dangerous and long-term ones such as osteoporosis, premalignant gastric lesions and stomach cancer.
- Antibiotics. The inadequate consumption of antibiotics worldwide puts pressure on microorganisms to generate resistance to these drugs. This is one of the most important global health problems of the coming years, according to the WHO.
Ban drug advertising? How to solve the irrational use of drugs
Damin believes that curbing drug abuse requires disease prevention funds, a policy that requires a lot of money and invests little in it.
“It is also necessary to ban the advertising of medicines and drugs, and to carry out large mass awareness campaigns so that people have respect for drugs and understand that the ideal is not to be medicated, because they have side effects”, he adds.
And he points out that a common practice that should be avoided is to suggest the use of a remedy to another person because the doctor prescribed it for them.
According to Damin, other mechanisms that drive over-medicalization are medical over-prescription, especially of psychotropic drugs and over-the-counter dispensing at the pharmacy because there are few controls. “But people also ask for it, then recipes are made in one person’s name for another person to use, for example,” he explains.
By Lucas Viano @LucasViano
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Tags: drug abuse | painkillers | antibiotics | self-medication | self-prescription | problematic consumption | pharmacy | drugs | advertising and health | electronic recipes