Incidence of drug misuse and abuse is on the rise as increasing number of Nigerians use drugs arbitrarily without doctor’s prescription or for purpose other than what they are meant for.
Although, most of the drugs abused are over-the- counter drugs , Business Hallmark investigations revealed that prescription drugs are also readily abused. A community pharmacist and Chairman, Community Pharmacists, Ipaja, Dopemu, Egbeda and Akonwonjo Zone(Lagos), Mrs Mfon Nsese, blamed rise in drug abuse and misuse on poverty, ignorance, peer pressure, poor regulation and sale of drugs in the open market.
“Drugs are sold through channels manned by people who are not professionals, so they cannot give people the right advice,” Nsese added.
Business Hallmark spoke to community pharmacists/medics and a cross- section of Nigerians ( on their drug use habits) to ascertain commonly abused or misused drugs and found that the following drugs top the table:
Tetracycline is an antibiotic used to treat a wide spectrum of bacterial infections in the body such as acne. However, many people self-medicate with the drug when they have running stomach.
A Lagos-based pharmacist, Pharm Hilda Iyoyojie, explained: “Ideally, tetracycline is used to treat infections after doctor’s diagnosis or a person is tested and the stooling is confirmed to be from bacterial infection but people use it at any sign of stooling.”
Experts caution that misuse and or abuse of tetracycline may lead to drug resistance, may impede fetal growth when taken by pregnant women/ nursing mothers or cause permanent yellowing of teeth when given to children under 9 years.
“ Abuse of tetracycline makes the drug becomes less effective in treatment of infection. It causes permanent yellowing of the teeth, ” noted Iyoyojie.
“You don’t give pregnant women and a child below 12 tetracycline. It causes stains in the teeth in babies,” added Pharm Nsese.
“Tetracycline passes into breast milk and may affect bone and tooth development in a nursing baby,” notes Drug.com.
Other side effects from tetracycline use include cramps or burning sensation in the stomach, diarrhea, photosensitivity, sore throat, nausea and vomiting . It can increase renal problem in persons with pre-existing condition.
Tetracyline interacts with some drugs and should not be taken together with drugs that contain magnesium, aluminum, or calcium such as milk of magnesium, antacids and so on.
Fragyl , also known as metronidazole, is another antibiotic commonly used by Nigerians to treat running stomach.
“It is an abuse to use it each time you have running stomach,” said Pharm. Iyoyojie who explained that it is advisable to undergo test first to determine the underlining cause of the stooling; whether it is caused by infection or other factors.
Instead of the haste to take flagyl or tetracycline for running stomach, Iyoyogie recommends taking of home remedies for rehydration: “Replace the lost fluid by taking ORS( Oral rehydration solution), drinking garri water, preferably ijebu garri with salt, or boil rice and use the rice water or use Mix-mag . Or you can take loperamide.”
She, however, advised that if the stooling becomes severe( like 8 times in a day), affected person should report to hospital, immediately.
Paracetamol is an analgesic- drug used to relieve pains and fever. Paracetamol is an over-the-counter drug routinely taken by some Nigerians at the least sign of pain, stress or discomfort. Some erroneously combine paracetamol with other analgesics like Ibuprofen or aspirin.
“When you take more than 6 tablets , a day or you use it more than 3 days. People who take paracetamol after everyday’s stress is an abuse,” insisted Iyoyojie.
Persons who abuse paracetamol may pay with their kidneys. A Consultant Nephrologist at the Lagos University Teaching Hospital,(LUTH) Dr Toyin Amira told Business Hallmark that excessive analgesic consumption increases risk of kidney disease.
Iyoyojie advised, “ If your symptoms persist after two days, see your doctor.”
Ibuprofen is a non-steroidal anti-inflammatory drug (NSAID) used to treat inflammation and pain in the body caused by headache, toothache, back pain, arthritis, menstrual cramps or minor injury but regularly misused or abused.
Side effects from its overuse include stomach or intestinal bleeding. According to pharmacists, high dose or long use of Ibuprofen may increase risk of stroke or heart attack. Its use during early pregnancy may hurt the foetus. Pharm Iyoyojie counseled that Ibuprofen should not be used without a doctor’s prescription.
Alabukun is a locally produced analgesic in powder form. According to the makers, the medicine is a combination of aspirin (Acetylsalicylic Acid -760mg) and Caffeine is for ‘fast relief of pain,cold, headache, and feverishness however, some Nigerians take it to neutralizing alcohol or to treat hangover. Pharmacists warn that Alabukun may cause ulcer and could also be addictive.
“You are not supposed to use it regularly or as first choice because of the fast onset of action. But those who have hangover use it to clear the head. It is a stimulant. It contains aspirin and aspirin causes stomach ulcer,” revealed Iyoyojie.
Benylin with Codeine
Benylin with Codeine is a syrup that contains Diphenhydramine hydrochloride (14mg) ,codeine phosphate (5.70mg) and L-menthol ( 1.1mg), used for the treatment of dry, irritating cough in children and adults to decongest the chest. But the drug is routinely used by some Nigerians to alter their mood.
“This drug is commonly abused by young ones, these days. Some of them buy it in cartons and drink it at parties,” observed Pharm Nsese.
Side effects from abuse of codeine according to Iyoyojie, addiction, loss of quality of life and neo-natal effects on unborn child.
Antimalarials are drugs used for the treatment and prevention of malaria. However, due to the fact that malaria is endemic to Nigeria, many Nigerians are wont to take anti-malarials once they experience fever or fatigue.
“Any small headache, they say ‘it is malaria and typhoid’,” observed Pharm. Nsese. Experts warn that arbitrary use of antimalarials leads to drug resistance to malaria parasites.
WHO recommends that “Patients with suspected malaria should have parasitological confirmation of diagnosis with either microscopy or rapid diagnostic test (RDT) before antimalarial treatment is started. The body also advises, prompt treatment( within 24 hours of fever onset) with an effective and safe anti-malarial, particularly the recommended ACTs- drugs, to prevent life-threatening complications.
Tramadol is an opioid pain medication used to treat moderate to severe pain. Tramadol is a prescription drug but is easily accessed and abused by young people who take it for its mood altering properties just to get ‘high.’
“It is a prescription drug but people buy it and use without any prescription because drugs are not left in the hands of professionals,” said Pharm Mfon Nsese , a community pharmacist.
According to pharmacists, Tramadol abuse may lead to addiction, overdose may lead to death.
“Without using it, they cannot be normal,” observed Pharm Elizabeth Ugwuoke.
Amoxil is a penicillin antibiotic that fights bacterial infections. It is used to treat pneumonia, bronchitis, tonsillitis, infections of the ears and nose, but mostly prescribed in Nigeria by doctors for treatment of typhoid fever. However, Pharm Nsese disclosed that many people take it any time they have fever without resort to the doctor.
“They take it any time they have fever. They take it once a day instead of 8-hourly,” She disclosed.
On the side effects from abuse, apart from drug resistance, Nsese noted, “ They(abusers of the drug) are labouring their liver.” Other dangers listed by WebMD, include stomach cramps, skin rashes and itching.
Dexacoitin ,(generic name- Dexamethasone) is a corticosteroid hormone medication used to treat arthritis, blood or immune system disorders, allergic reactions, certain skin and eye conditions, breathing problems, bowel disorders or certain cancers but is being used by some persons for weight gain.
“It is supposed to be used shortly because it is a depressant but because it encourages storage of fluid in the body, they use it to gain weight, “ observed Pharm Nsese.
More worrisome is that persons with preexisting conditions of tuberculosis, herpes, kidney disease, liver disease, mental problem, depression, low blood minerals , thyroid disease, stomach and intestinal problems who are not supposed to used the drug at all except under supervision of a doctor, are abusing it.
According to WebMD, side effects from Dexacoitin use include headache, dizziness, menstrual changes, insomnia, increased appetite, blurred vision and mental depression.
“It depresses the immune system,” warned Nsese.
- Postinor 2
Postinor-2 tablets is an emergency contraceptive containing the active ingredient- levonorgestrel (progestogen-only ) targeted at female victims of rape. However, the drug is being routinely abused by women and girls who use it without prescription.
“They come to ask for it and when you ask them they say they have been using it. Postinor 2 is not supposed to be taken more than four times in a month but many of them take it after sex,” worried Nsese.
She however who added, “many of them come back complaining of prolong bleeding during their menstruation, or that they don’t see it for months and they are not pregnant, or bleeding that comes twice a month.”
Confirming the dangers of abuse of postinor -2, a gynaecologist, Dr Joseph Akinde warned on its implication on fertility.
“It may cause menstrual irregularities. The woman may not be ovulating such that it would be difficult for her to get pregnant when she wants to,” cautioned Akinde, who is the Medical Director, LivingSpring Hospital, Ejigbo, Lagos.
Alcohol oils the wheel of social interaction and networking. When taken in moderation, alcohol offers some health benefits. But increasingly many Nigerians take more than the WHO- recommended daily maximum limit of 60 grams of alcohol. According to NDLEA, alcohol is the most abused substance.
Apart from the fact that alcohol is socially acceptable, its abuse has been made easy with the new trend of packaging of spirits in small containers or sachets which are sold in motor parks. Some of them are touted as herbal-remedies for malaria and sexual dysfunctions such as Alomo, Kerewa, Pakurumo and Ogidiga.
Alcohol abuse has been blamed for impairment of judgment and the attendant road mishaps, dehydration, hypertension, kidney diseases, impaired sexual health and deaths. According to the UK Royal College of Physicians, at 80 mg/100 ml there is an impairment of driving ability.
“Excess alcohol in-take can destroy the kidney,” warned, Dr Amira. Also Alcohol abuse in pregnant women leads to fetal alcohol syndrome.