Who Let The Doc Out?! #026: Self medication works but can backfire

The World Health Organisation defines self medication as the treatment of self-diagnosed disorders or symptoms with drugs, or the intermittent or continued use of a prescribed drug for chronic or recurrent diseases or symptoms. This is usually done without the input of a doctor. It applies to all kinds of illness, from infectious diseases to mental illnesses.

Self medication is viewed in a negative light these days, but it hasn’t always been the case. Self medication has been a part of life throughout human history. Before the advent of modern medicine, the business of healthcare was generally an individual or familial endeavour.

Treatment often involved self medication with locally produced herbal preparations with uncertain efficacy. However, this was a self-sufficiency borne of necessity. In the 21st century, with evidence-based and safe medication and healthcare practice readily available to most people, many assume that the risks of self medication outweigh the benefits.

Why do people self medicate?

A variety of individual, economic, and physician-related factors contribute to the prevalence of self medication. For some, the costs involved in doctor visits push them to self medicate. For others, the discomfort associated with seeing a physician along with crowding at health facilities deter them from seeking a doctor’s opinion. Other reasons cited include;

  • Having what one perceives as enough medical knowledge to treat oneself. This is especially common among medical students or people with close proximity and access to doctors.
  • Having previous experience with a similar condition where they received medication from a doctor.
  • Access to medical information on the internet.
  • Easy access to medication.
  • Failure to take the health issue seriously enough to warrant a hospital visit.
  • Lack of confidence in conventional healthcare.

Dangers of Self Medication

Uninformed self medication can expose people to risks. Unless you have the appropriate knowledge regarding a specific health condition and the medication required to treat it, it is quite easy to take the wrong medication or unsafe and ineffective doses of the medication.

Irrational use of antibiotics, which is quite common among people who self medicate, contributes significantly to the rising burden of antibiotic resistance, making common illnesses like typhoid, malaria, and cholera difficult to treat. The problem here is that self medication may suppress the symptoms of the disease without treating the actual cause of illness, worsening a person’s prognosis when they eventually seek out professional healthcare.

For example, cancer symptoms can be non-specific  early on. A person may experience fevers, body aches, and fevers. Oral painkillers and steroids may suppress these symptoms at first, but by the time the person seeks medical care, the cancer may have progressed.

People who self medicate, especially with multiple different medications, run the risk of dangerous drug interactions. Drugs which should not be taken together can cause lethal reactions or reduce the overall efficacy of the medication. This is common in medications for treating chronic illnesses like hypertension and convulsion disorders.

Benefits of self medication

The attitudes towards self medication are not all bad. There is a growing body of work that supports a departure from the paternalistic nature of medicine and the transfer of responsibility for one’s health to the individual as opposed to healthcare professionals.

In 2000, WHO published a set of Guidelines for the Regulatory Assessment of Medicinal Products for use in Self-Medication to help solidify the place of self medication in healthcare. In these guidelines, the WHO cites the following as some of the benefits of self medication:

  • There is a wider availability of medicines to patients
  • People have a greater choice of treatment options
  • It allows people to have direct rapid access to treatment
  • It allows individuals to play an active role in their own healthcare
  • It empowers individuals with self-reliance in preventing or relieving minor symptoms or illnesses
  • It is convenient
  • It is economically feasible as the costs of medical consultations are avoided
  • It provides people with educational opportunities on specific health issues

Overall, however, healthcare providers urge people to seek a trained medical professional’s opinion before taking most medications. Certain non-prescription or over-the-counter drugs like non-opioid painkillers and cold medication are safe to use without the input of a doctor. However, when in doubt, a person should always seek the opinion of their doctor.

At the end of the day, self care and self medication have an important place in healthcare, but they should be practised with the patient’s wellbeing and knowledge limitations kept in mind.

Innocent Immaculate Acan is a medical doctor and writer. She won the Writivism Short Story Prize in 2016 and has published an illustrated children’s book titled The Pearl Trotters in Black, Yellow, Red. She was part of the 2018 class of the Young and Emerging Leaders Project.

Innocent Immaculate Acan