As an extremely busy mom, I am absolutely guilty of just grabbing anything over the counter for my family. Mainly because of the convenience, but also I’ve always assumed that pharmacists are experienced so I’d leave it to them. It was my norm until I can across the article below, and I just had to share it.
Increasing research shows the growing risk of abuse and misuse of over-the-counter medicines. These medicines, frequently used to treat common ailments like headaches, colds and coughs, can have dangerous consequences – and the ease with which they are dispensed and purchased poses a real threat to self-medicating South Africans.
“It’s alarming how many people trust the medicines they’re dispensed over the counter in their local pharmacy,” says Christine Venter, President of the South African Association of Community Pharmacists (SAACP). “Without giving it a second thought, they then dispense these medicines to their family. Over time, these meds can cause serious damage.”
The benefits of being able to self-medicate, as explored by Richard J. Cooper in Over-the-Counter Medicine Abuse: A Review of the Literature, is that individuals have convenient access to, and choice of, medicine and can actively participate in their own health and treatment. These medicines are generally obtained either when prescribed by a doctor, or when purchased directly by the customer. In either case, the threat of misuse and abuse is very real.
Which are the malicious meds?
Cooper describes harmful OTC medicines as generally falling into five key groups: codeine-based, cough products, sedative antihistamines, decongestants and laxatives. Each of these medicines has their own unique risks, when not dosed correctly. It is both psychological and physical – including addiction and dependency, extreme sedation and gastric or hepatic damage.
Unscheduled and unsafe
The common misconception that OTC medicines are ‘safer’ than prescribed, scheduled medicines plays a key role in creating margin for abuse and misuse. Individuals believe if their doctor has prescribed something that can’t be given to the patient by a pharmacist at the dispensary or self-medication counter, it has more serious effects and there’s higher risk of overdose.
“It’s simply not the case that OTC medicines are safer than scheduled. Even unscheduled medicines pose their own risks when they’re not administered properly – and the fact that they’re perceived to be ‘less effective’ means they’re frequently given in extreme doses, and taken whenever the patient feels like it,” says Venter.
In an article recently published in the New England Journal of Medicine, experts expressed further concern over the marketing of OTC medicines to parents, playing on their guilt when their child is ill. A frequent theme, experts say, is that these medicines can be given to children as and when they like, to make them relax (even if this isn’t expressly stated in the advertisement, it’s the underlying message).
The marketing of these OTC children’s medicines doesn’t always accurately reflect its risks. This creates the illusion parents can simplify their lives and bring calm into their homes. This by simply dosing their children with cough syrups and tablets.
Risks of abuse
The risks of abusing ephedrine-based OTC medicines has a huge range. From central nervous system stimulation, hypertension and agitation, to restlessness, insomnia, psychosis and even seizures. Toxicity from overuse of decongestants can also include arrhythmias, extreme sedation, strokes, bowel infractions and, in extreme cases, death.
“The growing case against dangerous OTC medicines highlights the need for education amongst consumers. Individuals self-medicating need to take cognisance of dosage instructions and side effects in package inserts. They should opt for safer meds with no known drug interactions that don’t post a risk,” advises Venter. “Patients should speak to their pharmacist or doctor and find the safest possible medicine available.”