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December 2013, Volume 63, Issue 12

Student's Corner

The self-medication epidemic: The prevailing use and abuse of non-prescription medications in developing countries like Pakistan

Dania Aijaz Shah  ( 1st Year MBBS Student, Dow Medical College, Karachi. )

Madam, self care, being a widespread phenomenon, is practiced depending on cultural and societal norms. List of things used range from traditional herbal remedies to prescription based medication. Being an inexpensive alternative to visiting a healthcare facility, responsible self-medication is encouraged by the World Health Organization (WHO) to treat minor illnesses.1 It is recognised as beneficial for patients and governments if practiced judiciously and sensibly to treat common medical conditions.1 However, excessive and unchecked dispensation of non-prescription drugs by pharmacies and their widespread use exposes the public to adverse reactions2 - an escalating crisis in developing countries that needs to be addressed without delay.
Self-medication is defined as the use of non-prescription medicines by people on their own initiative.2 The factors contributing to the practice include time constraints in the face of increasingly fast paced urban lifestyle, financial constraints coupled with the political and economic instability of the country, lack of accessibility to healthcare facilities which is a predicament of the public in the country\'s rural areas, female gender and the restrictions that come with being a woman belonging to the overtly religious and feudal society of this part of the world, cultural norms that put emphasis on out-dated home-made remedies and faith healers, and psychological dependence mainly on painkillers and mood-altering drugs.
According to one study, 80% of the drugs are supplied to the general population by the 63000 pharmacies established throughout the country. In light of this, the rise in self-medication is not exactly surprising.3 Data on the prevalence of this practice in the developing world remains scanty. The prevalence in Pakistan is around 51%, based on local studies.2 For the portion of the populace lacking access to healthcare, pharmacies and small town dispensaries which are present almost ubiquitously all over the country, are the first sources of healthcare. The majority of the drug sellers are unqualified and lack information on the indications, contraindications and the associated side effects of the drugs being dispensed, putting the lives of the public at risk. Other developing countries face the similar situation as that in Pakistan with widespread availability of prescription medication such as antibiotics, analgesics, sedatives and even corticosteroid ointments over the counter.2,4


1. Sontakke SD, Bajait CS, Pimpalkhute SA, Jaiswal KM, Jaiswal SR. Comparative study of evaluation of self-medication practices in first and third year medical students. Int J Bio Med Res 2011; 2: 561-4.
2. Zafar SN, Syed R, Waqar S, Zubairi AJ, Vaqar T, Shaikh M, et al. Self-medication amongst University students of Karachi: Prevalence, Knowledge and Attitudes. J Pak Med Assoc 2008; 58: 214.
3. Hussain A, Malik M, Toklu HZ. A Literature review: Pharmaceutical Care an evolving role at Community Pharmacies in Pakistan. Scientific Research; Pharmacology & Pharmacy, 2013; 4: 425-30.
4. Nasir MA, Hashmi RI, Ahmad NS. Drug utilization pattern in Rawalpindi and Islamabad, Pakistan. J Pak Med Assoc 2012; 62: 426.

Journal of the Pakistan Medical Association has agreed to receive and publish manuscripts in accordance with the principles of the following committees: