Misusing Drugs: Is medical advice needed? – Pt 2

Dr Temitope Olayinka

In the first part of the 2-part series, we’d looked at misusing drugs – it’s meaning and some consequences.

Here we look at some examples of how these could impact people – read on.

Daud’s Story

Daud, aged 35 years knew he had to stop taking the tablets.

Taju was still lying in the hospital, unconscious after another seizure and the doctor had said it was due to Tramadol overdose.

He remembered six months ago; when Taju, his fellow Okada rider had introduced Tram to him after he developed back pain from a motorcycle accident.

He now wished he had refused and had instead gone to the clinic.

However, the drug had been cheap, available and effective: a strip from the local mallam (a peddler) costing merely a hundred naira.

It had made the back pain disappear; given him the energy to do more trips, and even improved his performance in bed.

The vicious cycle

He had paid no attention when he started needing more tablets to take care of his back pain and now, he could not stop.

Every time he tried to stop, he developed body aches, a racing heart, and overall weakness. He was scared each time he tried.

And, he felt horrible; he could not think or sleep; he felt pain and was too tired to do anything.

Treating his backache himself seems to have led him into trouble. He feared for his life.

When Amalar Did Not Work: Bolu, Aged 11 years

Mama Bolu was distraught. Only a few days ago, her only son had been laughing and playing.

Now he was lying in the intensive care unit fighting for his life from an attack of severe malaria.

She wept as the doctor told her that this state could have been prevented – if he had been treated properly at the beginning.

Just the last week, when Bolu had refused to eat his evening meal, she had known he was sick.

She had felt his body, which had been hot but only used a cool wet cloth to wipe him down.

When he had complained of joint pains the next day and still had the fever, she knew that it was malaria and had sent his elder sister to buy Amalar from the Chemist.

That was her go-to drug for malaria; – it still worked and wasn’t as expensive as the new drugs.

She wished she had taken him to the clinic instead of giving him those tablets. She had thought malaria was just a ‘small’ disease.

If she had known it could be this disastrous, she would have brought him to the hospital sooner.

Edwin and ‘his sickness’

Edwin, aged 30 years was weak and tired.

He used to tell people that diarrhoea was ‘his sickness’ but this time, diarrhoea had come with something else.

He had used the Flagyl as was his custom earlier on and he had gone to have drinks with his friends that same evening.

Some time afterwards, he started to get dizzy and unwell, feeling warm, he’d had a headache and his chest felt tight.

His wife had forced him to come to the hospital when he started vomiting.

He felt horrible and still could not believe that this was because he had used Flagyl and gone to have a few drinks.

No one had ever told him Flagyl could have such side effects.

The worst outcome: Adanna Aged 11 months

Ngozi sat and stared into space.

Her precious jewel was gone…., gone …….and she had helped death take her away.

She could still remember the nurse asking why she hadn’t brought her earlier.

Ngozi herself couldn’t answer the question.

She had thought the fact that her baby was teething was the cause of the fever and in the past, Adanna’s temperature had always come down after she gave her the Paracetamol syrup.

But this fever had lasted nearly a week, and instead, her baby had only gotten worse and then had stopped moving overnight.

The doctor said, “Fever was a symptom, not the disease”.

She had been busy taking care of the wrong thing and not realised when her baby’s condition worsened.

What Ifs???

Regardless of age or sex, we all need accurate medical advice before starting any medication, whether it’s a prescription drug or an over-the-counter drug/medical supplement.

As Daud discovered, taking a drug recommended by your friend without first checking with your doctor can lead to very bad outcomes.

He’s become addicted to Tramadol, a very potent opiate-like drug with similarities to Morphine and will need therapy to overcome this problem.

When Cost trumps Care

Mama Bolu has discovered to her sorrow the costliness of cheaper treatment alternatives.

But rather than blame her, let us really think through her options.

The mother recognised that her son had malaria

Her son is 11 years old; so well past the ‘under-5’ age category where illness and even death in children in Nigeria are very high.

One of the limitations of accessing doctor’s care in Nigeria and in many developing countries is cost. This is related to poverty and quite clearly at play here.

Prevention and early treatment of malaria are important measures.

Prevention of malaria in this age group in Nigeria is advocated by using long-lasting insecticide-treated nets (LLINs).

Was the mother using LLINs?

Poor Healthcare Structure

On another hand, does the health care system have a responsibility?

Could she have been able to access a doctor’s care early if there was no cost barrier?

Could/should she have been sold the recommended and better-formulated antimalarial; more appropriate for a malaria-endemic area like Nigeria (i.e. combination treatment of Lumefantrine and Artemether)?

Why did the Chemist sell Amalar; which contains Pyrimethamine and Sulphadoxine, and is not as effective a first-line malaria treatment in an environment such as Nigeria where there are multi-drug resistant strains of falciparum malaria is endemic?

Similar questions could be asked in many cases of drug misuse in Nigeria.

And in the sad story of baby Adanna; while Ngozi is left with only ‘what if’ questions and feelings of guilt; perhaps she also had cost challenges.

Did she attend a well-child or immunisation clinic? Did she know of any? Were they close by to her home?

At such settings, Mums are educated about basic care for very young children and signs to watch for that may suggest their child is more seriously ill than they realise.

Did she have access to this kind of health awareness program? Are there ways we address people’s limited access to appropriate medical care in Nigeria and other developing countries?

The patient or parents or spouses or families may know that they should see a doctor, but they often consider the alternative because of cost barriers.

This is why there have been increasing calls for Universal Healthcare Coverage, knowing that for many households in Nigeria and in other developing countries, they are only one consultation (for common illness such as malaria), away from financial catastrophe.

And finally, Edwin’s habit of self-medicating with Flagyl eventually caught up with him.

Because unknown to him, Flagyl is one of the drugs that you should not take with alcohol.

When this happens, it causes a reaction in the body (which is a hypersensitivity to alcohol) characterised by nausea, vomiting, flushing, dizziness, throbbing headache, chest pain, abdominal discomfort, etc.

This can happen even with small amounts of alcohol.

The medical advice is to generally avoid alcohol when you are on antibiotics and for 48 hours afterward.

Conclusion

This article targets the individual and household levels to provide important information using scenarios to connect with readers in diagnosing the problem of misuse of drugs and in proffering solutions, which in this case is to always seek medical advice.

It’s important for people to be careful, seek the right information even when you have resources to get some medicines – check they are actually the right ones to use; and how best to use them.

Read Part 1 here.

Editing by AskAwayHealth Team

Disclaimer

All AskAwayHealth articles are written by practising Medical Practitioners on a wide range of health care conditions to provide evidence-based guidance and to help promote quality health care. The advice in our material is not meant to replace the management of your specific condition by a qualified health care practitioner.
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