Sunday, May 25, 2025 11:15 [IST]
Last Update: Sunday, May 25, 2025 05:40 [IST]
Self-medication is the practice of using medications, homemade remedies, or Ayurvedic herbs independently or based on advice from non-professionals without valid prescriptions or consultation with registered medical or healthcare professionals.
In developing countries like India, self-medication has become an alarming issue due to the widespread influence of advertisements in the media, easy access to online information, misleading websites promoting counterfeit medications, and over-the-counter (OTC) sales by pharmacies without valid prescriptions. Other contributing factors include advice from friends, family, colleagues, and the practice of reusing old prescriptions. Pharmacies may even encourage this trend to increase profits. One significant concern is the conversion of prescription drugs to OTC status. Initially, these medications are introduced as prescription-only, but after extensive market use and safety data collection, they are sometimes reclassified for OTC use, increasing the risk of misuse.
According to a study by Fathima Johnbasha, Aumrin, Vignesh Tamilchelvan, and Sevranthi Kumar, titled “Prevalence of Self-Medication Practices and Their Associated Factors in Puducherry, India” (Journal of Research and Health, 2022), Allopathy was found to be commonly used form of self-medication (84.6%), followed by Homeopathy (9.7%), Ayurveda (1.2%), and a combination of Allopathy and Ayurveda (4.4%). The highest incidence of self-medication was found in the age group 30–60 years (78.1%).
Similarly, Rathod et al. (2023), in their study “Prevalence, Pattern, and Reasons for Self-Medication: A Community-Based Cross-Sectional Study from Central India” published in Cureus, noted that people often relied on pharmacists (17.92%), advertisements (9.2%), friends (7.92%), and the internet (2.08%) for information. Analgesics (66.25%) and antipyretics (59.16%) were the most commonly used drugs for conditions such as fever, body aches, and coughs.
In Sikkim, the prevalence of self-medication follows similar patterns. Many people avoid consulting qualified healthcare professionals due to lack of time, convenience, social hesitation, or perceived stigma. A significant instance of self-medication is seen during pregnancy, especially in cases of unwanted pregnancy. Many individuals use oral contraceptives and abortifacients without consulting gynecologists, driven by guilt or the desire to avoid hospitals. Another serious issue is the misuse of antibiotics, which contributes to rising antimicrobial resistance. Despite being prescription drugs, antibiotics like Metronidazole, Azithromycin, Amoxicillin, and Ciprofloxacin are widely available as OTC drugs and used indiscriminately. According to a study by Gutlapalli and Yarra (NeuroQuantology, 2022), 70% of antimicrobial drug resistance in India is linked to Gram-negative bacteria, with resistance patterns commonly observed in Fluoroquinolones, Penicillins, and Cephalosporins. Resistance in Gram-positive bacteria is also rising, especially against Tetracycline, Fluoroquinolones, and Cotrimoxazole.
The COVID-19 pandemic significantly worsened this trend, with fear of infection, limited hospital access, and lockdowns prompted a surge in self-medication. Online pharmacies also played a major role by enabling people to order medications, including psychotropic like antidepressants, without verification of prescriptions or medical history. The lack of regulation in the digital pharmaceutical space is a matter of significant concern.
Even though responsible self-medication for minor ailments may offer certain advantages such as convenience, affordability, and self-reliance, however the risks associated with unsupervised usage are significant. These include drug overdose, misdiagnosis, side effects, drug interactions, abuse, and failure to recognize contraindications.
Globally, different countries have implemented effective regulatory practices to control self-medication. For instance, Germany allows OTC availability of only low-risk medications and enforces strong regulatory oversight. Norway mandates pharmacists to provide proper guidance for all OTC drug sales. Sweden requires medications for children under 12 to be sold only with pharmacy staff consultation. In the UK, the MHRA regulates drug reclassification and monitors safety after switching from prescription to OTC. Japan classifies OTC drugs into categories based on risk and restricts higher-risk drugs to sales only by pharmacists with required counselling. Australia mandates prescriptions for codeine products and maintains strict labeling laws. Singapore enforces rigorous prescription regulations, especially for psychotropics, and requires medical documentation for travelers carrying such drugs. These countries demonstrate that through strong regulations, public awareness campaigns, and strict pharmacy laws, the risks arising out of self-medication can be significantly minimized.
Pharmacists have a pivotal role in this effort. As they hold a key position in the healthcare system, they must ensure responsible dispensing of both prescription and OTC medications. They are expected to educate patients on proper drug use, timing, administration, dosage, potential side effects, overdose management, and expected benefits. Their role in patient education bridges the gap between drug dispensing and safe medication practices, thereby safeguarding individual and community health.
To effectively address self-medication in India and particularly in regions like Sikkim, a multi-pronged approach is needed. This includes stricter enforcement of prescription regulations, pharmacist-led patient education, improved healthcare access, community-level awareness campaigns, and the development of policies that regulate online pharmacy practices. Responsible self-care should be encouraged, but not at the cost of public safety and health.
