Why that painkiller will be hard to get

Are you in the habit of rushing to your local chemist to buy some painkillers after a night of binge drinking?

Or you regularly resort to antacids after a heavy meal?

You will soon find it difficult to buy these over-the-counter drugs from your local chemist without a prescription from a registered health practitioner.

Penalties

A proposed law imposes punitive penalties for pharmacists to discourage sale of non-prescription drugs like painkillers, antacids, anti-malarial drugs, cold and cough syrups. 

The Pharmacy and Poisons (Amendment) Bill, 2021, seeks to prohibit the sale or dispensing of medicine without a written prescription from a registered health practitioner.

“A person shall not sell or dispense medicine to another person without a prescription signed by a registered health practitioner, medical practitioner, dentist or veterinary surgeon,” reads the amendment proposed to replace subsection 5 of the Pharmacy and Poisons Act.

The proposed law prescribes a fine of Sh30, 000 or a three-year jail term or both for anyone convicted of the offence.

The subsection proposed for deletion stipulates: “Nothing in this section shall be deemed to make it unlawful for any person to sell any non-poisonous drugs provided that such drug is sold in its original condition as received by the seller or to require such person to be registered as a pharmacist.”

The Bill, which has been published and awaits formal introduction in the National Assembly, says Kenyans should be protected from casual use of drugs that is harmful to their health. 

 “The sale of over the counter medication has always encouraged self-diagnosis of ailments without the benefit of medical advice from a medical practitioner. This endangers lives of those who may consume harmful medication, suffer adverse reactions or develop drug resistance,” says the Bill.

Misdiagnosis

According to the Bill’s sponsor, Nandi Hills MP Alfred Keter, self-medication is ruining people’s lives by encouraging misdiagnosis and serious illnesses are being detected when it’s too late.

Mr Keter explains the frequent abuse of drugs is harmful to body organs like the kidney and the liver.

“We are killing our people. We have all become doctors, treating ourselves with dangerous consequences. We have had people taking these drugs for a long time presumably to treat a persistent headache. Only later is it discovered that one has cancer, but by then it’s too late,” Mr Keter says.

The MP argues if one has a minor ailment, like a flu, then it would go away without the need for medication but what is persistent means it’s serious. “That’s why you need to see a doctor. The abuse of antibiotics is making some diseases resistant. Some of the drugs people are taking casually have serious side effects including raising the blood pressure.”

Mr Keter recalled a visit to Japan when he went to a drugs outlet to get some painkillers because he had a headache.

“They couldn’t sell me the drugs without a prescription. In fact, I had to undergo a series of tests before I could get medication. That’s the reason people in Japan live over 100 years. They are in good health,” Keter says.

According to the World Health Organization's (WHO), self-medication is defined as the use of drugs to treat self-diagnosed disorders or symptoms, or the intermittent or continued use of a prescribed drug for chronic or recurrent diseases or symptoms.

Dr Fred Siyoi, Deputy Registrar, Pharmacy and Poisons Board, explains in an Avoid Self-Medication article that self-medication is increasingly becoming a common practice.

The article states that the most commonly abused drugs through self-medication are over-the-counter medicine, which include painkillers, antacids, vitamins and cough remedies.

It notes that one of the biggest problems associated with self-medication is anti-microbial resistance, which was in 2016 declared a major threat to global public health by the United Nations General Assembly.

Anti-microbial resistance occurs when bacteria, viruses, fungi and parasites change over time and no longer respond to medicine.

This makes it harder to treat and increases the risk of disease spread, severe illness and death.

Dr Raymond Bosire, a general physician at Komarock hospital, says self-diagnosis is a dangerous habit as there is possibility of misdiagnosis.

“There are diseases that show the same symptoms. For example, when a woman experiences some pain while peeing, that condition can either be a urinary tract infection or a sexually transmitted one. However, that can only be confirmed by laboratory results, and the two conditions are treated differently. Wrong diagnosis goes hand-in-hand with wrong treatment, and raises different complications as well,” Dr Bosire explains.

Dr Bosire adds that over the counter medication without prescription can make a patient run the risk of underusing or overusing medicine.

“If you travel to a mosquito infested area and develop chills, headaches and vomiting, you will assume that you have malaria. Without a prescription, you might be given tablets, which usually are administered when the malaria is not severe, yet you may have severe malaria. Alternatively, you might get three consecutive injections, that are usually administered when a patient has severe malaria when in fact you have it in mild form,” says Bosire.

He notes that when something like this happens, a patient might mistakenly think that he/she has recovered.

“It is only that the malaria parasite has been suppressed. When you get sick again, you will have severe form of the disease,” he warns.

The physician also explains that drug resistance may develop over prolonged self-medication.

The Bill proposes that only a registered pharmacist shall conduct pharmacy business, and if someone else has to say, prepare, mix, compound or dispense any drug, it shall be under the immediate supervision of a registered pharmacist.

There are fears that the number of quacks may however increase as they may not have to struggle so much if the patient is coming in with a written subscription.

Another concern is that this might push the practice underground- and cause a spike in drug prices.

At the moment, prescription only medicine are the only ones that are closely monitored, and can only be dispensed to the public as per the prescriptions from licensed medical practitioners.