Addressing drug prescription problems in Nigeria

The lady’s murder triggered a frenzy of emotion, as different parties tried to trade blames over who was responsible for what in the incident. Contrary and contradictory versions of the story were circulated by the media, making it hard for the citizens to discern the fact from the fiction. When Osokogu’s alleged killers were eventually […]

The lady’s murder triggered a frenzy of emotion, as different parties tried to trade blames over who was responsible for what in the incident.

Contrary and contradictory versions of the story were circulated by the media, making it hard for the citizens to discern the fact from the fiction.

When Osokogu’s alleged killers were eventually caught, they confessed that they used Rohypnol Flunitrazepam — a prescription drug used for the treatment of insomnia or as an anaesthesic — to facilitate their crime.

The suspects reportedly confessed that they had used Rohypnol Flunitrazepam on other women, prior to the Osokogu episode.

As the nation awaits the trial of the suspected killers of Okosogu, one of the major areas of public concern is the unfettered access of the citizens to prescription drugs, which ordinarily should not be dispensed to people without a doctor’s prescription.

Rohypnol Flunitrazepam is reportedly a choice drug for rapists because it has some hallucinatory and memory-eroding properties.

Following the Okosogu incident, the police arrested two pharmacists for selling Rohypnol Flunitrazepam to the suspects but their arrests provoked stiff opposition by the Pharmaceutical Council of Nigeria (PCN)

Mr Azubike Okwor, the President of the PCN, said that if the two pharmacists were indeed guilty of selling the drug to the suspects without due prescription, they should be handed over to the PCN for disciplinary action.

“If they have sold the drugs without prescription, there is a procedure already in place that provides how such matters are dealt with by the Council.

“It is logical to believe that at best, there might have been breaches of professional ethics but this should be handled by the PCN, which is also a Federal Government agency,’’ he said.

Observers, however, note that Okwor’s argument is somewhat logical, saying that charging the pharmacists as accomplices to the crime is, perhaps, a bit excessive since there was no established relationship between them and Osokogu’s assailants.

They also argue that the two pharmacists are only unlucky, as several other pharmacists across the country are similarly guilty of selling prescription drugs across the counter without the required doctor’s prescription.

Prof. Abdu Aguye, the Dean of Kaduna State University’s Faculty of Medicine, says the problem with drug dispensation in the country is the weak regulation system, which is compounded by a lot of overlapping functions by regulatory agencies.

He said the regulatory bodies for medicine include the National Agency for Food and Drug Administration and Control (NAFDAC), the National Drug Law Enforcement Agency (NDLEA) and the PCN.

Aguye, nonetheless, insists that most Nigerians do not comply with the rule, which states that doctors should prescribe certain medications before pharmacists could dispense them to the people.

He stressed that many medications, which should rightly come under prescription drugs, are sold in the open market as over-the-counter (OTC) drugs.

He said in spite of the tendency to blame unclear legislation or inadequate implementation of laws for the anomaly, health professionals are at the heart of the problem.

“A survey among various health professionals reveals that the law is defined by individuals as they deem fit.

“Doctors with private facilities often keep large pharmaceutical products without qualified pharmacy personnel.

“Pharmacy outlets sell whatever they have and do not feel any obligation to register the prescription drugs which they dispense,” he says.

Besides, Aguye observes that other medical personnel, with varying certification and medical knowledge, are often allowed to have access to virtually all categories of drugs.

He stressed that it was not uncommon to find incomplete courses of treatment being sold, in utter disregard for ethical standards, because of the profit-making inclination of those who made the drugs available.

Aguye, saidthis development could cause untold complications for patients, as many citizens engaged inself-medication.

The professor insisted that writing drug prescriptions had some legal implications, indicating that the prescriber had taken responsibility for the clinical care of the patient, the medication’s efficacy and the patient’s safety.

“In many countries, legislation governs who can write a drug prescription that can be legally filled,” he adds.

Aguye explained that in Nigeria, medicines are broadly classified into three categories.

These are prescribed drugs which could be obtained from a pharmacy, the OTC drugs freely sold by pharmacists and those drugs that could be dispensed by patent medicine vendors.

“As a general rule, the OTC drugs are used to treat conditions not necessarily requiring care from a health care professional and have been proven to meet higher safety standards for self-medication by patients,’’ Aguye said.

He explained that medications with lower strength are often approved as OTC drugs, while those with higher strengths require a doctor’s prescription before they could be obtained.

He argues that the rules are primarily enacted to safeguard the people against numerous health problems which could crop up from irrational drug use.

“Studies have shown that 20 to 25 per cent of all hospital admissions are drug-related and this figure is expected to rise with continuous irrational drug use,” he added.

Aguye defineed rational drug use as the administration of the correct drug, in the correct dosage form, in the correct dose, to the correct patient, for the correct duration of time.

“Given the poor state of our medical services, it is hardly surprising that irrational drug use is rampant and that most drugs used in Nigeria are not prescribed by qualified personnel,” he added.

Aguye reiterated that the implication of the citizens’ unfettered access to restricted drugs is quite disturbing, as it affects the entire society and not only the individual.

He listed the dangers as drug addiction, unchecked adverse drug reactions, complications induced by unnecessary drug interaction and evolution of drug-resistant diseases, among others.

(NANFeatures)