Drug abuse gets to the peak in Abuja, warns pharmaceutical society

There are concerns over drug shops being run by untrained persons. What is the difference between a drug shop operated by a pharmacist and one operated by a non pharmacist? Nigeria is one of those very peculiar countries in the world where you have multiple outlets for drugs. In most countries, you get your drug […]

There are concerns over drug shops being run by untrained persons. What is the difference between a drug shop operated by a pharmacist and one operated by a non pharmacist?

Nigeria is one of those very peculiar countries in the world where you have multiple outlets for drugs. In most countries, you get your drug from one source and that is from the pharmacist.

In this country, by law, you can get drugs from two sources even though there are different types of drugs. A drug shop run by a pharmacist can sell all drugs—you can find any type of drug there.

By law, you have the patent medicine stores—they are legal but they are allowed to dispense a very limited number of drugs—drugs that we call OTCs. You don’t need prescription for them. They are considered relatively very safe and you need them for First Aid, basic health care—things like paracetamol tablets, aspirin tablet, cough syrup…

And then we have the third one which is more common than any of these two. These ones are not registered by anybody, they are illegal yet they give drugs, just any drug.

We do have a challenge in our society where law enforcement is not strong—even keeping the patent medicine stores within the limit of their licence is a big challenge. Remember, to be registered as a patent medicine dealer, you need only a school certificate. So ideally, they are not supposed to even open the package. They are to pass it to you the way it is. But they go beyond that which exposes our people to risk.

Pharmacies run by pharmacists would have a sign in front of them with a white background, big green cross and under that, you will have the name of the pharmacy. And when you walk into the shop, you will find the licence of the pharmacist with his picture hung in that pharmacy. This is one easy way for the public to identify a pharmacist shop.

What is your association doing practically to stop those who are not registered but do handle sensitive drugs?

I look at drugs as a very sharp knife. It’s fantastic tool. If mishandled, it becomes a weapon, it becomes very dangerous. There is none of us who would sharpen a brand new knife and give it to a child. We are very concerned about who handles drugs, who gives drugs to people because it can be very dangerous if not properly done.

Since we don’t have enforcement powers, we collaborate with government agencies like NAFDAC [National Agency for Drugs, Foods Administration and Control] and the PCN [Pharmaceutical Council of Nigeria] which register pharmaceutical premises and patent medicine stores—they have the legal responsibility to work with the law enforcement agencies to ensure that people practice within the confines of their licence and if they have no business practising, they do not practice.

As part of our advocacy, we were able to get government to accept the concept of Pharmaceutical Inspectorate Committees. These are committees that carry out routine inspection of premises where drugs are stocked or handed to people. We are members. The committees operate under the supervision of the PCN.

So we do educate the members of the public. Let them know, “If you want safe and efficacious drugs, go procure them from pharmacies.” We put up jingles, newspaper adverts…we continue to do advocacy with government. We talk with legislators, people in the executive arm of government so our drug laws can be brought up to date.

Compared to even these small West African countries, our drug laws are out of date! Some of the things we presently do need not be done. For instance, what is the excuse for allowing the patent medicine dealer to have a patent medicine store in the FCT? There is no excuse! We have more than enough pharmacies in the FCT.

Much is said about the abuse of prescription drugs. What is the situation in the FCT?

Few years ago, when we heard that somebody was a drug addict, the picture that came to our mind was motor park tout or some ruffian or someone who does manual labour on building site. Now, drug abuse has come into our homes. It has come into the homes of the middle class, the educated, those who think they are a little cosy in life through the root of abuse of prescription drugs which leads onto other things.

The epidemic that this country is facing now is the abuse of Codeine containing cough preparations. There are a lot of brands all over the place. In this city [Abuja], if you walk into any of the parks first thing in the morning, you would be surprised at the number of empty bottles of cough syrup you would find there.

This particular drug being abused now has the possibility of affecting the neurological system of a person. It can lead to psychotic problems—it can lead to system damage ultimately. Of course, we have history of people abusing paracetamol. They would say just paracetamol! I know people whose kidneys have shut down because they’d used too much paracetamol.

But we are more worried about this cough preparations because they are addictive. And unfortunately, children are being exposed to it very early in life—children in junior high school whose friends bring this cough syrup to school and they start using it. They are hooked on it and they graduate from this onto other things.

What we have done in our branch of PSN is to say that you cannot find those cough preparations in places they can be easily accessed. We are moving them into the reserved part of our pharmacies where we keep Dangerous Drugs.

But the pharmacist would not sell to this young man who obviously does not have cough, who you know should not buy this drug, who buys five bottles when nobody needs five. When you don’t sell to him as a pharmacist, he goes to any of these other shops and they will sell as many as he wants. We heard stories of some of these shops keeping these in the refrigerator as if they were drinks.

How do you feel when you see a hawker carrying drugs from one street of Abuja to another?

It’s difficult to put into words what I feel. Sometime it’s depression, sometime it’s raw fear especially when you are passing by and you see this man bring it down like groundnuts and they are discussing—telling the buyer to buy this one not this one! The man who is talking does not even know colour not to talk of what is contained in it. And you see people taking decisions based what the hawker is saying.

I look at the buyer and say what is going to happen later? Some of them are taking them home for their children. In the first place, these drugs have been exposed to all kinds of things. The man had been walking all over in the sun—some of them sleep in the street. And in some cases they are carrying around Soft Gelatine Capsules. These are supposed to be stored in very cold and dry environment.

In the course of ones practice, we have met people whom drugs have done very terrible things to. It is a disgrace that for our level of enlightenment and development as a country, even in the Federal Capital Territory, you can find people hawking drugs.

Hawkers of local Viagra commonly called Buran Tashe abound in Abuja. Do you see them?

I see them. I started my practice in Zaria so I know them. When you see these so called herbs, you have to be careful. Historically, in our culture, where do you find traditional medicine practitioners? Did they hawk their property? No! People consulted them, people go to them! When I see people hawking what they call traditional medicine, I get worried. There may be some that are good. But all this stimulant business is just a disgrace to us. It shows we are a society where anything goes.

I simply walk into the bush, cut some stalk, dry it up and I start giving it to people and nothing happens to me. Whether it works or not, whether it harms people, nobody stops me.

What are we to expect from the Jalingo conference?

We shall be exchanging ideas on what things pharmacists can do better to ensure that Nigerians get safe and efficacious drugs. This year, we’ll be looking at the NHIS [National Health Insurance Scheme], a wonder concept which has very serious flaws in actual practice.

What have been pharmacists contributions to NHIS?

We have practically been completely left out. In the original concept of the scheme, you were supposed to visit the medical practitioner, and when the drugs were prescribed, you were supposed to receive your drugs from the pharmacist. There is a difference between professionally giving drugs to people and selling drugs. Anybody can sell drugs. The pharmacist counsels the patient. Pharmacists are one professionals that you can consult for free. You can walk into a pharmacy, discuss with the pharmacist, buy nothing and walk out after collecting good professional information!

The prescriptions are not coming out from the hospitals in the NHIS. In this city, pharmacists that are registered with the NHIS, in the past three years have not received a single prescription to dispense.