That Medicine You Bought Could Be Poison

I have done this long enough to know that most people do not set out to poison themselves. You wake up with a headache, malaria creeping in, or a child whose fever will not subside. You go to the nearest chemist shop or the cheerful man by the bus stop with a multitude of drugs […]

I have done this long enough to know that most people do not set out to poison themselves. You wake up with a headache, malaria creeping in, or a child whose fever will not subside. You go to the nearest chemist shop or the cheerful man by the bus stop with a multitude of drugs on display. You ask for something strong. You pay less than you would at the big pharmacy. You go home, swallow the pill or give it to the child to swallow, and wait for relief. That relief, for too many Nigerians, never comes. Or worse, something deadly shows up.

Now, let me tell you about Esther. She was three years old, living with her grandmother somewhere in the city. A fever, then convulsions. The grandmother bought what the seller called “genuine paracetamol syrup” because the usual brand was out of stock. Three doses later, Esther’s liver began to fail. Unknown to her grandmother, what the little girl actually swallowed was a mix of industrial paracetamol powder, cornflour, and a glue-like binder. No one knows the exact ratio because the people who manufactured it did not bother to measure it. By the time they reached the nearest teaching hospital, her eyes had turned yellow. She died on a Wednesday morning.

In Nigeria, it is estimated that the prevalence of fake or counterfeit drugs is alarmingly high. Some industry experts and reports suggest that up to 50% to 70% of drugs in circulation are counterfeit or substandard. Common examples include falsified antibiotics, antimalarials, and analgesics, which often contain either no ingredients or improper ingredients. Although the National Agency for Food and Drug Administration and Control (NAFDAC) has disputed a strict 70% figure, the consensus from various sources is that the prevalence is significant. Think about that. You could be managing your hypertension with chalk and dye for months, walk around feeling fine, and then drop dead from a stroke because your “amlodipine” was actually ground-up roofing sheet residue.

Here is the part we do not discuss enough: the damage is rarely dramatic at first. Fake antibiotics do not kill your infection. They just make it angry—literally. So, your cough lingers for weeks, you buy another round, the bacteria grow resistant, and one day, a simple pneumonia leads to unpleasant consequences. Fake artesunate for malaria leaves the parasites in your blood, reproducing quietly until your haemoglobin crashes. You tell yourself the medicine “did not work”. No. It was never medicine. It was poison dressed in foil.

I have sat with pharmacists in Lagos who showed me how to spot a fake. Run your nail across the expiry date—if it smudges, run. Check the seal: original brands have a clean crimp; fakes look like a child folded it. The truth is that most of us do not have time for forensic analysis when a child is crying in the middle of the night. That is why the real solution is not just more inspections or raids, though we need those fiercely. The real solution is personal responsibility that starts before you fall sick.

Here is what I mean. You have to become your own gatekeeper. That means deciding, right now, that you will never again buy medicine from a market stall, a bus stop table, or a shop without a pharmacist’s licence displayed. It means paying the higher price at a reputable pharmacy as the cost of staying alive. It means asking for the receipt and checking NAFDAC’s mobile authentication scratch panel—the one that lets you send a code to 3832 for free. It takes a few seconds. It can save you years of dialysis when your kidneys finally give way from processing what you have no idea of.

I know money is tight right now. I know that the fake drug seller is often closer, friendlier, and offers credit. I know that when your rent is due, and school fees are looming, saving N1,000 on malaria drugs feels like wisdom. But I also know that death has no payment plan. The families who have lost someone rarely say, “At least we saved money.” They say, “If only we had known…”

Another danger is the erosion of trust. You stop trusting any treatment once you realise that your headache relief might be rat poison. People have died from curable diseases because they assumed the hospital would give them fake drugs, too. That is the silent epidemic: suspicion that turns into neglect. A man up north had a simple urinary tract infection. He bought “antibiotics” from a roaming seller. Nothing changed. He bought a different brand. Nothing. By the time he saw a doctor, the infection had reached his kidneys. He survived, but just barely. His words were, “I did not know I was feeding the sickness instead of fighting it.”

Now, where does responsibility begin? With regulators, yes. NAFDAC has made progress: the mobile authentication system, the destruction of seized batches, and the sting operations. But the agency is underfunded and outnumbered. It operates with about 2,000 permanent staff, which stands in contrast to the over 10,000 staff it requires for effective nationwide regulation. And that is from its director general.

So, where does that leave us? I do not ask that to scare you but to wake you up. You can start with your medicine cabinet. Go through it right now. Any drug without a NAFDAC number? Throw it out. Any pack that looks faded, reprinted, or sealed with cheap plastic? Gone. Any shop you have been buying from that is not a licensed pharmacy? Stop going there. It is uncomfortable to change habits, but so is a funeral.

I also want to say something to the young people reading this, the ones who buy rohypnol or tramadol from social media dealers for recreational use. You are playing Russian roulette with industrial-grade fillers. Some of those pills contain rat killer, brake fluid, or lead. Not metaphorically. Actual lead. The same substance that causes brain damage and seizures. The people selling them do not care if you do not wake up. All they are interested in is your money, and they already have it.

We have a saying in our village: “The thing that looks like water is not always water.” Fake drugs look like help, but they are a slow betrayal. Every time you take one, you are not treating your illness. You are adding to it. You are telling your body to fight two enemies: the sickness and the poison. Most bodies eventually lose that war.

So, this is my submission for the week, but more than that, it is my plea. Trust your suspicion. Pay the extra fare to the real pharmacy. Use the scratch card. Ask the pharmacist, “Show me that this is real.” If they hesitate, walk out. Your life is not a gamble, even though the system sometimes treats it like one. And if you have lost someone to fake drugs, I am sorry. Their death was not an accident. It was a crime. The only way we can honour them is to refuse to be the next victim.

Stay careful. Next time you reach for a pill, ask yourself: “Do I know where this really came from?” If the answer is anything less than a confident yes, put it down. Drop it and look for a trusted alternative. As we often say, “Life has no duplicate.”

Ojenagbon, a health communication expert and certified management trainer, lives in Lagos.