In December 2017, Oluwatayo Akingbile, then 20 years old, understood the harsh implication of using medications without a prescription after losing a friend who thought he had malaria and had used an anti-malaria drug without testing or prescription. 

“We were university students, and my friend bought the drug on the counter at a pharmacy, and after taking the medication, he started complaining of unusual sweating and abdominal discomfort. 

We rushed him to the school clinic, but they later transferred him to a tertiary health facility because of the severity of his reaction to the drug. He never got better as he died three days later,” he said. 

Mr Akingbile said he since understood the importance of getting tested and prescriptions from experts before using any medication. 
 
“I often hear that drugs can have an adverse effect or lead to death when taken without prescriptions, but I did not know it was true until this happened. It taught me a lesson, and I educate people against self-medication when opportune to,” he said. 
 
Misuse/drug abuse 
 
In the case of Stanley Okonkwo, using some over-the-counter drugs has become a pastime even when not ill. 
 
“I buy some over-the-counter drugs (pain relief) from hawkers during recreational (alcohol) drinking because people do. I stopped when a friend educated me about the harmful effects of drugs on my body, especially my liver and kidney. I think people misuse drugs because they do not understand the damaging effects they can have on their health,” he said.  
 
A hawker who retails medicine at recreational parks in Abuja, Abdullai Garko, said he does not know the composition of the drugs but sells it because it is a lucrative business. 
 
He said I do not sell all medicine, only pain-relieving drugs and some drugs in high demand. I do not know if using drugs without getting prescriptions from experts can cause harm.  
 
Medication without harm 
 
According to the World Health Organization (WHO), medication harm accounts for 50% of the overall preventable harm in medical care.

To acknowledge the substantial burden and recognize the complexity of medication-related harm prevention and reduction, "Medication Safety" has been selected as the theme for World Patient Safety Day 2022.

World Patient Safety Day takes place annually on September 17 to raise awareness and drive worldwide intervention for the safety of patients.

 As regards the problem, this year’s Patient Safety Day campaign is envisaged to provide the needed push to consolidate the efforts of the existing WHO Global Patient Safety Challenge: Medication Without Harm, emphasizing the need to adopt a systems approach and promote safe medication practices to prevent medication errors and reduce medication-related harm.

Detrimental use 

Buttressing the importance of reducing medication harm, a pharmacist in Abuja, Chidi Lawrence, warns of the grave dangers of using drugs without doctors' prescriptions and not purchasing from certified pharmaceutical outlets.

Mr Lawrence said the likelihood of people misusing pharmacotherapy to the extent it causes health hazard is high.

“As such, there is a need for consistent sensitization to enlighten them about the harm in the misuse/abuse of drugs. Inappropriately used medicine can be poisonous and cause side or adverse effects. Drug misuse cause it to lose its therapeutic value and cause harm to the body or lead to drug resistance and not work when needed. 

Drugs should be bought with prescriptions from experts, patients should know the implication of using the drugs and all prescription lists should be retrieved from patients to deter them from reusing or abusing drugs.  There is a need to strengthen the medication system from prescribing, dispensing, usage and monitoring drug use to reduce the hazards caused by wrong medication,” he said. 

Furthermore, the WHO Regional Director for Africa, Dr Matshidiso Moeti, in her message to mark the 2022 World Patient Safety Day, said global estimates show that medication errors contribute to over 3 million deaths yearly.
 
She said while there is limited data for Africa, the continent has a high magnitude of unsafe medication practices. 

 “Among low- and middle-income countries, the African Region has the highest prevalence of substandard and counterfeit medicines. Administration of surplus medication at home, the purchase of medication from pharmacies on the advice of friends and relatives rather than trained professionals, and the use of old prescriptions to buy medication to treat a current ailment are all common practices that should be avoided. 

Meanwhile, WHO is working with the Member States to implement the WHO Global Patient Safety Action Plan 2021–2030, and a regional patient safety strategy and road map are currently being developed to guide its implementation.