Saturday, December 9, 2023

Hospital pharmacists are becoming Botswana’s biggest drug dealers

What do pharmacists and dealers have in common? They both deal with drugs. After alcohol, marijuana, and tobacco, prescription drugs which are administered by pharmacists are among the most commonly abused drugs.

Dr Orapeleng Phuswane-Katse, a physician with the Ministry of Health says, “There are a number of reasons for why prescription drug abuse could be on the rise, but a lot of it could be the result of a cultural shift where we take a pill every time there is a “problem.” With regards to sleep medications, their uses particularly in a great amount than prescribed fashion or in combination with other drugs is why they can be so dangerous. If not taken properly, sleep medications can cause respiratory and cardiac depression which could lead to death. This is dangerous enough alone, but when you add other drugs to the mix, especially alcohol, it can be quite fatal. Young adults (age 18 to 25) are the biggest abusers of prescription opioid pain relievers, ADHD stimulants, and anti-anxiety drugs. They do it for all kinds of reasons, including to get high or because they think stimulants will help them study better.”

Prescription drugs are typically given to those suffering various health ailments such as chronic or severe pain, sleeping disorders, and anxiety disorders. However, this type of medication is designed to be taken for a short period only because of its potential for abuse. Misuse of prescription depressants, and stimulants is a serious public health problem and although most people take prescription medications responsibly, people have misused such medications. The reasons for the high prevalence of prescription drug misuse varies by age, gender, and other factors, but mostly likely include easy access. However, misinformation about the addictive properties of prescription drugs and the perception that prescription drugs are less harmful than illicit drugs are other possible contributors to the problem. Although misuse of prescription drugs affects many, certain populations such as youth and older adults are at particular risk.

One of the biggest problems with prescription drugs is the fact that most people believe them to be safe. The fact that they are typically taken on the advice of a doctor gives people the impression that they are not harmful at all. However, abuse and even long-term use of prescription medication can lead to addiction. Strong painkillers like opioids and sedative drugs such as benzodiazepines are available only on prescription precisely because they can be so dangerous. Most people do not realise that addiction can happen quite quickly. It usually begins with an increased tolerance to the drug. Once the body gets used to its presence, it will adjust its production of feel-good chemicals. The result of this is that the user will believe that the medication is not working as it did in the beginning. Moreover, because the person believes the medication to be completely safe, he or she may not see the harm in taking a few more pills. Unfortunately, abuse of prescription drugs is what usually leads to full-blown addiction. But what often happens is that those who abuse prescription medication, do not realise they have become physically dependent until their supply of medication runs out.

Dr Sophie Moagi, clinical psychologist in Gaborone says, “Dependence occurs as a result of physiological adaptations to chronic exposure to a drug. It is often a part of addiction, but they are not equivalent. Addiction involves other changes to brain circuitry and is distinguished by compulsive drug seeking and use despite negative consequences. Those who are dependent on a medication will experience unpleasant physical withdrawal symptoms when they abruptly reduce or stop use of the drug. These symptoms can be mild to severe (depending on the drug) and can usually be managed medically or avoided by slowly tapering down the drug dosage. Tolerance, or the need to take higher doses of a medication to get the same effect, often accompanies dependence.”

Prescription drugs classified as controlled dangerous substances are essential therapeutic medicines in treating a variety of healthcare conditions; however, their pleasurable side effects can appeal to patients for uses other than their intent. More than 80 percent of older people (ages 57 to 85 years) use at least one prescription medication on a daily basis, with majority taking more than five medications or supplements daily. This can potentially lead to health issues resulting from unintentionally using a prescription medication in a manner other than how it was prescribed, or from intentional non-medical use. The high rates of chronic illnesses in older populations, age-related changes in drug metabolism, and the potential for drug interactions make medication (and other substance) misuse more dangerous in older people than in younger populations.


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