Mirta D’ Ambra*
Received: November 29, 2019; Published: January 07, 2020
Corresponding author: Dr. Mirta D’ Ambra* FMWAMS M.D Epidemiologist in Public Health Uba Ministry of Health Teacher U.B, A. Argentina
There are medicines registered as such-and subject to the legislation of pharmaceutical specialties-and products that, without being registered as medicines, are sold and actively promoted, giving them medicinal virtues.
Among the medications it is necessary to distinguish those of prescription or prescription sale, of those without prescription or over the counter (over the counter or OTC counter medications in Anglo-Saxon terminology). On these there is the wrong an installed assumption among the general public, which considers “over-the-counter” medicines safe.
All medications without exception, used in excessive doses or for too long periods, in situations where they would not be indicated, can cause side effects, collateral, undesirable or adverse effects, generate interactions with other drugs or substances, induce behaviors of abuse or dependence and even delay the diagnosis of a condition that requires medical care.
Thus, for example, according to a study by Morlans, M., Laporte, J. et al., About 13% of all the etiological burden of terminal nephropathy that leads to dialysis or transplantation in our environment is due to the chronic use of painkillers, almost always in the framework of self- medication.
The sale of any medicine outside the pharmaceutical establishments is highly risky for the health of population. As the Argentine Pharmaceutical Confederation (COFA) warns, 20 percent of the drugs consumed in the country are purchased outside pharmacies, such stores include kiosks, supermarkets, service stations, gyms and even hotels accommodation. Sometimes this also applies to prescription drugs.
The traceability of a drug is the monitoring of the route that the product takes at all stages of its marketing, it is essential to achieve a correct use of the medications (pharmacovigilance, detection of chronic patients, patient monitoring) as well as to establish an action Therapeutics free of complications. It is also a tool that uses the health system to detect counterfeits, adulterations on medications. When separating from the original sales channel, traceability becomes difficult, if not impossible .
There is also a legal vacuum over their control by the national authority, since ANMAT has no jurisdiction over establishments that are not authorized by the Ministry of Health. In other words, the referred “sales channels” (kiosks, warehouses, service stations) are outside their jurisdiction and competence.
The impact of the advertising of medicines on the behavior of consumers is undeniable, and hence the potential risks it represents for the health of the population. The National Academy of Medicine warned on repeated occasions about “advertisements that encourage the use of treatments and medications without medical supervision, and the proliferation of advertising messages advising medications and therapeutic procedures of benefit sometimes not established and sometimes exaggerated, with the purpose to encourage their consumption”.
The World Health Organization (WHO) created the “Ethical criteria for the promotion of medicines”, a theoretical framework where recommendations are made on advertisements aimed at the public “should help the population to make rational decisions about the use of medicines that are legally available without a prescription.
According to studies carried out by the Maimonides University and the Argentine Institute of Pharmaceutical Care (IADAF), the advertising of medicines encourages self-medication or drug misuse, a problem that takes 700 lives per year in the country.
In a note from health issues journalist Pedro Lipcovich, ( “Today we are addictive”) analyzes a television message of aspirin (acetylsalicylic acid) mentioning the striking omission of any of its therapeutic properties as anti-inflammatory, anti-fever, anticoagulant, associating its consumption “with ageneric welfare state and high social and labor performance”.
We passively assist in the promotion of bad eating habits, widely publicized, to increase the sales of a medicine that supposedly counteracts the effects. The induction to the conduct of immediacy in the installation of a treatment according to the symptoms, gives results: everything can be solved with a tablet and even some dietary supplements are preferred to be marketed as medicines because they “sell more”. But this attitude has its When a teenager is offered a “tablet” of ecstasy, with the promise of well-being and pleasure, it is utopian to think he could say “no.”
To all this must be added the lightness with which we assist in the prescription of medications. The mother, the coworker, the hairdresser, the kiosk and even the doctor’s office, among patients, recommend medications.
Advertising and active promotion by mass media, increases irresponsible self-medication and irrational use of medications. Medicinal drugs or medicines thus leave their place of social good, essential for public health, and become a consumer good.
Numerous medications are used to produce changes or
changes in mood, alone or in association with drugs or substances
of abuse. According to the 2008 National Survey on Prevalence of
Psychoactive Substance Consumption, conducted by INDEC, almost
4% of the population between 16 and 65 years of age consumes
It cannot be taken into account that almost all drugs of abuse today were initially medications, which due to their pharmacological and toxicological characteristics (tolerance, abuse, dependence) began to be used for their psychoactive effects, being then restricted or withdrawn in your pharmacological employment. Such is the case of cocaine, some opiates (morphine, codeine), amphetamines, anesthetics (ketamine), ephedrine, popper, etc.
The Abuse Medicines Observatory (WCO) in Spain conducted a study that verified the non-medical consumption (substance abuse) of a total of 27 substances. 22% consumed analgesics, some 12% anxiolytics or tranquilizers (benzodiazepines); 10% stimulants and the rest a wide range of substances.
Majority use patterns included mixtures with drugs and alcohol and abuse of tranquilizers. Medications have always been part of the “drug culture” in non-therapeutic uses, in order to experience new sensations or obtain better yields. The modalities of drug abuse change and it could be said that some of them “become fashionable”. Currently, the “crazy jar” is the most common form of alcohol and medication use-mostly benzodiazepines- among teenagers and young adults.
According to data from the Toxicology Unit of the “Juan A. Fernández” Hospital of the City of Buenos Aires, during 2008, 2182 consultations related to acute poisoning by substances of abuse were attended; 292 of them were due to abuse of some type of medication and another 205 were due to the association of some medication with alcoholic beverages .
The equation between inappropriate promotion of drug use, forms of facilitated or uncontrolled accessibility and patterns of inappropriate use and substance abuse constitutes an increased risk trilogy, which exposes the potentially most vulnerable population.
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