Anthony Ademiluyi
Analgesics are medications that help to relieve different types of. They are also called painkillers and while some are prescribed many are available in pharmacies without a prescription. Painkillers abuse, misuse, and addiction, experts say, are on the rise, warning that this poses a serious public health challenge. ANTHONY ADEMILUYI reports
George Izulu, 48 works as a security guard in a company attached to the French Oil Multinational, Total in Victoria Island, Lagos State. He is a contract staff of Total as he was employed by a different company but posted to Total.
In his much younger days, he was a spy policeman and had worked with Royal Dutch Oil Multinational, Shell otherwise known as Shell Nigeria Exploration and Production Company in Marina Lagos. He disclosed that he worked for about thirteen years with Shell before he was laid off in 2015.
Now close to 50, Izulu battles constant back pain and usually resorts to getting relief from the pain by using painkillers.
He said, “I use Ibuprofen for my pain. There is also this drug called Real extra but I have forgotten the medical name. it is stronger than the normal Panadol, I use it as well.
There is this other one called Ibrufin which is also a brand of ibuprofen. it is very strong. I use it whenever I am in pain.
“It dulls the pain and especially when you go through strenuous training or like when we work in the beat when we stand for hours. Some were prescribed to us once so there is no need for you to go back to the doctor. We just keep on buying it because it is effective that is the bottom line. It’s good as it works. I know they are bound to have side effects as I use them whenever I have pain but I don’t really see the big deal in self-medicating on them. I know the danger of self-medication, but what do we do? I know the dangers involved but the cash flow is so little so what do we do? That is the bottom line,” he said.
Izulu said he also used to take Tramadol but insisted that he is not addicted to the drugs. “No I am not addicted but I have some colleagues when I was working for Shell company who were very much addicted because they must take it every morning and night. Some take two tablets in the morning and another two tablets at night making four tablets daily.
“When you finish using the drug, the pain will be gone but you feel kind of lazy and weak then later your body will pick up. it will give you this kind of feeling of as if you are weak and you can’t move very fast at some point in time but later your body will now adjust to it probably the system will be working out itself, I don’t know.”
‘I use painkillers as a form of First Aid’
Our correspondent also spoke with Orlando Danjuma, 25 an athlete. Danjuma said he often uses painkillers as first aid whenever he has pain.
Some of the painkillers that Danjuma uses personally are tramadol, diclofenac, and ibuprofen. He also disclosed that he occasionally overdoses on paracetamol when he is in pain.
He said, “Most times athletes do use painkillers without a doctor’s prescription because it acts as first aid treatment before any professional help comes.
“I know it is harmful taking them without the doctor’s prescription but those painkillers being administered initially are not really harmful to the health because they are the same that will be prescribed by the doctors, but the difference is that you take it before the prescription of the doctor”.
Even though he takes it whenever he feels pain, he also insisted that he is not addicted. “No! Addiction is not good. Addiction to it is not good. It is harmful to get addicted. Most times probably you can take it for two days at a stretch, but the continuous use of it is harmful to health.”
Findings by Reportr Door HealthWise revealed that the attitude of Izulu and Danjuma to painkillers is reflective of how many Nigerians see analgesics. Many people view painkillers as harmless medications that can be taken anytime they feel they need them without much thought about the risk of misuse, abuse, and even side effects.
However, experts are warning that this attitude is unhealthy as painkiller abuse often leads to addiction which increases the risks of some serious health complications.
What are Painkillers?
Painkillers also called analgesics are used to treat pain or manage a lifelong painful condition. They can be bought over the counter or with the doctor’s prescription.
Examples of painkillers include Paracetamol, NSAIDs – Ibuprofen, aspirin, and diclofenac gel; Compound Painkillers such as Co-Codamol, Codeine, and Ibuprofen.
A global health problem
According to a report published online by the American Psychiatric Association, nearly one in 10 people say they have taken an opioid or prescription painkiller without a prescription. Five per cent of US adults say they have abused or have been addicted to opioids or prescription painkillers, up from 1 percent in 2017.
The situation may not be much different across the world as painkillers abuse has become a global problem.
Abuse of painkillers causing serious harm –Experts
According to Oluchi Linda Nwosu, a pharmacist with the Administrative Staff College of Nigeria, Badagry, Lagos, and a public health enthusiast, the real challenge is the abuse of over-the-counter painkillers by those indulging in self-medication.
Nwosu said, “Painkillers are drugs that relieve pain. However, using them repeatedly without a doctor’s prescription makes them unsafe”.
The pharmacist explained that while not all painkillers require a doctor’s prescription, it is still wrong to abuse drugs, especially painkillers by using them at the slightest feeling of pain, noting that it may be necessary to find out what is causing the pain and deal with it appropriately.
Also speaking with Reportr Door HealthWise, senior registrar, Family Medicine Department, Usmanu Danfodiyo University, Sokoto, Dr. Laurat Mahmud, warned against painkiller misuse noting that those taking them without a prescription should exercise caution as analgesic abuse over a long period can lead to damage of important organs of the body.
Dr. Mahmud said, “There are a lot of implications of using these painkillers without a doctor’s prescription especially if the use is chronic. What I mean by chronic use is prolonged continuous use. Each drug has a certain dose and any drug can be a poison. So if one takes this medication without the prescription of a doctor, especially for a long period it can affect different organs of the body. To make it brief it can affect the kidney as it can lead to kidney failure. It can affect the liver, it can affect the heart and many other organs. These are major organs of the body that can be damaged. So it is very wrong to take painkiller medications without a doctor’s prescription, especially for a very long duration.
“To take painkillers for like for two to three days could be okay and may not be harmful provided it is a known painkiller like paracetamol, but to continue to take it for a very long time like mechanics or other artisans that do a lot of heavy work daily and now take painkillers every day after or before their work is very detrimental to health. Another major organ this chronic taking of painkillers can affect is the stomach. It can cause gastritis and it can cause erosion of the intestine and stomach.”
When not to take non-prescribed painkillers
According to experts, it is also not advisable to take painkillers without a doctor’s prescription, when pregnant or breastfeeding, or for underweight babies – especially those less than 16 years old. It should also be taken with caution for persons over 65 years old and not be taken by persons that have allergies, constant headaches, lung problems like asthma, or have had or have fits or seizures, have problems with the liver and kidney, or have had a stroke. It should also not be taken or taken with caution when taking other medicines.
WHO’s position on painkillers
The World Health Organisation says it remains fully committed to ensuring that people suffering severe pain have access to effective pain relief medication, including opioids.
The global health agency, however, noted that while expanding access to painkillers was important, the need for access to pain relief must be balanced with concerns about the harm arising from the misuse of medications prescribed for the management of pain, including opioids.
WHO stated that scientific evidence indicates there are risks associated with the use of painkillers — “such as the development of dependence, overdose, and accidental death.”
WHO noted that even when prescribed according to established clinical guidelines and patients’ needs, and used as directed, certain factors may increase the risks of painkillers, stressing that potential harms can be reduced through enforcement of proper regulation of controlled medicines, careful initial assessment of patients before prescribing, and regular patient monitoring and patient education.
WHO added that the differences between acute and chronic pain also need to be understood and managed accordingly, stressing that recent research in the fields of palliative care and pain management has identified many strategies for managing pain, beyond drug treatment alone.
“Evaluating this new evidence and establishing best strategies for alleviating pain—both acute and chronic—is an important area of work for WHO,” the global health agency said.
The WHO said it remained committed to working with member states to support the development of evidence-based policies, regulations, and best practices to promote access to safe, effective, and affordable medicines for the management of pain, and to prevent their misuse and harm.
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