This article is based on my daily  observations of Drug use in Nigeria as a community Pharmacist. I will not be talking about substance abuse which involves the use of psychoactive substances but rather drug misuse.

Nigeria has a chequered history of drug delivery and usage, almost all drug types could be bought over the counter in Nigeria,  before I go further Drugs in the Pharmacy are classified into Over The Counter (OTC) drugs and Prescription Only Medications (POM). OTC drugs are medications that could be bought without a doctor's prescription while POM are medications that you can only buy with a valid prescription by a medical, dental or veterinary practitioners.

In Nigeria, virtually all drugs are sold as OTC, you can simply walk into any pharmacy or drug store and purchase the most ethical drug without any prescription and this has resulted in a lot of drug misuse in the society today with a lot of implications.

Another factor is that once an average Nigerian takes a drug once, he/she assumes the role of  an expert in that particular drug, he will start prescribing for himself and to every Tom, Dick and Harry without taking into consideration that drugs are most times prescribed to suit a particular patient and that one drug could be used to manage different conditions. 

Sometimes, people also take drugs for conditions that are entirely different from what the drug is meant for, you will see someone with a cold and flu buying a heavy antibiotic.

Most Nigerians do not follow or complete a dosage regimen, sometimes a drug especially antibiotics and antimalarials are prescribed to be taken for a given interval of time for a particular number of days, it is common to see people that will just take a dose of a drug and when they get better, they will just abandon the whole thing, the risk here is that if you don't take drugs such as antimalarials and antibiotics as prescribed, there is a chance that the bacteria or malaria parasite being treated will develop resistance to that particular drug so that when you take it next time the drug may not work again and the danger is that the resistant strain of the bacteria or malaria parasite can be transmitted from one person to the other, and when this happens, the drug becomes more or less useless and there would be need to start developing another drug molecule that can take care of the new resistance strain and the development of a new drug takes years and billions of dollars.

I will be listing some drugs that I have noticed people taking in ways that they are not meant to be taken.

Ampicillin/Cloxacillin (Ampiclox is the most popular brand). In my opinion, this is the most abused antibiotic in Nigeria, there is nothing that people don't take this drug for, some take it immediately after having sex to 'flush their system", some say it is an abortifacient, some take it when they miss their period,  others use it to treat "toilet infection".  This drug is an antibiotic that should only be used when prescribed by a competent person and when you want to use it, please use it as prescribed, the culture of buying drugs from roadside "chemist" is about to render this drug useless in this country, it is not uncommon for people to walk to a patent medicine dealer and demand for two capsules of Ampiclox, when you take it this way, you are exposing the drug to bacteria resistance, hence rendering it useless.

Metronidazole (popular brand is Flagyl). Also in my opinion the second most abused drug in Nigeria, people normally buy it together with Tetracycline especially when they are purging, most people do not know that Flagyl is an antibiotic and that it has a dosage regimen that should be strictly followed when taking it. I am skipping the dosage regimen on purpose because it should be the job of your prescriber and your pharmacist, you shouldn't self medicate. Please avoid alcohol while taking this drug.

Acetaminophen (Paracetamol). This drug is an OTC drug that could be purchased at anytime, the normal dose for an adult is two tablets every eight hours for a maximum of three days, I have seen someone swallow four tablets of paracetamol at once, his excuse was that two tablets no longer work for him, the danger with the drug is that the overdose causes liver problems, therefore do not take more than two tablets per dose and do not take another earlier than eight hours after the previous dose.

Non Steroidal Anti inflammatory drugs (NSAIDS). This includes Diclofenac, Ibuprofen, aspirin, piroxicam (felvin) etc. It is very common to see people taking two or more of these at the same time, these drugs share similar mechanism of action, therefore they are not meant to be taken together or taken more than the required dose, when someone takes an overdose of any of these drugs, the person is at risk of developing stomach ulcer and it is always advised that any of these class of drug should not be taken on empty stomach and no matter the severity of the pain, the prescribed dose should not be exceeded.

Steroids (Prednisolone and dexamethasone). Yoruba people call these drugs "yodi" or "dikonga", people buy these drugs not because of their medical uses but for their adverse effects, long term use of this drug cause weight gain and this has made it a hot cake for people that want to put on weight, the adverse effects of this drug include increased appetite, puffy face, increased hair growth, lowering of immunity (increased risk of infections), osteoporosis (weak bones), blurred vision, high blood pressure and diabetes. There is also a report that links long term use of these drugs to glaucoma. These drugs should be only used on the advice of a doctor or a pharmacist.

Worthy of mention are also antibiotics such as ciprofloxacin (Ciprotab), Amoxicillin (Amoxil), Amoxicillin/Clavulanic acid (Augmentin), these are drugs that require advice by professionals before you take them.

In conclusion, drugs are also poisons depending on the usage, if you must use any drug, let your doctor prescribe it and buy it from a pharmacist, follow the given instructions and do not self medicate, you might just be killing yourself and also let the prescriber know what else you are taking apart from the drug, ask questions no matter how stupid they may sound, ask what food you cannot take alongside the drug, that question that sounds stupid might be what will save your life. Because prescription drugs are readily available here in Nigeria does not make you the buyer a drug expert.