JEDDAH, 24 February 2007 — If you live in the Kingdom long enough, chances are you’ll eventually go to a pharmacy and pick up prescription-only medication as easily as picking up a package of Panadol, an over-the-counter, non-narcotic painkiller.
The practice of buying drugs illegally conjures up images of drug addicts finding ways to obtain controlled substances in order to abuse them for a cheap high. However the most “under-the-counter” drugs are antibiotics and other powerful medications used for treating diabetes, heart conditions or depression.
Drugs such as antibiotics require prescriptions in many countries, including Saudi Arabia. The realty is that virtually any pharmacy in the country will dole out powerful antibiotics or antidepressants without so much as the pharmacist blinking.
Few people seem aware that buying certain drugs available in pharmacies without a doctor’s prescription is, legally speaking, illegal.
Pharmacists recently spoke to Arab News and openly admitted that they often sell drugs that require prescriptions from doctors, including diabetes, cholesterol and blood pressure medications. Doctors warn against self-prescription because some of these drugs can be harmful if not taken properly, or taken when they aren’t needed.
Ahmad Al-Muhamadi, a Jeddah-based pharmacist, said that customers are increasingly coming in without prescriptions. “People come and take medicines that they are familiar with,” he said. “Those who ask for medicines without medical prescriptions are mainly expatriates who work for individual businesses, such as shopkeepers.”
Nabeel Al-Tihami says he would never give customers prescription drugs commonly abused for recreational purposes, such as Valium or narcotic painkillers.
Patients tend to shun doctor’s visits because of the cost and time involved with making an appointment just to get a prescription for a condition they have self-diagnosed, in many cases correctly.
For example, getting diarrhea from unclean water is an easy and cheap diagnosis, and many people, especially lower income laborers, may simply run to the pharmacy to pick up antibiotics to cure it.
Health officials worldwide are becoming increasingly alarmed by the excessive use of antibiotics in particular. While antibiotics are very effective against bacterial infections over time these microbes can develop defenses against the antibiotics, rendering the drugs useless.
Immunity to antibiotics can cause sufferers to succumb to infections, particularly in the developing world where, in some cases, antibiotic treatment is the only sure cure available for serious cases of bacterial infections caused by unhygienic living conditions.
Doctors recommend only taking antibiotics when necessary and not each time a minor infection appears, particularly infections that a person’s natural defenses can fight on their own.
Pharmacies in Jeddah, for example, freely dispense extra-large 750-mg-sizes pills of the popular antibiotic amoxicillin to patients who ask for something to clear up a relatively minor bacterial infection. Also, misdiagnosing a viral infection as a bacterial one means the medication is completely useless since antibiotics do nothing against viral infections, such as the flu.
Medical authorities say antibiotics should only be taken with discretion, and with doctor’s supervision.
In the Kingdom, on the other hand, heavy doses of antibiotics are as easy to buy at pharmacies as shaving cream. Patients that stop taking the antibiotics before completing the full regime prescribed by doctors because they start feeling better risk getting sick again days later as the surviving bacteria re-populate and cause the symptoms of the illness to return. These are primary reasons why many countries require doctor’s supervision for accessing antibiotics.
Al-Radi said that for children’s illnesses people tend to get medical prescriptions. Most adults however think that they are knowledgeable enough to get medicines on their own.
“Other patients who come to take medicines without medical prescription tend to explain their cases to pharmacists, pharmacists then provide the suitable medicines,” he said. “In more complicated cases the pharmacists ask patients to consult a doctor.”
Jamal Al-Said, a Palestinian living in the Kingdom, said he does not consult doctors when he’s suffering from light ailments.
“I buy medicines that I am familiar with,” he said. “Some doctors ask for unnecessary X-rays and tests. They even write a long list that could include antibiotics. I believe that some of these medicines are not necessary so I do not buy them. “
Muhanad Al-Isawi an Egyptian working at a pharmacy in Makkah said the majority of pilgrims coming from abroad tend to buy medicines from pharmacies without consulting doctors.
He added that most of his pilgrim patients are elderly seeking medicine for common cold and flu.
