The health profession is a conglomeration of different medical professionals who come together to better the health of the general populace.

One of the greatest advancement in health is the invention of drugs. They have been responsible for "miraculously" curing, preventing, or managing patients ailments.
As such many people abuse and misuse drugs without being aware of the potential harm it might cause

Perhaps the greatest paradox in disease management concerning drugs is this: every drug is a potential poison.

It is almost comical that the very agents responsible for saving millions of lives, of being responsible for humanity’s survival in this era, the very agents that have been now taken for granted but have single handedly had massive effects on civilization have the potential for ending life.

These drugs can also cause diseases so complex that remedies can be very costly. This article will attempt to explain this paradox while highlighting the Pharmacist’s role as a barrier between a drug being a poison and a curative agent.

First, what is a drug?
The Food and Drug Administration has as one of its definitions that, a drug is "a substance intended for use in the diagnosis, cure, mitigation, treatment, or prevention of disease." More specifically, a drug modifies a drug target in order to change the functionality of that target. What then is a poison? Generally speaking, a poison is any substance, including any drug that has the capacity to harm a living organism.

At this point, one might wonder, when does a drug become a poison?
Perhaps the man often regarded as the "Father of Toxicology", which is the science of poisons or poisoning, can give more insight. The Renaissance physician Paracelsus (1493-1541) explains:
"What is there that is not poison? All things are poison and nothing is without poison. Solely the dose determines that a thing is not a poison." Thus, any substance, any drug, has the capacity to act like a poison.

When does a drug become a poison?

Simply put, when it is misused or abused.

Drugs often cause adverse drug reactions. These are "unexpected, unintended, undesirable, or excessive responses to a medicine, and they may be harmful to the patient."
According to the Center for Disease Control and prevention, adverse drug events are responsible for approximately 1.3 million emergency hospital visits yearly and some 300 thousand patient hospital admissions after the emergency visits. This figure is staggering and represents just how much harm drugs can cause. This harm is further increased when drugs are misused or abused.

How can one misuse or abuse a drug?
This is done by using medicines other than how it is prescribed by a licensed medical practitioner. Self medication is the term used to describe this practice.

The World Health Organisation defines it as "the selection and use of medicines (including herbal and traditional products) by individuals to treat self-recognized illnesses or symptoms."

Two elements of self medication stand out here: first, self recognition of illnesses and second, self treatment of those illnesses. Hence, there are two issues with the practice. First, the illnesses may not be correctly recognized by individuals since they are not trained in that aspect.

Hence, the drugs may not be the right one, nor may it be the right dose or right dosage form or the other many factors that affect drug therapy. This is because these individuals are not trained in drug therapy. Therefore, the possibility of drug harm is largely increased in self medication.

Data shows that self medication is a serious challenge globally, with a prevalence rate of 11.2 % to 93.7 % depending on the country. No wonder adverse drug reaction rates are so high!

Self medication or generally drug misuse could lead to problems because of several reasons. One such reason is taking the wrong drug.

Wrong drug for a particular person depends on the disease condition of the person or even the physiological state. Example, there are drugs pregnant women or children should not take, or that people with certain diseases should not take. Such drugs can become poisons to those individuals. Another way is taking improper dosages.

Drugs are precisely dosed so they are not harmful. Therefore, if improperly taken, such drugs become poisonous and deadly. More than that, there are patient specific factors that medical experts take into consideration before prescribing drugs.

Things like genetic disposition, allergy history, other disease states, age and sex of the individual. These all affect the potential of a drug in becoming a poison.

So, how do we stop our drugs from becoming poison? Take drugs only after seeing a medical professional and consult a pharmacist before taking any drug. Any drug at all.

The pharmacist is the drug expert trained in the correct and safe use of drugs. Considering the several variables that may make a drug poisonous, the pharmacist is in the best place to give advice regarding drugs and the best part is this: a pharmacist is always ready to do so even without an appointment.

Remember, although drugs are one of the greatest victories of humanity, they are also an ever present danger. Therefore, our best bet in the continuous safe and effective use of drugs are the Pharmacists.

May it be our goal to always consult a pharmacist before we commence any drug use at all.

Author: Pharm Nsidibe Ekpenyong

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