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10 Classes Of Drugs You Should Not Use Without A Prescription

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By Alebiosu Omobolaji Taiwo

All drugs are foreign substances which can be harmful (i.e. act as poisons) when administered in wrong doses and when administered wrongly. Although some are more potent than others and cause more serious side-effects than others, all drugs should be treated as what they are – poisons, and should not be taken without seeking advice from a board-certified Medical Practitioner and  a board-certified Pharmacist.

Drugs are categorized into two:

1) Over-the-counter (OTC Drug) which are available without a Physician’s prescription.

2) Prescription-only-medicine (POM Drug) which are not available without a Physician’s prescription.

Using drugs requiring a prescription without a prescription is tantamount to abuse but it must be stated that both OTC drugs and POM drugs can be abused.

Many deaths have been linked to the misuse of prescription drugs. Stars like Michael Jackson, Heath Ledger, Marilyn Monroe, Elvis Presley, and more recently Whitney Houston, have been caught by the clutches of death through such misuse.

I have compiled TEN classes of prescription drugs with some brand names in bracketsthatI know to be commonlyabused in the Nigerian Society. This is not to say that POM’s not included in the list can be used without a prescription and this is not to say that OTC’s should be used without receiving advice on their safe use from a Pharmacist.

1)    Antimicrobials:

Self-prescribing, dose incompletion and incorrect usage has lead to resistant strains of microbes which no longer respond to the antibiotics.

Classes under this group that are commonly available and used without a prescription include the Beta-lactam antibiotics which include Penicillins and Cephalosporins and the Tetracyclines which include Tetracycline, Doxycycline, Chlortetracycline, etc.

Other common examples include Ampicillin and Amoxicillin.

 

2)    Alcohol and other drugs of abuse

Alcohol is present in many beers and wines.

Ethanol, Methanol, Phencyclidine, Marijuana ‘igbo’, Lysergic acid diethylamide (which has no clinical use) and Cocaine are substances in this class. Some abusers use them because of physiological actions like euphoria, arousal, sedation, excitation, etc. Other physiological actions include slurred speech,  decreased liver and hepatic function, hypersalivation, disturbed mood and perception, red conjunctiva, hallucinations and psychosis, and coma.

They all have a high risk of dependency and addiction and cause severe withdrawal symptoms.

 

3) Anxiolytics, Hypnotics, and Sedatives:

These are drugs that can be used to treat anxiety, sleep disorders, panic disorders, alcohol withdrawal, convulsion, etc. They include Diazepam (Valium), Temazepam, Alprazolam, Nitrazepam (Mogadon), Flurazepam, Flunitrazepam,  Buspirione,  Zaleplon, Phenobarbital,  Pentobartital, Ethanol and other examples. These drugs are not usually prescribed in large quantities because of risks of dependency and addiction.

Remember  Cynthia Osokogu who was sedated with Flunitrazepam (Rohypnol) which was purchased without a prescription from a Pharmacy by some persons she met via facebook after which she was  raped, attacked, and beaten.[1She was the daughter of a retired Army General. Also, “Mr. Heath Ledger died as a result of acute intoxication by the combined effects of  Oxycodone, Hydrocodone, Diazepam (Valium), Temazepam, Alprazolam, and Doxylamine.”[2]  He was a thespian who was notable for his role as the Joker in The Dark Knight.

 

 4)    NSAIDs

Nonsteroidal anti-inflammatory drugs are used to treat mild to moderate pain, inflammation (when administered in  higher doses), and fever.

“The common ones like Aspirin, Ibuprofen, and Naproxen are available over the counter in many areas. Others are available only with a prescription from a physician or a dentist.”[3]

The drugs Ibuprofen, Aspirin, Sulindac, Diclofenac potassium (Cataflam), and Diclofenac Sodium (Voltaren) are in this class.

 

5)Anti-depressants:

These drugs are used to treat depression which is an affective syndrome characterized by a feeling of intense, general  loss of interest in the everyday aspects of life, insomnia, changes in appetite, and low self-esteem.[4]

They include Amitriptyline (Tryptizol), Imipramine (Tofranil), Chlormipramine (Anafranil), Floxetine, Sertraline (Zoloft), Phenelzine, Trazodone, and Venlafaxine. Side effects include nausea, hypertensive crisis, sexual dysfunction, weight gain and others.

 

6) Corticosteroids:

Steroids are grouped into:

a)     Mineralocorticoids: an example is Desoxycorticosterone

b)    Glucocorticoids: examples include Prednisone, Dexamethasone, Beclomethasone, and Betamethasone.s

 

There was a time when it was the craze for a medication popularly called “mawu-mawu”. “It was a drug called Dexacotin, a steroidal preparation which was immensely abused in the weird African concept of equating beauty with obesity.” [5] I am sure most of the women were not aware that the weight gain caused by such drugs will not be evenly distributed  and that the weight gain is not as a result of the pharmacological activity of the drug but is a side-effect (as earlier stated) of the drug and even if they were, there is little assurance they would have ceased it’s usage.

A number of persons still abuse these drugs whose side effects include weight gain, adrenal suppression, and osteoporosis (disease of the bone that leads to an increase risk of fractures).

 

7) Anabolic Steroids:

These are examples of  performance-enhancing-drugs and individuals using them are highly prone to dependency and addiction. They increase muscle mass and enhance athletic performance.

“A Nigerian hurdler, Ogoegbunam Amaka tested positive for the anabolic steroid metenolone at Berlin world championships.” [6] Another notable athlete , Marion Jones a U.S. Olympian has also been sanctioned for using such drugs.[6]

Side effects include low sperm count, shrinkage of testicles, and baldness (in men), loss of  breasts, a deepened voice, and hair loss (in women).

 

8) CNS Stimulants:

These drugs cause an increase in motor activity, cause excitement, and decrease feelings of fatigue. They include Methylxanthines, Nicotine, and the Amphetamines.  Of all the classes, most of us are familiar with Methylxanthines and Nicotine. The former includes Caffeine contained in  beverages such as coffee, tea, and energy drinks and Theobromine contained in cocoa.

Use of Caffeine can cause side effects such as insomnia, vomiting, and  convulsions while Nicotine contained in cigarettes can cause side effects like tremors, irritability, and diarrhea.

 

9) Appetite Stimulants:

Loss of appetite is a problem in many debilitating diseases such as HIV/AIDS and Cancer. Stimulation of a patient’s appetite is important to improve nutritional status and the  patient’s sense of well-being. Alcohol, Cyproheptadine (Cypron and Cyprigold), and Megestrol acetate (to treat cathexia in AIDS patients), and Corticosteroids (in palliative care) are  common examples.

Again, cases have been reported where individuals with no medical reason or disease necessitating it’s use administer them because of the desire to gain weight for example, Cyproheptadine “a form of multivitamin that was effective as an appetite stimulant was also massively abused by our women folk in the craze for getting fat” in the mid-nineties. [5] It is still greatly abused by administering in an over-dose.

Side effects include:  sedation, dizziness, weight gain, nausea, impotence, vomiting, and shortness of breath.

 

10) Opioid Analgesics

These drugs with morphine-like activity are potent pain-killers which can also be used to treat illnesses like cough , diarrhea, and cardiac asthma. Examples are Pentazocine, Morphine, Heroin, and Codeine.

It is important to add herethat Benylin with Codeine (a cough medicine) which is an OTC in Nigeria is abused by many adults and youths; some use it as  a substitute for cocaine as it is relatively cheap and available.

The Deputy Director of Public relations and Protocols, National Agency For Food and Drug Administration and Control (NAFDAC) Mr. Abubakah Jimoh said NAFDAC was aware of abuse of cough syrups. He stated that the Agency was torn between an outright ban to make it a prescription drug or taking codeine out of the syrups, but since Nigeria is a country with a large number of rural dwellers with huge medical issues, it will limit access to such drugs if  it is made a POM.[7]

Effects of opioid analgesics include euphoria which is characterized by a freedom from tension and fear and analgesia thus such drugs (including the OTC Benylin with Codeine) can be used perpetrate evil acts like robbery when used under their influence. Also persons who have jobs requiring hard labour have been known to abuse Benylin with Codeine because it enhances tolerance for hard work.

 

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