Take Your Medicine with a Pinch of Salt. Elizabeth Pittman

a product is harmless. As a rough rule of thumb, any drug that is powerful enough to have an effect is probably capable of doing harm. The very reason prescription drugs are so tightly controlled, and well researched, is that they are powerful enough to produce serious side effects. For example, in 1997 the US FDA banned or restricted eleven popular drugs because doctors ignored safety warnings or prescribed them inappropriately. If you are self-medicating be warned—follow the instructions for use and do not overdose—more is not necessarily better.

      Much of this discussion on self-medicating has dwelt on the negative aspects because these are usually only talked about when some disaster occurs. Most of the time, we just take our OTC medicines trusting that all is well. Yet OTC preparations are not always benign, or free from side effects. Their safety and efficacy are not guaranteed just because they are considered ‘natural’ or because they have had centuries of traditional use. As we have already seen, the belief that dietary supplements are always harmless is erroneous—incorrect processing or substitution can cause safety hazards and an incorrect dosage can lead to unwanted effects that are quite serious.

      On a more positive note, OTC medicines are generally both gentle and safe. After all, they are intended for the self-treatment of minor ailments or health maintenance. Provided they are properly processed or manufactured, there are relatively few reports of serious adverse reactions compared to those for prescription medicines. In Australia, for example, only three per cent of reported adverse reactions concern over-the-counter remedies, but another ninety-four per cent are for medicines prescribed by physicians. This may be because OTC remedies are self-administered, and so unwanted effects are seldom reported and, in any case, most consumers lack information on how to go about reporting, whereas professionals have clearly identified mechanisms for advising on adverse events for prescription drugs.

      Although consumers in developed countries are supposed to be protected from fraud, quackery and unsafe products by their statutory authorities, unfortunately protection sometimes arrives after a catastrophe has happened, so being an informed and critical consumer is essential. In the next chapter we will examine the ways in which advertisers can influence how we self-diagnose and self-medicate. Astute advertising can make suckers out of any one of us. ‘Buyer beware’ is still a good maxim.

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