OPINION: Non-medical use of prescription drugs is worrisome

By Dennis Wendo

The rising misuse of prescription drugs for non-medical purposes is alarming. Whether abused deliberately or unintentionally, it is critical to establish or reinforce mechanisms to curb this growing threat, which poses serious and potentially irreversible health risks.

Non-Medical Use of Prescription Drugs (NMUPDs) refers to the consumption of prescription medication without a doctor’s advice or in ways that deviate from prescribed guidelines.

Globally, the availability of prescription drugs in both legal and illicit markets has increased, fueling a surge in non-medical use.

In April 2025, for example, Kenya’s Pharmacy and Poisons Board (PPB) ordered all pharmaceutical outlets, healthcare facilities and professionals to immediately stop the sale of falsified Augmentin 1g (Batch SGS2), Augmentin 625mg (Batches 8X3K and EU7C), which had infiltrated the Kenyan market.

The PPB also flagged a product mix-up involving S-Prazo (Esomeprazole 40mg), where a strip of Levofloxacin 500mg was discovered in a pack of Esomeprazole capsules.

Additionally, substandard batches of Paracetamol 1000mg/100ml Injection were reported due to a visible color change.

According to a 2020 report by the United Nations Office on Drugs and Crime, NMUPDs exceed many illicit drugs in usage and rank second only to cannabis in most countries.

The misuse includes using medications to relax, get high, or self-medicate beyond their intended medical use.

In Kenya, the 2018 NACADA report highlights that NMUPDs are particularly prevalent among adolescents.

Data from a 2016 study revealed lifetime usage rates of 10.4% among primary school pupils and 16.1% among secondary school students.

Lab analyses confirm that antidepressants, antipsychotics, anticholinergics, opioid analgesics, anesthetics and antihistamines are among the most commonly misused prescription drugs.

Despite the global scale of this issue, NMUPDs have not received sufficient attention, especially in Africa and Kenya is no exception.

For instance, in Nigeria, over 4.6 million people were reported to use pharmaceutical opioids non-medically, with tramadol being the most common.

The world has been grappling with an opioid epidemic since the 1990s. While heroin was once the most abused opioid, synthetic fentanyl analogues have now taken precedence.

Opioids are a broad category of pain-relieving medications that act on the brain's opioid receptors to block pain signals and elevate pleasure.

They can lead to dependence, addiction, and severe health complications, including respiratory failure and heart issues.

These drugs may be derived from natural sources, like morphine from the opium poppy, or synthesized in laboratories, like fentanyl. Other examples include codeine, hydrocodone (Vicodin) and oxycodone (OxyContin).

Codeine, closely related to morphine, is also derived from opium and is known to cause tolerance, dependence, addiction, poisoning, and, in high doses, death. Tramadol is a potent narcotic painkiller used to manage moderate to severe pain, such as after surgery or injury.

A growing concern is the widespread misuse of these medications due to their psychoactive effects and the misconception that, because they are legally available in hospitals and pharmacies, they are safe.

Many users view them as more accessible, cheaper, and less risky than illicit drugs like cocaine, heroin, or marijuana.

To combat NMUPDs, Kenya must enhance its current strategies for drug and substance abuse prevention and control.

The government should implement tighter controls on the prescription and distribution of high-risk medications, strengthen collaboration between law enforcement and healthcare providers to prevent diversion and misuse.

There is a need to promote public education and prevention strategies to reduce demand, especially among vulnerable groups like adolescents.

It is imperative that we act decisively to address this emerging threat before its consequences escalate beyond control.

The writer is a staffer at the Integrated Development Network- Public Benefits Organization(PBO)