A network of government pharmacists in two areas of Ayutthaya province has set up a monitoring mechanism to make sure people, especially low-income earners, do not misuse medicines or take them based on a misunderstanding about the drugs.
The network, focusing its campaigns initially in Bang Ban district and Khlong Takhian sub-district, emphasises the education of patients and other people about the hazards of using low-quality or potentially dangerous medicines, which are cheap and widely available.
A senior pharmacist with the provincial consumer-protection office, Santi Chomyong, said the medicines on a watch list are those mixed with steroids, antibiotics and pain-killing substances.
The most vulnerable are long-time users, who are mostly poorer people and those finding it more convenient to purchase over-the-counter items from general stores rather than see a doctor or buy them at pharmacies, he explained.
The network was founded three years ago, and is now extending its work to onsite visits and inspections, Santi said.
The medicines are sold in packs at grocery and mom and pop stores in Khlong Takhian. The packs consist mostly of steroids and antibiotic substances, which are bad for users who consume them over the long term.
Santi told the story of a truck driver, already down to one kidney, who has taken "kidney-nourishing" doses for years and is now going to lose the remaining organ as a result.
Most buyers of these drugs take them at will, and stop once they feel their pain has gone or their symptoms have improved, which is contrary to the medications' conditions for use.
For example, antibiotics must be taken completely for a certain duration, in accordance with a pharmacist's instruction, otherwise drug resistance will develop due to users taking them incorrectly and inconsistently, Santi said.
Apart from much lower prices, regular buyers also prefer convenience, as these stores are easier to visit, while the nearest drug stores with certified pharmacists are in some cases 5 kilometres away, the network has found. There are 10 stores in Khlong Takhian sub-district where these medicines can easily be purchased, he added.
Repetitive over-use of some drugs is another problem detected by the network, especially among people living in frequently flooded Bang Ban district, who take medicines widely available through donations almost year-round, said Santi.
Moreover, many medicines of the same formula have different colours and tablet shapes, or bear different trade names. Although these drugs are generally not efficacious, locals continue to be given them, he said.
The pharmacist also said young people in Bang Ban normally took a paracetamol-based stimulant before going out to fight rival groups.
They also take this drug to keep them awake in order to play games at an Internet cafe, or in the belief that it will prevent pain when their parents or teachers cane them as punishment for misbehaving.
This stimulus drug is also popular with labourers, as a means of giving them extra energy.
Santi said the use of such drugs in cattle or other farm animals would result in them developing drug resistance. One example is the use of antibiotics with fighting cocks.
Such practices would result in these animals developing a greater potential for generating zoonoses, with infectious diseases spreading from species to species, and possibly to humans, he warned.