In contrast, in countries like India, almost any thing is available, at a price. Certainly there are restrictions on the sale of certain so-called scheduled drugs, but the regulations are ignored more often than not. In recent times, a strict vigilance, on the sale of tranquillisers like diazapam has reduced their availability without a prescription. Otherwise, it is free trade, even of drugs banned elsewhere. The need for a rational policy regulating drug supply and use in India has been reiterated recently (Phadke, 1998).

        Ayurvedic and homoeopathic medicines do not require a prescription at all. Nothing prevents one from buying these drugs, though many of them are quite dangerous, if used without medical supervision.

        In the west there are restrictions on advertising drugs except in professional journals. In India, a very large number of medications, more in the name of herbal products, are freely advertised in the press and on the TV. This practice should be discontinued.

        Popularisation of medicine through advertisement and an easy availability of drugs without a prescription, promote free-lance prescription and self-medication.

        Administration of a medicine and treatment of an ailment is a serious matter. Some medicines are not safe for use, even under medical supervision. The following are some of the reasons, which the general public are largely unaware of, for discouraging free-lance prescription and self-medication:

a) The seemingly harmless aspirin considered a safe analgesic till recently, is now known to cause a severe and dangerous gastric bleeding and other complications in some people. Penicillin, a very useful antibiotic, safe for many people, can cause severe and some times fatal reactions in some. Some people develop serious reactions against certain drugs at later stages of their life, though the drug was well tolerated earlier. An absence of a reaction on the first few doses is no guarantee against the onset of an adverse reaction, on a subsequent dose. Medical supervision is needed with any drug at any stage of its administration.

b) The body gets acclimatised to a drug on consistent use over a period of time. People who take analgesics regularly, find that they need to increase the dosage and/or frequency of intake of their favourite anlgesic, for example aspirin. After a time the body does not respond to aspirin and a switch to analgin or ibuprofen or something else, will be needed. Then on the story repeats.

c) Some medicines are addicting. Tranquilisers, cough syrups, etc., among the allopathic medicines, and alcohol containing Ayurvedic medicines are some examples. The number of people caught on to Draksharishta in the olden days was a legion. In the wake of prohibition, in the early 1950s in Andhra Pradesh, Draksharishta was in great demand as a worthwhile substitute and this misuse made it necessary to impose certain restrictions on its manufacture and sale. The risk of addiction to coffee and chocolates is hardly known. But for the problems of addiction, opium, cannabis and cocaine would have served the cause of medicine more profoundly. Against the background of the current serious reluctance in permitting such drugs as medication, the recent discovery that cannabinoids control spasticity and tremour in multiple sclerosis models (Baker et al., Nature, March 2, 2000) is a sad case.

d) In the case of infectious diseases, only the appropriate medicine, at an appropriate dosage, should be used against a particular pathogen, as there is an antibiotic-pathogen specificity, though some antibiotics have a broader range of action. Antibacterial antibiotics are ineffective against viral infections. If antibiotics are taken in such a case, the disease cannot be controlled and the antibiotic will affect the bacterial populations in the gastro-intestinal tract and disturb the natural balance of the body’s micro-flora. If subsequently, for any reason the same antibiotic is needed to be used, it may not be effective, as the micro-organisms which were already exposed to that antibiotic might have acquired resistance to it.

e) One should take the full course of the medicine prescribed, more particularly so if the medicine is an anti-microbial agent. Dosage of a medicine is carefully calculated, to keep in the body, a particular concentration of the drug for a specified period. If the medicine is stopped at a point when patient on his own feels cured, there is a chance of only a partial cure, or a segment of the microbial population becoming resistant (acquired resistance) to the medicine, resulting in a new strain which proliferates. Both these situations may lead to a relapse of the disease. In relapse, the same medicine may be of no use. There have been instances where patients have misused, through improper or self-medication, the only antibiotic that could have otherwise saved them.

f) One does not know which medicine can cause what kind of side effects and to what degree and under what conditions.

g) Popping in so many a day of those multivitamin and other concoctions is largely useless, dangerous and wasteful. The body can absorb and utilise only very small quantities of exogenous vitamins, iron, etc. Most of what is taken is excreted. Identifying and using dietary items rich in a specific nutritional additive is far more useful and inexpensive.