One habit that has existed for as long as memory can recall is self-medication. Growing up, complaints of headache, runny nose or fever were often handled at home. There was usually a medicine within reach, and once the symptoms eased, the matter was considered settled. Even in adulthood, many people continue this pattern, taking paracetamol or antibiotics without first visiting a clinic or speaking with a qualified health professional.

In many rural communities, the practice goes a step further into what can best be described as informal drug mixing. A visit to a nearby patent medicine store is often enough. A person walks in, describes general symptoms such as body pain or headache, and the attendant behind the counter recommends or combines different drugs on the spot. In some cases, multiple painkillers that contain the same active ingredient are given together, alongside antibiotics, without proper diagnosis or prescription.

This is not based on hearsay. In a recent visit to a drug store, an instance like this played out in plain sight. A health worker on duty combined different painkillers, all containing paracetamol, along with antibiotics for a farmer who had complained of body pain and headache. The interaction was brief, with no clear diagnosis, no laboratory test, and no explanation of possible drug interactions or dosage considerations.

Widespread practice backed by data

What appears routine is strongly supported by research. Studies across Nigeria show that self-medication and informal self-diagnosis are highly prevalent across different groups and locations.

In a rural community study in Ogun State, about 78.4 percent of adults reported self-medicating within the past year. More than half indicated that they used medication occasionally, while nearly a quarter had done so within a week prior to the survey. Respondents commonly relied on their interpretation of symptoms rather than clinical diagnosis when choosing treatment.

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Similar patterns appear in other populations. Among healthcare students, about 54.6 percent reported engaging in self-medication, often using analgesics, antimalarials and antibiotics to manage common complaints such as headaches, malaria symptoms and cough.

In clinical settings, the numbers are even more striking. Research conducted in Ebonyi State found that nearly 90 percent of patients attending outpatient services admitted to using medication without a prescription. Older hospital-based surveys have also reported figures as high as 85 percent among general outpatient respondents.

Taken together, these findings show that self-medication is not confined to a particular class, age group or location. It cuts across rural communities, urban populations, students and even individuals who eventually seek formal healthcare.

Drivers, misinformation and the risks involved in self-medication

The persistence of self-diagnosis in Nigeria is tied to a combination of structural and behavioural factors. In rural areas, limited access to healthcare facilities and financial constraints play a major role. In the Ogun State study, cost of treatment and the perception that illnesses were minor were among the most common reasons respondents gave for self-medication. In urban settings, convenience and prior experience often influence decisions, even where healthcare services are available.

Health misinformation has further complicated this pattern. Social media platforms and messaging applications now serve as informal sources of health advice, where unverified claims about symptoms and treatments circulate widely. Research shows that exposure to online health information can distort how individuals interpret symptoms, increasing the likelihood of incorrect self-diagnosis and inappropriate treatment choices.

The risks linked to these behaviours are not theoretical. Data from clinical and public health studies point to measurable consequences. The rise in non-prescribed antibiotic use has been identified as a contributing factor to antimicrobial resistance, a global health threat that reduces the effectiveness of standard treatments. Studies show that analgesics, antimalarials and antibiotics are the most frequently used medications in self-treatment, often taken without proper dosage guidance.

Regulatory authorities such as the National Agency for Food and Drug Administration and Control have repeatedly warned about the dangers of unregistered and improperly labelled medicines in circulation. These products, often sold through informal drug outlets, increase the risk of adverse drug reactions, treatment failure and prolonged illness.

There are also indirect health consequences. When symptoms are repeatedly treated without proper diagnosis, underlying conditions may go undetected. This delay in seeking professional care can result in more severe illness at the point of hospital presentation, increasing both treatment cost and health risk.

Cynthia Nwanonyiri