“The real question is not why Nigerians self-medicate. It is why the system makes self-medication so often the rational option—and what the law expects of those who stand at the counter.”
Self-medication and the law
Imagine waking with a fever, headache and body pains. There is work to attend to, money is tight, and reaching a hospital may mean transport costs, consultation fees, tests and hours away from work.
A nearby pharmacy is easier to reach. You explain your symptoms, ask for medicine, and leave with something that may bring temporary relief.
It is easy to blame the patient.
But a person who cannot afford a consultation, cannot take a day off work, and cannot reach a hospital is not making a careless choice. They are making the only choice available to them.
The real question is not why Nigerians self-medicate. It is why the system makes self-medication so often the rational option—and what the law expects of those who stand at the counter.
The Pharmacy As A First Point Of Contact
Pharmacists are trained health professionals. Their work is not merely selling products.
The Pharmacy Council of Nigeria (Establishment) Act 2022 recognises pharmacy practice as including patient-centred care, drug information, monitoring drug therapy and clinical interventions.
A responsible pharmacist can help a patient understand how to use a medicine, what precautions to take, and when symptoms call for medical assessment.
The difficulty arises when access to a medicine becomes a substitute for appropriate assessment. A medicine may ease a symptom without treating its cause. A recurring headache, persistent abdominal pain or repeated fever may require investigation rather than another round of tablets.
Self-medication can mean using leftover medicine, taking a drug prescribed for someone else, repeating an old prescription, or buying a medicine without the prescription required for that product.
Not every use of medicine without a new doctor’s visit is unlawful or harmful. Appropriate over-the-counter medicines can have a place in self-care. But that is not a licence to guess at a diagnosis or use a medicine whose risks are not understood.
The Antibiotic Warning
The stakes are especially high with antibiotics. They treat certain bacterial infections; they do not treat viral illnesses such as the common cold. Unnecessary use helps drive antimicrobial resistance—the process by which microbes no longer respond to medicines that once worked.
A Nigerian study published in 2025 surveyed 420 community pharmacists and reported that 98.1 per cent of respondents sometimes or always dispensed antibiotics without a prescription.
That finding must be read with care. The study relied on voluntary, self-administered online responses recruited through professional networks.
Most respondents practised in urban settings, and over half were from the South-West. It records what participating pharmacists reported about their practice. It is not a nationally-representative measurement of every Nigerian pharmacy.
But the figure is still a warning. It suggests that the barrier between a patient and a prescription-only medicine is often not a doctor’s assessment—it is a transaction.
What The Law Expects
The Pharmacy Council of Nigeria Act 2022 provides the central statutory framework. It is not silent on these questions.
Section 47(1)(f) identifies as professional misconduct “engaging in conduct likely to deceive, defraud or harm the patient or the public.”
Professional responsibility does not end at the counter. How a medicine is supplied, and how a patient’s concerns are handled, can matter. A disciplinary finding, however, requires the process and assessment provided by law.
Section 61 is more specific: a pharmacist shall not dispense dangerous drugs except under a prescription issued by a licensed medical practitioner, dentist or veterinary practitioner.
This is not a general rule covering every medicine. Whether a particular medicine was supplied contrary to law depends on its classification.
Section 29 requires every pharmaceutical premises to be under the direct supervision of a superintendent pharmacist. This places a management obligation on the business, not merely the individual at the counter.
The Act also distinguishes pharmacies from other outlets that sell medicines. The legal question is not simply what sign is on a shop, but whether the outlet is registered in the relevant category and operates within its authority.
Responsibility Is Shared, But Not Always Equal
Patients should use medicines carefully, disclose relevant conditions, and seek medical attention when symptoms persist. But patients are not expected to possess the professional knowledge of a pharmacist. A person who arrives in pain, frightened or unable to afford another consultation may have limited choices.
The fact that a patient requested a particular medicine does not automatically excuse an inappropriate supply.
A pharmacist must exercise professional judgement. That includes checking the applicable supply requirements, giving appropriate information, recognising when a request raises concerns, and directing a patient to medical care when the problem needs assessment.
Commercial pressure, customer insistence or fear of losing patronage cannot replace professional judgement.
A prescribing practitioner may also be accountable if their own conduct contributed to harm.
Ultimately, liability depends on evidence: what was supplied, what information was available, what standard applied, what each person did or failed to do, and whether that conduct caused the injury. An adverse reaction alone does not establish negligence. A patient’s request alone does not settle the matter either.
The Patient Is Not Merely A Customer
There is a deeper question. A person entering a pharmacy with a health complaint is not simply a customer seeking a product. They may be in pain, anxious or uncertain about what is happening to their body.
Human dignity requires respectful treatment and information a person can understand.
Section 23 of the National Health Act 2014 requires healthcare providers to give users relevant information about their health status and necessary treatment, in a language the user understands and in a manner appropriate to the user’s level of literacy.
We must also be honest about the conditions that encourage self-medication. The cost of care, distance, long waiting times and difficulty obtaining timely attention are real pressures. Telling Nigerians simply to stop self-medicating, without confronting those barriers, will not solve the problem.
What Must Change
First, accessible primary care. Self-medication flourishes where consultation is expensive and distant. Expanding affordable primary care and health insurance reduces the pressure that pushes patients to the counter.
Second, enforcement that matches the law. The Pharmacy Council must inspect, not merely legislate. A framework that exists only on paper does not protect patients.
Third, clear public information. Patients should know which medicines require a prescription, what questions to ask, and when to insist on seeing a doctor.
Fourth, protection for pharmacists who refuse. A pharmacist who declines to dispense inappropriately should not lose the customer to the shop next door. Enforcement must be consistent across all outlets, not just the conscientious ones.
What Nigerians Should Know
Prescription medicines: Some medicines legally require a prescription. Ask whether the medicine you are requesting falls into that category.
Your information: Under Section 23 of the National Health Act 2014, you are entitled to relevant information about your condition and treatment in a language you understand.
Ask questions: What is this medicine for? How should I take it? What side effects should I watch for? When should I see a doctor?
Persistent symptoms: If symptoms return or worsen, seek medical assessment. Relief is not a diagnosis.
Complaints: Concerns about a pharmacy can be raised with the Pharmacy Council of Nigeria.
The Bottom Line
A pharmacy is not a hospital. It cannot replace a doctor’s assessment. But it is an important part of the health system, and the law expects professionals to take their responsibilities seriously.
The question is not whether Nigerians should visit pharmacies. They will, and they should be able to do so safely.
The question is whether each visit will be treated merely as a chance to sell a medicine, or as an opportunity to protect the person who needs it.
A medicine should never be supplied at the expense of the person it is meant to heal.
•Sanu is a Nigerian legal practitioner and health-law researcher. This column explains health law and policy for everyday Nigerians.
