The prevalence of medications uses without a prescription in Al-Najaf province

The study aim to identify the extent of spread the phenomenon of widespread use of medicines without a prescription. Methodology: This study surveys was conducted on (204) persons in the province of Najaf. (Sadr Medical City, Al-Hakim General hospital , Hospital of Middle Euphrates and Al-Zahra teaching Hospital). From (31 \ 4 \ 2012) to (1 \ 11 \ 2012) The total sample of study was 204 persons Where 102 ( 50% ) were males, especially young people, and 102 ( 50%) was females. Results: ` 136 (66%) of the study samples are in the levels of education (primary schools (42) , secondary schools (46), Tertiary schools (48), Technical Diploma (16), BSc (28) and illiterate (24). On the basis of geographic distribution ,the results showed that (178) 87.3% were from residents of cities and (28) 12.7% was from the rural population. Depending on the basis of the using of prescription medicines or over-the-counter, drugs we found there were (134) 65.7% of the study sample used medicines without prescription, (70) 34.3% using medicines by prescription . 80 (59.7%) using correct dose, (72) 53.7% reading the pharmaceutical letter , (80) 59.7% ask about the complications result of medicines. When we investigate the types of medicines which be used without a prescription, the results of this study showed that there are 95 (70.9%) of the study sample was using antibiotics, (13) 9.7% using sexual activator and (26) 39.4% of women using contraceptives . When we asked about the reasons for the spread of this phenomenon. The results showed that (86) 42.2% laying blame on Ministry of Health, (79) 38.7% related to ignorance of the community and ( 39) 19% laying blame on public information circles responsibility in confronting of this phenomenon . Conclusion : The results showed that the phenomenon of using medicines without a prescription is a common in society of al-Najaf province. Recommendations : The formation of local committees that included physicians, pharmacists and health personnel, and concocting the training programs to them to teach them how to monitor and improve the use of medicines at all levels in the health system to work periodically in raising awareness about the risks from the indiscriminate use of drugs, especially drugs antibiotics.

The prevalence of medications uses without a prescription in Al-Najaf province

INTRODUCTION
Medicines are those chemical compounds which consists of a single substance or more and is obtained through natural (plant or animal), as well as industrial methods, by chemical reactions that utilized in the treatment of diseases that can infect human and animals or alleviate illness , prevention or diagnosing.If every medication and each drug dose of its own quantity and time of use and any defect in it, will inevitably lead to complications ,future very serious immune system natural and other services for people used the drug, the drug double-edged sword in I the one he is treating wholesome and effective as what the best use of hand marking assassin on the other hand as misused (1) .That health education and awareness of the rights eight fundamental human approved by the UN in 1985 to protect members of the community ( consumers of drugs), which include the right to satisfy its basic needs, right information, right of choice , participation and compensation and the right education and the right to live in a healthy environment (2) and therefore pharmacological issue of health education and the development of ideas and the building of a culture of drug necessities that help build healthy human who has physical and mental health of being able to achieve good duties that requires every member of society towards society.The ignorance in the use of drugs is extremely dangerous health, economic and social .These effects do not stop at this point and even beyond to the next generation, which requires the state to take measures to actors in the Medication Awareness and deliver medication sound ways for the citizen and the lowest possible cost does not make evades citizen of the proper use of drugs and resort to ways to hurt citizens in particular and society in general (3,4) .The extent of this phenomenon (epidemiological) worldwide research indicated conducted by organizations, companies and universities such as the World Health Organization (who) , Synovate Egyptian Company and Baghdad university to following results ;Locally and regionally, the UAE ranked first in the world in the use of pain killers without a prescription The survey showed that 72% of the country's population bought analgesic drugs during the first half of 2010 Mfima company confirmed 62% of them to use it on a regular basis (5) .In Iraq, research conducted by the University of Baghdad in the capital Baghdad noted 195 samples that 46.5% of people use drugs without a prescription and 37.4% use medicinal herbs (6) .The World Health Organization reports indicate that 50% of patients do not take medication the right way that has been described by the doctor, there are also a lot of patients who depend on their handling of the drug on the advice of their relatives or friends to save time and to reduce to spend money and this thing shows a lack of pharmaceutical and health education and non-compliance with the rules of medical and health systems (7) .
Draw the results of some studies done at the global level for the prevalence of this phenomenon Taiwan 10%, Hong Kong 15% ,Chile 17% ,Australia 61% and United Kingdom 62% used methadone for pain relief in the UK is responsible for 27 percent of deaths from misuse of drugs.The United States offended 6.2 million people use prescription drugs in 2008.In Mongolia study confirmed that the prevalence of the use of antibiotics for young children without a prescription high in Ulaanbaatar.The results of this study have important implications for public awareness and strengthening systems for the sale of antibiotics in Mongolia (8,9,10) .
Globally ,applied Synovate survey on more than 12 thousand patients from 14 countries :-United Arab Emirates, Australia, Chile, France and the United States, Hungary, Indonesia, Taiwan, Spain, Serbia, Korea, Britain, Hong Kong and the Netherlands (11) .
Studies have indicated that the United States warns against excessive use of different types of sedative medications and pain killer that are sold without prescriptions, and caused a hundred deaths annually in the United States (12, 13, 14,).Study carried out to discover the reasons of spread of this phenomenon those causes included; Financial reasons, legal reasons, Announcements, Security reasons, Benefits from the sale of medicines, Lack of health control, Shame, Ignorance and Neglect. (15)

OBJECTIVE:
This study aims to identify the spread of the use of medicines without prescription (misuse of medicines) in the al-Najaf province society.

Tool of study :
The nature of this study needed to use of survey mode to verifying the aims of study ,therefore ,the questioner organized previously for this purpose to know the opinion of study sample about the use of medicines without prescription and asking them about another questions which have relation by uses of medicines.204 sample collected and statistically classified .Data was analysis by using percentage and frequencies.The result of this table shows that the people who is using the herbs in treatment of diseases (29)person with percentage 21.6%.But the people who is don't using the herbs in treatment of diseases was (105) person with percentage 78.4%.

DISCUSSION
The study results show that (134) 65.7% of the study sample using drugs without a prescription, while results of the present study showed in the capital Baghdad on 195 sample (118) almost 45.6% use drugs without a prescription and 11.5% use herbs without consulting (1) ,while in the United States has shown the results of a study conducted on 12 million sample that 70%of people use pain killers without a prescription (16).The results showed that (54)40.3% of those who use drugs without a prescription do not adhere to the pharmacological dose (62) 46.3% do not read and pharmaceutical bulletin (54) to 40.3% do not care complications resulting from use drugs without a prescription, while results of the study showed by the University of Baghdad (31) 15.9% do not read and pharmaceutical bulletin (26) 13.3% do not adhere to the dose of the total 195 samples (2) .Evidenced by the results of present study that the most commonly used types of medicines without prescription antibiotics by (95) 70.9%, followed by contraceptives (26) 39.4%, and other drugs (31) 23.1% and sex steroids (13) 9.7%, while results of the study showed in the United States on the 2500 sample (2150) 86% of people use pain killers without a prescription pain, (267) 10.7% used sedatives, (264) 10.5% using psychiatric drugs without a prescription and (69) 2.7% use drugs pneumonia (17) , and in another study showed that 70% of the study sample in the United Arab Emirates using analgesics (18,19).The study results showed that (86) 42.2% of the study sample blame the Ministry of Health in the spread of this phenomenon, while results of the study showed the University of Baghdad in the capital (135) 69.2% holding and the ministry of Health negligence towards this phenomenon and inadequate programs offered by the Ministry of educational and (183)93.8%assert the absence of an effective regulatory system in Iraq (2) .The results showed that (39) 19.1% holding and media responsibility in the spread and prevalence of this phenomenon in this regard showed results of a study the University of Baghdad that (99) 50.8% assert insufficient programs, media and the need for a means of media in various forms to reduce this phenomenon and citizen awareness and education (1) .

CONCLUSIONS:
The results of our study showed there are ( 65.7%) of the study sample using medicines without a prescription and (34.3%) using that medicines by medical prescription .(40.3%) of those who use medicines without a prescription do not adhere to the medicines dose, (46.3%) do not read the bulletin pharmaceutical and (40.3%) do not care about the complications resulting from the use of medicines without a prescription.The most commonly used types of medicines without prescription antibiotics increased by 70.9%, followed by contraceptives 39.4% and other medicines 23.1% and sex steroids by 9.7%.(21.6% )of the study sample ,dependent on use of herbs from the customs and traditions.(42.2% ) of the study sample laying blame on the Ministry of Health in the spread of this phenomenon, ( 38.7% )related to ignorance of the community, while ( 19.1%) the holding in media responsibility in the spread of this phenomenon.

RECOMMENDATIONS
1 -The formation of local committees that included physicians, pharmacists and health personnel ,and concocting the training programs to them to teach them how to monitor and improve the use of medicines at all levels in the health system.2-The stressing and emphasis on pharmacists not to sell any drugs or

1
) represents the distribution of cases, depending on the gender & age groups ,the total number of cases was 204 .The highest number of cases in males and females was occur in age groups (20-24) year with percentage 34.3%,22.5%.

Table ( 2
) represents the distribution of cases ,depending on the profession.The result of this table shows that the highest number was occur in class of Housewives with percentage 36.3%followed by Students 26.9%, the Officers were 21.1% and Free jobs were 15.7%.

3
) shows that the highest number of cases were the Academics class with percentage 23.5% followed by the Intermediate class with percentage 22.6%,ThePrimary education class was 20.6%, BSc 13.7%, Don't reading & writing were 11.8%, and lastly The Diploma were 7.8%.

4
) shows that the most cases from Urban area with percentage 87.3%followed by cases from Rural area by percentage 12.7% depending on the geographical locations.

5
) show the most of cases which using medicines without medical prescription with percentage 65.7% ,and the persons which had been used medicines with medical prescription by the percentage 34.3%.

Table ( 7
) shows the number of persons was under obligation by dose (80) with percentage 59.7%.The number of persons reading the instructions (72) with percentage 53.7%,add to that the number of persons was anxious with complications were (80) with percentage 59.7%.

Table ( 9 ) represents distribution of cases, depending on Reasons for the spread of the phenomenon of the use of medicines without prescription
table (9) show the highest frequency of reason in happening this phenomenon was because of Media of information with rate 42.2% , and the least frequency was 19.1% because of Ministry of health.