Self-Medication as a Systemic Risk to Public Health

Self-medication with potent pharmaceuticals is becoming an increasing trend with potential systemic consequences. Patients are increasingly making therapeutic decisions without consulting a specialist, underestimating the risks of improper use, drug interactions, and delayed diagnosis. Desislava Vlasakieva, zdrave.net founder and editor-in-chief of Healthcare Magazine, discussed this topic with zdrave.net.

The topic of self-medication and its inherent risks is becoming increasingly relevant. What does your experience show?

Desislava Vlasakieva: The topic of self-medication is not abstract—it is part of my daily work, where real clinical cases intersect with the way patients seek and perceive health information.

I observe a systemic deficit of accessible yet correctly interpreted information, which leads to decisions based on fragmented or unreliable sources. In practice, this manifests as improper treatment in patients who have sought a quick and often more budget-friendly solution.

In a broader sense, this behavioral pattern is not limited solely to the choice of medications.

Following the boom in demand for more affordable treatment in recent years—including consultations in informal settings, choosing more affordable dental and aesthetic interventions abroad, as well as treatments outside the EU regulatory framework using medical devices of unclear origin—we are now witnessing a new, equally alarming trend.

This trend follows the same logic of seeking a quick and affordable solution. This often comes at the expense of control and traceability, as the selection criteria themselves gradually shift from medical justification toward price, time, and marketing.

Particularly indicative are cases of dental and aesthetic interventions where follow-up observation is lacking; when complications arise, the patient returns to a different healthcare system that is unfamiliar with the initial intervention. Thus, an individual decision begins to generate systemic risk.

In this context of expanding practices outside of medical control, the increasing use of medications without specialist consultation poses new challenges and further complicates public health risk management.

Is there truly a trend toward more frequent self-medication and self-prescribed therapies?

Desislava Vlasakieva: Yes, and it is clearly pronounced. Self-medication with potent drugs without medical consultation is observed more and more frequently. Data from international studies show that globally, up to approximately 40-50% of people resort to various forms of self-medication. In parallel, the use of dietary supplements is often unregulated—in significant volumes and without a real assessment of quality, dosage, and potential interactions.

Added to this trend is the expansion of practices positioned as “wellness” or “anti-aging,” which are essentially medical interventions—such as intravenous vitamin drips or so-called NAD therapies. These are often offered as universal solutions without clear medical indications and without the necessary oversight.

The popular concept of “longevity” has become a modern trend today, spreading from conferences to dietary supplements. It is striking that the Bulgarian word for longevity (“dalgoletie”) is almost absent—as if it does not sound “saleable” enough or does not fit well into the commercial narrative. In my opinion, the main problem lies in the substitution of meaning. On one hand, we have a medical approach—therapies applied to improve health and extend life. On the other hand, there is a trend of presenting dietary supplements almost as medicinal products, which blurs the line between prevention and treatment.

The key principle that must not be overlooked is the role of medical expertise. Both therapies and dietary supplements should be administered only after consultation and under the supervision of a physician. In particular, intravenous therapies must be applied following a medical assessment, by qualified medical personnel, and in a controlled medical environment.

In the same context, interest in peptide therapies is growing—a topic with scientific potential that is increasingly presented in the public space as quickly applicable and widely accessible, including through social networks. This creates a sense of safety and efficacy that is not always supported by sufficient evidence.

Another alarming practice is increasingly observed—the pursuit of aesthetic and injectable procedures in unregulated, “back-alley” clinics outside of a medical environment. These lack both the necessary qualifications and guarantees regarding the origin and quality of the products used.

The consequences of these processes are not only individual but have a broader scope. They include improper treatment, drug interactions, complications from procedures, delayed diagnosis, and the worsening of conditions that could have been controlled with timely medical intervention. Alongside this, a broader risk is created—burdening the healthcare system with complicated cases, a loss of trust in medical expertise, and the gradual blurring of boundaries between evidence-based medicine and commercial practices.

Thus, a trend with potentially significant risk to public health is emerging.

What are the main reasons people choose this approach?

Desislava Vlasakieva: The reasons are multifactorial. On one hand, patients seek a quick solution to a health problem. On the other, limited access, time pressure, and the digital environment create a sense of self-sufficiency in diagnosing and choosing therapy.

Thirdly, vanity is easily misled, and solutions are offered quickly, cheaply, and accessibly. For a few clicks, we receive a promise to be smarter, more beautiful, thinner, and healthier.

The role of commercialization should not be underestimated either—health is increasingly presented as a product or service rather than a process requiring medical observation and expertise.

There is also a behavioral factor here—the suggestibility toward easily accessible solutions that promise a quick effect, as well as the tendency to trust popularity and personal experience instead of expert evaluation.

In your opinion, what is missing to change this trend?

Desislava Vlasakieva: What is missing is a structured, expert, and consistent public conversation. Accessible yet scientifically grounded information is needed to support the patient’s informed choice.

A clearer balance between regulation, professional responsibility, and public sensitivity is also necessary. When medical activities are offered in a commercial environment, the boundaries must be clearly defined and respected.

When it comes to human lives—including people without established chronic diseases—there is no room for delay or compromise in presenting the risks. Clinical reality demands clarity and timeliness.

What would you say to people who frequently resort to self-medication?

Desislava Vlasakieva: Self-medication is not a risk-free alternative. The lack of predictability and control over the consequences is often the result of “quick fixes.”
Available data show that substandard and falsified medicinal products represent a global problem with significant health impacts. According to World Health Organization data, they cause hundreds of thousands of deaths annually. In certain regions, up to 10% of medications are of compromised quality.

The risk lies not only in ineffectiveness but in the potential worsening of the condition, drug interactions, and delayed diagnosis.

Consultation with a specialist is key to adequate and timely therapeutic behavior.

It is paradoxical that patients who show high sensitivity to the quality of everyday factors such as water or food sometimes underestimate the origin and composition of the products they ingest or apply.

How do you see this topic developing in the future?

Desislava Vlasakieva: I expect the topic to gain even greater significance. A systemic approach to increasing health literacy and clearly positioning responsible behavior as the standard, rather than the exception, is required.

At present, there is a lack of sufficiently clear awareness regarding the scale and the snowballing dynamics with which the problem is growing and beginning to have a systemic impact on public health.

If coordination is not achieved between institutions, specialists, business, and society, the risk is that these practices will continue to expand in the gray zone between medicine and commerce.