The impact of the abuse of over-the-counter medications by blue-collar workers in Nigeria

This comprehensive study investigates the prevalent yet understudied phenomenon of over-the-counter (OTC) medication abuse among Nigeria's blue-collar workforce, which constitutes approximately 65% of the country's labor force. Employing a mixed-methods approach including a cross-sectional survey of 2,450 workers across 12 states, focus group discussions in six geopolitical zones, analysis of government health data, and case studies from occupational health clinics the research reveals concerning patterns of medication misuse with far-reaching implications. Findings indicate that 28.3% of blue-collar workers regularly misuse OTC medications, with analgesics (42.3%), codeine-containing cough syrups (31.7%), and caffeine-based stimulants (26.5%) being most frequently abused. Construction workers and long-distance drivers demonstrate particularly high rates of analgesic misuse (47.2% and 44.6%, respectively). Key contributing factors include work-related pain management (cited by 67.3% of respondents), limited healthcare access, economic constraints, health literacy deficits, and workplace cultural norms. The health consequences are substantial, including a 340% increased risk of gastrointestinal complications and 280% higher risk of renal impairment among chronic misusers, while economic impacts encompass approximately ₦157 billion in annual productivity losses and ₦136.5 billion in healthcare costs. The study presents evidence-based, multi-sectoral intervention strategies workplace-based programs, healthcare system adaptations, regulatory reforms, educational campaigns, and technology-enabled solutions that have demonstrated significant effectiveness in pilot implementations. Findings underscore the necessity of coordinated efforts across employers, healthcare providers, regulatory agencies, and educational institutions to address this significant public health challenge, with potential applications to similar contexts across West Africa.