What drives intentional overdose with non-prescription drugs? A cross-sectional study

Background Use of overdosage of Non-Prescription Drugs (NPD) among university students is a serious public health issue. However, there are no extensive studies that measured the prevalence of taking more than the recommended dose of NPD and/or identified the risk associated with this behavior among university students. Objectives This study was undertaken to assess the prevalence and associated risks of self-overdosage with NPDs in university students in United Arab Emirates (UAE). Methods A cross-sectional survey-based study was conducted from January to April 2014, among 2875 students in three randomly selected universities. A structured and validated questionnaire was used to collect the responses of the students. SPSS version 20 was used to analyze the data. Results Out of 2875 students, only 2355 surveys were fully answered, returned back and included in the present study. Of 2355, more than half (1348; 57.2%) the participants reported using Oral NPD (ONPD) in the past 90 days before conducting the study and were asked to complete the survey. Only 290 (22%) of a total 1348 participants reported taking more than the recommended dose of ONPD in the previous three months before conducting the study. Analgesic/antipyretic (223, 16.5%) and anti-allergic (67, 4.9%) drugs were more than other classes of the ONPD, reported to be taken in a dose, more than the recommended dosage. The most common justifications for taking more than the recommended dose of ONPD among respondents were severe symptoms (6%), the belief that the recommended dose would not be sufficient to relieve the symptom (5%), the belief that a stronger dose would relieve the symptoms faster (11%), and previous experience (4%). Our results identified three risk factors for taking more than the recommended dose of NPD. High frequently drug-users of daily use (OR = 3.494, 95% CI: 1.677–7.279) (P < 0.001), and students from non-medical colleges had higher odds of taking more than the recommended dosage as compared to students from medical colleges (OR = 1.486, 95% CI: 1.060–2.085, P-value < 0.05). Furthermore\re, participants with a poly-pharmacy behavior had higher odds of taking overdosage of ONPD than single NPD users (OR = 1.918, 95% CI: 1.440–2.555) (P < 0.001). Conclusion There are a sizable proportion of university students that use overdosage of NPD, but it is more serious issue when it comes to non-medical student. There is a need for educational programs designed to increase awareness among all university students and to motivate them not to use overdosage of NPD. Further studies are also required to investigate additional explanatory variables that could influence the practice of overdosage with NPD